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Evaluation article: Music and reminiscence therapy

Published: Wednesday, 30 March 2016

Dr Dan Nightingale looks at the practical use of music and reminiscence therapy (MaRTiS©), incorporating storytelling, in a care home environment.

Summary

  • Music is one of the most effective vehicles for communicating with people, and can have a positive impact on physical and mental health and well-being.
  • The music part of the brain appears to survive long past the other language centres of the brain.
  • Music always triggers memories – some positive, others not so positive.
  • Music is an easy tool to use for engaging with people of all ages, and in all care settings.

Music is everywhere. Whether we use it to get up in the morning, use it during work hours or to relax after a stressful day, it's safe to say that for most people, music forms part of their everyday life. Indeed, music shapes our mood, encourages us to move and, of course, evokes memories of all kinds. Most people remember the first record, cassette or CD they bought.

First introduced in 1950, music therapy is increasingly being used to help people living in a care home environment to cope with the grief that comes with losing much of their independence and physical strength, as well as to improve memory, movement and to assist in relaxation.

In this article, I aim to demonstrate the positive impact of the use of MaRTiS in a care home environment, and demonstrate how to facilitate a MaRTiS session.

A cautionary note: research has found that some people have an inability to find music pleasurable and stimulating – a psychological condition known as musical anhedonia.

However, most studies suggest that most humans have a genetic predisposition to respond to music, and music is universal to all human cultures. Simply listening to music releases endorphins in the brain, which are chemicals that trigger positive feelings.

What is MaRTiS?

Music and reminiscence therapy incorporating storytelling is an interactive and engaging activity I developed in the UK a number of years ago. It should be fun and supportive, with leadership coming from the residents, not the caregiver. Music triggers memories, and memories trigger conversation. Conversation leads to reminiscence. Hence, MaRTiS. As the music centre of the brain appears to survive long after other language centres are affected by various diseases, the use of music becomes ever more powerful and effective.

Facilitating a MaRTiS session

There should be no less than four and no more than six people in each session. The session tends to last for approximately one hour (however, allow 90 minutes as sometimes sessions go well beyond one hour. Occasionally, they run for under one hour, but I have found this to be unusual). You should plan for six sessions, one per week.

You will need a CD player, a stack of CDs, an area where the session will not be disrupted and four to six participants. Ensure you choose music that the participants like by suggesting they bring along a couple of their own CDs – or support them in choosing some from a selection available. Research has found that we engage best with music we enjoyed from age 15 to 30, which is the time of life associated with major events such as education, marriage and parenthood.

Next, choose a topic to start a conversation. It can be any topic, but I find the best one is the most positive news item of the day – something that is headlining in the newspapers and on national television.

Now you need to identify one of the participants to lead the session. Your role is to guide and support, to get things going again if the conversation dries up. The group leader is in charge of playing music and generating a discussion around any memories that music awakens.

Always end the session on a positive, and if the group agrees, play Cavatina as people enjoy a relaxed few minutes. The beat of Stanley Myers' Cavatina is in sync with the natural heart rhythm, so is great for ending the session by releasing endor-phins in the brain (endorphins are the chemicals of happiness).

Desired outcomes

The key objective is to change any evidence of ill-being into signs of well-being. This is achieved in a number of ways:

  • empowering each member of the group to be involved in all decision-making and all aspects of MaRTiS
  • enabling one individual to lead the session – each week, the group can elect a new leader or vote to retain the same person
  • both socialisation and communication are encouraged and enhanced.

Examples of evidence of ill-being include negative body language, expressions of sadness, crying and withdrawal from the environment. On the contrary, evidence of well-being includes smiling, laughing and interacting with the environment and those within it.

What to be prepared for

The aim of MaRTiS is to evoke positive and enjoyable memories that stimulate conversation and socialisation between group members. However, it is possible for this activity to awaken negative memories, and the facilitator must be ready should this happen. Never try to distract the person if such a memory surfaces, as suppressing it can lead to malignant social psychology (a negative outcome). It is crucial that you enable the person to express that memory, whether in the group or during a one-to-one session afterwards. I have found that the group is very supportive of members who do bring up unpleasant memories of past events, and a huge advantage is that they already know each other and have a relationship at some level.

Further information

  • Cavatina, Stanley Myers, 1970.
  • Ernest Mas-Herrero et al, 'Dissociation between musical and monetary reward responses in specific musical anhedonia', Current Biology, published online March 6, 2014.
  • T F Sheibani et al, 'Effect of music therapy, reminiscence and performing enjoyable tasks on loneliness in the elderly' Journal of Applied Psychology, 2010.
  • K Smith-Marchese, The effects of participatory music on the reality orientation and sociability of Alzheimer's residents in a long term care setting, Journal of Music Therapy, 27(1), 2–12, 2008.

About the author

Dr Daniel Nightingale is a clinical dementia specialist, speaker and author.

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