Rocking all over the ward

10 Jul 2012

Music is having a miraculous effect on the lives of care home residences and patients, reports Barbara Lantin The Times, 10th July 2012

 
When we first see Henry he is slumped in a wheelchair in a care home, his head down, his face expressionless. Then a member of staff puts headphones over his ears and tells him that they are going to play his music. A transformation takes place. Henry’s eyes open wide, he sings to himself and beats out the rhythm. His whole body becomes animated.
Later, he talks passionately and coherently about his musical tastes. It is as if a stimulant has been pumped into his brain, which in a sense is what has happened. Music is doing its miraculous work.
            The mesmerising YouTube clip of Henry has notched up 5.7 million views and alerted the world to something that those in the know have been aware of for many years – that music can have a profound effect on health and wellbeing.
           From hospital foyers to operating theatres, from labour wards to care homes, music in all its forms is used to calm, to stimulate and to speed recovery. It has been found to lower blood pressure and heart rate, to alter brain chemistry and levels of antibodies in the blood.
            On a practical level, its effects can be extraordinary. When music from the Twenties and Thirties was played at mealtimes, care home residents ate more. Hip and knee replacement patients exposed to music and art needed less pain relief and left hospital a day earlier than those deprived of these stimuli.
            According to Dr Claudius Conrad, the director of music in medicine at Massachusetts General Hospital, Mozart could save your life by reducing the need for sedation after surgery.
            It is in dementia where the biggest strides have been made, from singing groups to reminiscence singlongs and improvisation. Dr Trish Vella-Burrows, a music and health researcher at the Sidney De Haan Research Centre for Music, Arts and Health at Canterbury Christ Church University, says; “It’s a fantastic field to be working in now because the Government’s commitment to dementia care and the awareness that we need to reduce pharmacological interventions has coincided with the rise in community singing and music sweeping across the UK.
            “At the same time we have more sophisticated tools for looking at the brain and the blood and working out what is happening,. A study of amateur singers found raised levels of the hormone oxytocin, which helps to stimulate memory and social bonding.
            “Brain scans show that the dorsal medial prefrontal cortex, an area of the brain that is highly stimulated when we make music together, is among the last to atrophy in many dementias. This may explain why music can elicit strong responses from people unable to communicate on any other level.”
            Caroline Wels, a flautist, witnesses this often through her work with Music for Life, a project run by Wigmore Hall and Dementia Uk that sends leading musicians into care homes.
            The residents selected to take part often show challenging behaviour that leads to them being isolated by staff and other residents. The aim is to encourage them to interact and show that a person remains – with history and a personality.
            The musicians visit for eight weekly sessions. “Once people lose language a whole range of things that matter to them cannot be discussed,” Welsh says. “They give up trying to communicate because it is too hard. But over the eight weeks we see people open up and try to communicate, and as they do they get more response from the musicians and staff. Because they feel somebody is trying to understand how they feel somebody is trying to understand how they feel, they make more effort.”
            Communication may not be verbal. “You can see changes in the way they sit and move. They breathe more easily and show less agitation. One man, who spent most of the day in a state of great anxiety asking where the toilet was, always went straight to the music room on the right day without being prompted. Staff were amazed.”
            Children with profound learning difficulties make up another group with whom music can be used as a communication tool. Felicity North, a senior therapist in the North West with the charity Nordoff Robbins, the UK’s largest private provider of music therapy, says; “At a non-verbal level, all the components of speech are present in music, including pitch, speed, phrasing and structure. Just as a baby vocalises and the mother repeats the sound, reflecting back what the child is doing, we can do that with music. We use music to work towards communication: some children may never actually develop speech.”
            North encourages children to experiment “They experience our understanding in a way that might be new for them. In time they learn about turn-taking, concentrating and imitation.”
            The rewards of producing music can help profoundly disabled children to make choices and take chances. “You may have a child who has found it very difficult to hold anything. Then they become motivated to play an instrument with a beater and to hold it longer because they enjoy it. In time, they may be able to take a spoon and feed themselves.”
            Mankind has probably been producing music longer than speech. Perhaps this explains why music can be used to calm and humanise the sterile settings of hospitals. Research at Chelsea and Westminster Hospital showed that music – sometimes in combination with visual art – reduced anxiety among new mothers, people receiving chemotherapy and patients being prepared for surgery.
            Similar findings came from a study at John Radcliffe Hospital, Oxford, among patients who listened to recorded music while having surgery under local anaesthesia. According to Dr Hazim Sadideen, who led the study, “calmer patients may cope better with the pain and recover quicker.”
            Dr Conrad, a pianist, has found that playing the right music – notably Mozart – to patients in intensive care lowered their blood pressure and heart rate, and they needed fewer drugs. “Respiratory complications are a major killer of postoperative intensive care patients. The quicker they can come off a ventilator the more likely it is that they will survive,” he says. With fewer sedative drugs that can happen faster. “You could say that Mozart helps you survive.”
            There’s little doubt that live music brings something extra to the party. The charity Live Music Now, founded more than 30 years ago by Yehudi Menuhin, works with young musicians in health settings. Trudy White, Live Music Now’s strategic director for health and wellbeing says: “The power of music…can be greatly intensified when played live by a skilled musician. The musician responds to the