NR Times looks at how Chroma music therapists support people living with dementia to connect and express themselves
Meg Dowling, an HCPC registered music therapist and neurologic music therapist at Chroma, has been working with people living with dementia since 2017 and currently works within two residential care homes in the South West of England. Her approach is person centred, informed by psychodynamic thinking and often harnesses the power of active music making and improvision as the main therapeutic intervention methods during sessions.
When working to support the needs of people living dementia, Meg uses her music therapy sessions as a way to offer opportunities to connect, explore and reminisce – all of which can be effective in helping people to communicate and express themselves within the boundaries of a secure therapeutic relationship and a safe therapy space.
This allows them the opportunity to share and explore things they remember or perhaps relive significant moments and, where pre-recorded music is incorporated within these interactions, might include listening to or singing meaningful songs from their childhood or adolescent years.
“It is important that all sessions are client-led, to treat them as a unique individual, to be alongside the person and to stay with them in the moment, to notice how they are presenting and where they are in the world. It’s important to acknowledge these things from the beginning in order to offer them the personalised support they deserve,” says Meg.
“With this approach, I can support them in whatever way they choose to communicate, whether that be verbal, non-verbal or simply being calm and relaxed in their environment.
“Encouraging people living with dementia to reminisce can set into motion a process to help make connections between themselves and the therapist.
“Getting to know them through making connections and developing a therapeutic relationship can increase a feeling of safety and security for them and this important unique relationship supports the opportunity to ask them about, for example, their family, their likes and dislikes or their feelings, both in the past and the present time.”
Accessing and expressing emotions, thoughts and feelings can be more challenging for a person living with dementia, which can make issues like processing grief or loss much more difficult. Memories might get muddled, making it feel confusing and unsettling and, if we were to keep reminding them of that loss, they would have to cope with re-living those emotions.
“In instances such as these, which can be commonplace when supporting older adults within a care home environment, it is important to be sensitive to the time it might take for them to process loss and how this process might present itself,” says Meg.
“If the person does not want to talk about it, that is of course ok because I’m working in a person-centred way so I must pay attention and go at their pace, but it is about offering opportunities to explore those emotions through, for example, indirect channels such as musical exploration, song choices, genres, and the mood of the music. As a music therapist, I enable and support the expression and communication of emotions to happen in whatever way is appropriate for the person I’m working with, in that space and in that moment.
“The focus of my work within these two care homes is to offer people living with dementia the opportunity to interact, communicate and express themselves through meaningful connection in music, sound and a secure therapeutic relationship. Their weekly, one-to-one sessions aim to support them to process feelings of grief and loss and to help enhance their health and wellbeing.
“Staff in both homes have commented that sometimes the people they care for who attend music therapy seem calmer following each session, more relaxed and more settled. Other times, staff have noticed how they have become more chatty, more animated and more engaged in the social aspects of the home, as if there is something within the experience of music therapy that inspires and motivates them to communicate and connect with people around them.
“Every week, personalised music therapy sessions offer the people I work with an opportunity to express themselves and share experiences in a safe supported space, with someone who is truly listening and who will respond to them and their needs in a sensitive, meaningful way.
“Human interaction and communication is inherently musical by nature, so offering meaningful musical connection at all stages of life is vital. This enables us to support people’s social, emotional, mental health, wellbeing and development, in a creative, accessible, relational way, which is especially important for the people in our homes and communities, our neighbours, friends and loved ones, who are living with dementia.”
