Practical approaches to staying connected with people with dementia through music.

“I felt empowered. My mum and I had a lovely moment, we connected, we laughed, I felt less stressed and able to carry on”

These are the words of one carer of a mum with dementia at the start of week 3 of the Musically Empowered Conversations course.

For those of you who have not yet read my first blog about this, I am talking about the musical sequel to Empowered Conversations course run by Six Degrees Social Enterprise in Salford

Empowered Conversations is an approach to communication in dementia care that is designed to help people living with dementia and their carers to:

• Find ways to stay connected
• Handle emotional stress
• Navigate the day together

The approach focuses on the practical features of communication that help to give people with dementia an invitation to respond.

Empowered Conversations ‘the Musical’ is expanding on the invitation to respond concept.

We set out to show the many ways in which music can be used when caring for a person with dementia. These include: -

• Using music for yourself – wind down, enjoy, release emotion.
• As a metaphor with regard to communication and conversation
• Using music with the person with dementia – finding new ways to communicate, to engage when words fail and to just ‘be’.

We began each week with a joyous call & response song (our invitation to respond). Apart from the simple enjoyment of making music together, singing this song in itself makes one think about how one has to listen carefully in order to respond appropriately. We can change tempo, dynamics and tone in response to others. We were, therefore, able to have a conversation and connect through music alone.

As a result of week one’s discussions on how speed, patterns and complexity affected conversation just like music, already we were hearing about positive changes in people’s behaviour and therefore connection with their loved ones. Some participants had slowed down and simplified their speech when talking to their loved ones with dementia, others had remembered to adjust the speed in a conversation to aid understanding.

Like a well written sonata, themes were introduced in the first week that we would develop and recap during the next two weeks, whilst also introducing new themes.

In week two we looked in more detail at how dynamics and tone can affect conversation both musical and verbal. We explored how conductors give signals to start the ‘conversation’ and how this can be translated into use in conversations with loved ones. We saw how conversations don’t have to start at full blast – they can just be quietly started or signalled and can be built or conducted as appropriate, not forgetting to use ‘the power of the pause’, as one participant described breaks in the music.

Music has the ability to bring forth emotions and feelings. Exploring a varied selection of music, we discovered, with some surprising results, how one piece of music can affect people very differently. This can be important when considering music to listen to with a person with dementia.

We talked about how we can use music as cues during the day. For example, an appropriate wake up song can help start the day well. We also discussed and had examples of how singing a request to a well-known tune can aid understanding and memory. How often have we learnt something through a song – for example the alphabet song?

This was a technique I was particularly fond of whilst caring for my own mother. I would use the tune of “there’s a hole in my bucket” to put a variety of requests to. For example – "Let’s go for a shower, a shower, a shower, let’s go for a shower and get nice and clean”. Another favourite was to the tune of “Lou Lou skip to my Lou” to aid walking anywhere – “left foot right foot, one two three …..” (You can see me talk about this and give examples here )

Margaret and I were absolutely delighted when one of the participants in the course came in for week three and declared that she had been making up songs at home to help get her mother out of bed in the morning. She had been a singing alarm clock, and although getting out of bed wasn’t initially improved they had had a good laugh together, and she had felt less stressed and able to carry on more easily. Sometimes music can have unexpected results.

I won’t cover everything we did here – it would take too long and some things are better said in music - so I will leave you an instructive song we left all the participants with, which pretty much sums up everything we covered. It is to the tune of “My Favourite Things” from the Sound of Music and the new words have been written by Margaret Garner (Flourish through Music) – Music Therapist and course leader.

See the video of the song here

Tips for Empowered Conversation

(Sing to the tune of “My Favourite Things” from the Sound of Music)

Here are some tips for Empowered Conversation:
First make connection
Then try Invitation!
Hold the chat steady in pace and be clear -
These are the ways it is easier to hear… 

When talking falters
Be patient, leave pauses.
Spaces are helpful,
Whatever the causes!
Look for the sense behind words that are said,
And when words are hard then try singing instead….. 

Sing your songs to:
Give instructions,
Sing your joys and pain.
Remember that music helps you as you use it-again
And again, and again. 

Find out more about Empowered Conversations here