Download Steps to creating a community-based music group for people living

Steps to creating a community-based music
group for people living with dementia and
their carers
Andy Baker, Anthea Innes, John Murphy, Kevin Pritchard &
Laura Reynolds
This guide is written for those interested in setting up a community
based music group. Every community music group will evolve
organically and be different, and each group will need to accommodate
individuals’ abilities and musical preferences. The authors have not
received any endorsements from companies or organisations
mentioned in this guide.
This booklet is freely available to those wanting more information
about running a community-based music group for people with
dementia and their carers. It should not be reproduced or sold.
If using the guide for academic purposes, please use the Citation
Reference. We are interested in knowing how this booklet is being
used, and therefore request that those wishing to use the booklet
contact the authors, not for permission, but stating circumstance of
use.
This booklet was funded by Dorset County Council’s ‘Inspired by 2012
Health and Wellbeing’ Legacy Fund as part of a wider project funding
the continuation of the BUDI Orchestra for people with dementia and
their carers from the local community.
Baker, A., Innes, A., Murphy, J., Pritchard K., & Reynolds, L. (2015). The
BUDI Orchestra Method: A Guide. Bournemouth, UK: Bournemouth
University Dementia Institute.
About this Guide ................................................................. 2
Philosophy and Principles ................................................... 2
Positive Expectations .......................................................... 4
................................................. 5
Creating the Group Environment ................................... 5
Selecting a Team ............................................................ 6
Instruments .................................................................. 12
Music Selection ............................................................ 13
Styles of Music ............................................................. 14
......................... 16
Warm-Ups .................................................................... 16
Rehearsals .................................................................... 17
.............................................. 18
Location ....................................................................... 18
Layout .......................................................................... 18
Before the Performance .............................................. 19
After the Performance ................................................. 19
................................................................... 20
1
Following the success of the original BUDI (“buddy”) Orchestra, we decided
to create a guide for those wanting to set up their own music-based
community groups.
This guide provides recommendations or ‘hints and tips’ that may be useful
when setting up a community-based music group. Although our previous
work has focused specifically on engaging people with dementia and their
carers, this does not mean that our approach will not work with other
groups of people. We hope this guide will provide the ingredients, rather
than the recipe, to create music groups that give pleasure, fun and a sense
of accomplishment to all involved.
The starting point for this guide to using music with people with dementia
is one of having fun, creating an opportunity for social engagement and
group learning. Core to our philosophy is person-centred care: each
individual participating in the group is celebrated as an individual and
welcomed and valued as a person. This approach creates the starting point
for a sense of community, bonding and social ‘togetherness’. These are
important values to promote life-long learning and a willingness to engage
in new learning.
The underlying assumption is that everyone who participates will benefit.
The aim of creating an orchestra or other musical ensemble is not just to
benefit people with dementia, even though they are central to the process.
Professional musicians, volunteers, academics/researchers and family
members are not just there as supporters or facilitators, but as coproducers and collaborators in the experience. The idea is to create an
environment that is normal; rehearsing and performing together is the
norm for musicians from any genre. Music can be used as ‘therapy’ or as a
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‘group activity’; the intention of this guide is to move away from a more
simplified use of music to entertain, distract or pacify people with
dementia. Instead, our orchestra approach aims to create a high level
expectation of inclusive learning, progression, achievement and success.
While recognising that music may sometimes be a solitary pursuit with
individual benefits, a lot of music making and listening is typically part of a
social activity or with a collective purpose. Providing an opportunity for
people to interact with others from different backgrounds and life
experiences creates a forum for people to feel included and welcomed and
accepted for what they contribute and bring to the experience.
In this way, the musicians, volunteers and those watching the performances
are able to find out more about dementia, helping to demystify the
condition. Furthermore, the approach allows for diverse music making,
allowing exploration of different genres that may have been previously
unexplored by those new to music. In this way, the orchestra approach can
challenge perceptions, create new ways of thinking and generate
knowledge for all involved.
Adopting these principles will benefit all those in the group and not just
people with dementia and will encourage continued learning.
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It is important to remember many members of the group will be beginners,
and even those with experience of playing an instrument may be hesitant
to perform straight away. Each member of the group may learn in a
different way or have individual needs that may need to be considered.
Try to begin the group with patience and an open mind; it is important to
be able to adapt to the needs of the group when required.
Many musical mistakes were made on our journey,
both by the group members and the professional musicians
because at times musical patterns were just too complicated.
By simplifying those patterns it was possible to perform to a
much higher standard and, with that, the group were able to
gain a high sense of musical achievement.
Eventually a repertoire of songs and
pieces emerged that the group liked and
enjoyed being part of performing. The
main thing that soon became very
apparent was that the music and
the sessions had
to be fun.
4
Allowing time to meet and greet, and for people to say a relaxed farewell,
as part of the rehearsal schedule is crucial for the success of the group
development. At the beginning of the rehearsals, everyone needs some
time to reconnect, relax with one another, chat and re-familiarise
themselves with the physical setting and with other members of the group.
Ensuring that time is allocated to build relationships, create rapport,
promote friendships and develop a social network cannot be
underestimated in the success of the group to work together. Name tags
offer a simple way for each person to be able to identify others, and may be
helpful when starting a group where people are unfamiliar with other group
members.
Creating a sense of social community encourages group cohesion and
ownership and belonging. If people enjoy the sessions, they will express an
eagerness to continue with the group and attend the rehearsal and
performance cycles regularly.
When selecting a venue, it will be important to consider the following:
 Does the venue accommodate different abilities (physical and
cognitive)?
 Is the venue on the ground floor, or does it have accessible lifts?
 Does the venue have parking?
 Do the facilities provide refreshments?
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 Is there enough room for the music, instruments, people and other
equipment to be accommodated?
 Is there space for the group learning environment and a space for
individuals if they require a break?
Food and drink creates the opportunity to socialise together. Starting the
session with time to have refreshments and chat will help people to feel
relaxed. Similarly, a break after intense periods of concentration will
reinvigorate and revitalise the group, and also promote bonding with
others. It is important to consider individual preferences when catering for
the group; not only to accommodate individual dietary needs, but to
demonstrate knowledge and value of peoples’ preferences.
The choice of players to facilitate the group is very important. The following
are key points to consider when selecting musicians to run the sessions:
 Lack of negative pre-conceptions of people with dementia; for
example, players who feel relaxed rather than awkward, and are
accepting rather than feeling intimidated by people with dementia;
 Personal skillsets including interpersonal qualities such as: energy,
enthusiasm, vision, musical diversity, flexibility, ability to improvise
and adapt, communication, openness to make mistakes, fun
outgoing, sociable and patient;
 Experience of working in a community-based project;
 Ability to work flexibly and improvise and/or adapt musically if a
particular piece is not working;
 Musical understanding (and what could be achieved);
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 Knowledge of the instruments that the people with dementia are
learning to play;
 Understanding their personal value and contribution within the
project.
Having a team who get on will always help, as
will having skills that complement each other. Choosing
the types of instruments is important, for example, the
piano is an excellent instrument as it can provide
harmony, rhythm and melody, giving the other team
members freedom to weave in and out of the
arrangements as needed.
It is important to have a team that are willing to be
musically flexible and take on different roles so that it’s
not always ‘here’s the melody instrument, here’s the
harmony, or here’s the rhythm’. It is imperative that at
least one of the team knows the instrument being
taught to the members of the orchestra,
and that they are able to
demonstrate the technical
aspects of playing the
instrument, yet at the same time
providing assistance on an
individual basis.
7
When I joined the BUDI Orchestra, I had very little experience interacting with
people with dementia and their carers, both professionally and personally. I did
have some experience of working with community projects, but not with this
approach. During the rehearsals, the other musicians and I would support
group members by helping with technical aspects of playing the instruments,
for example, how to hold the instrument, and by playing accompanying
arrangements; be that the tune or to help with pacing.
Through this experience, I have had the opportunity to explore different styles
of music, and develop my own musical skills through improvisation and the
(often impromptu!) refinement of the repertoire to accommodate the skills of
the group. As well as this, I feel as though my confidence to interact with people
has grown, and I am now able to be flexible in my approach to accommodate
individual group members’ needs.
This experience has opened my eyes even further to the power of music and its
ability to bring people together in a positive shared environment to celebrate
our skills and achievements. The sense of community within the group was
greater than we could have imagined; having the opportunity to play and make
mistakes together, and finding out about the rich lives of everyone involved has
inspired me to do so much more for people with dementia.
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Volunteers are important to provide one-to-one support to individuals with
dementia and their family members who are learning an instrument for the
first time. The volunteers can help to demonstrate how to physically hold
the instrument and how to follow the instruction to play a piece. There can
be tensions if a volunteer attempts to ‘take over’ the learning and ‘overcorrect’ the individual playing. Professional musicians need to be alert to
this process and intervene as required to allow for individual independent
learning to occur. Similarly, lack of support can be detrimental to the
learning process. Finding the right balance of encouragement and enabling
an individual to thrive independently will differ depending on the person.
Ultimately, the volunteer should enable and empower, rather than impose.
Volunteers require the capacity to listen and follow instructions and adjust
their input to accommodate the musical direction and challenges as they
unfold. The volunteer role is to guide those with dementia, reinforce
learning, but also to foster a sense of togetherness and learning alongside
one another.
It is also helpful if volunteers have knowledge of music, as the volunteers
can then input and feedback to the musicians on potential improvements.
However, previous knowledge of music is not an essential requirement.
Our team of volunteers were essential to the success
of the project. Being outgoing, empathetic and having a
willingness to learn was very important. Volunteers’ focus
should be to provide encouragement and assistance. Quite
often our volunteers would be like a mentor to the same few
people each week. Having that continuity and building a
relationship made learning much easier and fun.
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The primary purpose of creating a BUDI Orchestra (or similar music group)
is to celebrate the skills of those living with dementia. This may include relearning musical skills through a forum that previously did not exist. Equally
a music group provides the opportunity to learn new skills in a safe and
supportive environment.
Jack
Jack is a 78 year old ex-professional musician living with dementia. He played the double
bass. Jack’s confidence to perform with a group had been shattered by a number of
dismissals from previous bands due to his difficulties using some of the technical
equipment needed during performances. Jack found other community groups too easy,
and would often make mistakes on purpose to amuse himself. He frequently left these
groups feeling patronised and so stopped attending. Jack and his wife had tried to meet
other people in their local area for ‘jam’ sessions, but had been unsuccessful.
When Jack joined the group, he had not played around other people for a long time, and
his instrument was in slight disrepair. Despite this, he was encouraged to bring it with
him to the rehearsals. He did not enjoy singing or taking part in the body percussion
segments as much as playing his instrument, so he continued playing during these parts
to add an accompaniment.
The musician leading the group asked if Jack would like sheet music to use for each
song, but Jack preferred to improvise. Before each song, one of the musicians would tell
Jack which key to play and he would play along. To celebrate Jack’s skills, he was invited
to play in place of the lead musician during songs he enjoyed while the musician
encouraged others in the group. Jack would sometimes become tired during the
sessions and would sit out during some songs to rest.
As Jack’s confidence in playing grew, he was encouraged to perform a solo segment
during one of the songs in the performance to showcase his talents to the audience.
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Walter
Before Walter’s diagnosis of dementia, he had been sociable and outgoing with many
friends at a local sports club; he also loved to sing. As Walter’s diagnosis progressed, he
found his friends began to distance themselves, and trips to the sports club became less
and less frequent. His wife suggested he might like to join the group as they had enjoyed
going to a similar community group in their local area. He was hesitant as he had never
played an instrument before, but was happy to attend on the basis he could join in with
singing where possible.
As the rehearsals began, Walter found the body percussion segments difficult to keep
up with, though he enjoyed singing. His mistakes often frustrated his wife, as she tried
to encourage him to follow her lead or would take his hands to tap out the rhythm. A
volunteer suggested they try playing the violin together and, as the weeks progressed,
Walter found playing the instrument less difficult. The support from the volunteer
enabled Walter’s wife to play alongside Walter and engage with the music as an active
member of the group, rather than as an aide for Walter. She found she was able to relax
and enjoy the experience with him.
During one of the sessions, Walter suggested to a volunteer that he felt ‘scat singing’
(vocal improvisations that fit within a melody or rhythm) would work well in a particular
piece of music. The volunteer encouraged Walter to share this with the group, but he
was not comfortable to do so. The following week, he expressed the idea again, and the
lead musician asked if he would like to try. Walter did and the lead musician suggested
they could add this to the performance.
After the performance, Walter was pleased with all he had achieved and believed that
everyone in the group “had a professional part and did it very well indeed”.
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Maggie
Maggie is 92 years old. She used to sing in a community choir and taught dance during
World War II. Music was an important part of Maggie’s life as she loved to sing and
listen to music. Her daughter believed Maggie would enjoy attending the group, but felt
that she would only be able to sing or engage with percussion instruments, rather than
play the violin, due to Maggie’s deteriorating eyesight.
The songs chosen were familiar to Maggie and she would often dance in her seat, sing,
hum or tap along to the tunes. A volunteer encouraged Maggie to use the violin and
within a few brief sessions, she was able to pluck the strings with the support of a
volunteer. Her daughter was surprised at her mother’s abilities; she never thought
Maggie would be able to participate in this way.
During the performance, Maggie was nervous: it was an unfamiliar environment and
there were lots of people watching her. She did not want to stand from her wheelchair
to reach the stage, and so the volunteers lifted her in her seat. When she was handed a
violin, Maggie began to strum, and as the music started during the performance, she
played with the rest of the group, singing loudly and playing as much as she could. At
the end of the performance, while the group stood to take their bow, Maggie motioned
to a volunteer that she too would like to stand with her peers and receive her applause.
She walked down from the stage with the aid of two other people with dementia, head
held high.
When considering the instruments to use, the ease of
creating a sound is important. String instruments are ideal in
the sense that a beginner can produce sounds that make an
immediate contribution to a group piece. In practice, this
means selecting pieces that allow for a variety of playing
techniques and progression of abilities as confidence grows.
For example, selecting music where open strings can be
plucked at the outset, but as the group becomes more
12
comfortable with the instrument, they may begin to develop more complex
skill-sets, such as increased concentration, dexterity, co-ordination, as well
as musical abilities.
Some practical considerations when selecting the appropriate instruments
to use are:
 Availability of instruments;
 Previous musical experience e.g. if people already play an
instrument, encourage individuals to bring them along or if they
have enjoyed a genre of music this can be included;
 Facilitator knowledge and ability to play chosen instruments;
 Selecting one instrument (for example, the violin) encourages a
levelling between group members new to the instrument.
Choice of music is crucial to the experience of the group. The music should
demand an element of challenge, promote learning and enable a sense of
personal achievement.
When choosing the music the following points are useful:
 Encourage group members to suggest pieces of music they enjoy to
promote ownership and involvement e.g. based on previous musical
preferences;
 Select pieces that will ideally promote the opportunity to learn new
styles of music (e.g. jazz to opera);
 Be recognisable to the group members so they feel a sense of
accomplishment when performing;
 Use repetitive musical patterns to reinforce learning while allowing
individuals to regroup and join in again should someone lose their
place;
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 Ensure that professional players’ musical skills are maximised to
enhance the performance;
 Be musically ‘flexible’ - to fit any instrument available;
 Promote fun!
This song was originally made popular by Perry
Como in the early 1960’s and is likely to be familiar
to many people with dementia from the current
generation. Structuring the piece in a simple
repeated form, for example…
A number of musical ‘styles’ can be
included when choosing the
repertoire: for example, including
pieces of music that allow for
singing and body percussion as
well as instruments. Group
members
may
be
more
comfortable with a specific style of
music; therefore multiple styles
can promote a sense of inclusion
and provide individuals with the
incentive to showcase particular
skills.
Introduction
Verse
Chorus
Verse
Instrumental break
Chorus
Verse - sung as a ‘round’
Introduction
…can work well as the words are simple and
repetitive. Performing the verse as a ‘round’ allows
for a real sense of musical achievement.
Notation is a very important part of the process. Sibelius® software is one
way for experienced musicians to create parts and scores. The music scores
for the musicians leading the BUDI Orchestra groups were created using
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Sibelius® software. This allows the opportunity to create parts for all
musical abilities from professional musicians to beginners. This software
allows group leaders to transpose and refine the music to suit the
instruments used by the group.
Simplifying the music to enable everyone to participate, regardless of their
ability to read music, is fundamental. To achieve this in our project, we
used a simplified guitar tablature-type method, for example: 8 x ‘D’, 4 x ‘A’,
to direct group members.
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It is very important to begin with confidence building exercises to promote
bonding between everyone within the group and encourage a relaxed
atmosphere. Musical warm-ups serve to prepare the group for the session
ahead; they can also be used to:
 ‘Break the ice’. This will be particularly useful when starting a new
group;
 Enable the group to recognise a starting point to their music-making;
 Physically warm up the body and vocal chords to promote well-being.
Warm-up exercises can be continuously built upon to become more
elaborate and complex as the group becomes more confident. These may
be integrated into the final repertoire where appropriate to add variation
to the music-making. Body percussion (for example, stamping feet, clapping
hands, clicking fingers) can also form part of the warm-up. This might be
integrated into the pieces later in the rehearsals if enjoyed by participants.
One example is highlighted below.
This phrase was spoken and each word clapped along to by members of
the group to emphasise the pace they were to play the violin in specific
music pieces (slow – slow – fast – fast – slow). This is demonstrated by
music notation below:
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Variation of the repertoire, accommodating individual preference, can help
to sustain engagement and concentration and is a cornerstone for
rehearsing. It is important to include pieces to build on learning and
demonstrate progression. Facilitators need to be able to improvise and
refine ‘in the moment’ to respond to group members’ reactions and
individual abilities. The rehearsal repertoire needs to build up to the
performance over time at a pace that meets the members’ progress.
Remember: the aim of the rehearsals is to create a fun and engaging
atmosphere that is focused on enjoyment, rather than achieving a
musical masterpiece.
Ravel’s Bolero was chosen as it is a one bar (three note) pattern, repeated continuously
over a very hypnotic drum pattern. The beauty of this piece was that whilst being very
simple to accompany, it is also very challenging to perform, as it should never get
boring in its delivery. Instrumental ‘blending’ could also be experimented with whilst at
all times being underpinned by Bolero’s three note pulse.
When the professional instrumentalists were not playing, they were able to choose
their own musical pattern naturally adding to the piece contributing to the rhythm or
the simple ‘C major’ harmony. Group members also had a choice of the notes they
could play, as there were more than one that would work. This also allowed the
opportunity for experimentation, confidence-building and to change their musical
pattern to maintain their interest.
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Performing is a normal part of participating in a group music activity that
can often be lost when running music groups for people with dementia.
This was a key feature of the BUDI orchestra as performances offer the
opportunity for participants to showcase their skills while also providing
pleasure for the audience.
Choosing a setting that may be familiar to members can promote an
environment to perform that is less pressured and more informal. It can
promote direct contact with the audience much more easily and encourage
performance energy.
It is important to select a venue that has sufficient room to accommodate
everyone (including any physical requirements they may have) and have
enough space to be able to play their instruments comfortably. Mirroring
the set-up of the rehearsal room is important to feel familiar and secure.
Sitting in pairs can be very helpful to provide support as required. It is also
important that everyone can see the lead facilitator during the
performance as this may promote a sense of involvement and group
cohesion. Music stands for the song sheets enable members to focus on
holding the instruments.
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Factoring in time to have a brief rehearsal immediately before the
performance promotes confidence and comfort in the environment.
Repetition is paramount to promote a sense of security and confidence
when performing without losing the fun aspect or spontaneity when
playing.
Providing the opportunity for group members to socialise together and
celebrate their achievements after the performance is important. Reflecting
on the performance collectively creates a bonding experience and a
willingness and enthusiasm to rehearse and perform in the future.
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1
Make it fun!
2
Treat people with dementia as people.
3
Create a social environment that promotes
friendship and belonging.
4
Draw on, encourage and showcase the natural
and existing abilities of individuals.
5
Don’t underestimate what can be achieved.
6
Adapt the music to suit the needs of the group.
7
Develop a relaxed atmosphere to promote
learning.
8
Embrace mistakes and go with the flow.
9
Choose music that is meaningful to the group
and engages individual interests.
10
Provide refreshments to promote bonding
alongside learning.