Since 1998 I have specialized in working with older adults living in
long-term care homes. 1 have learned so much and in turn have always striven
to provide an experience that is meaningful for each group as a whole and
for each individual within each group. In 2003 I completed a major research
project in partial fulfilment of the Master of Music Therapy degree at Wilfrid
Laurier University, Ontario, Canada. This was an important opportunity to
better understand and articulate my own practice facilitating group music
therapy sessions.
Unfortunately, my enthusiasm for music therapy in geriatric and
dementia care seems at odds with common negative stereotypes and
misconceptions about what it means to work musically with older adults in
long-term or extended care. Much of the music therapy literature in dementia
care as comprehensively summarized by Brotons (2000) described cognitive,
behavioural, social, and emotional treatment interventions without
considering creativity. Ruud (2010) emphasized that respecting the dignity
and musical identities of individuals involved in music therapy sessions is
a priority. This important work is too often considered repetitive, boring,
and uninspiring, largely because of the belief that working with the elderly
involves singing the same songs day after day. But if singing old songs and
thrusting instruments into frail hands to play along is believed to be the extent
of the work, then I mourn a lost opportunity. It is possible to improvise with
older adults: I have even used atonal music and observed great responses!
The theoretical underpinnings of my music therapy clinical practice
in dementia care have been informed by the work and writings of Australian
music therapist, Ruth Bright (1972,1988,1997). Bright’s belief that persons
with dementia possess the capacity to be creative inspired me and is the
lens through which I have perceived and nurtured relationships with music
therapy clients. Bright motivated me to hear, see, and cultivate the gems
of musical creativity that are still present and accessible to persons with
dementia.
Much of the work done with the elderly focuses on who individuals
were, which is echoed through theme and reminiscence-based programs
intended to access and engage long-term memory. But I prefer to focus on
individuals as who they are now. My approach is very much in the moment; I
focus on the persons as they are that particular day. My goals have never been
to "improve" a person with dementia, but to support the person in the best
ways I can. For years now, my philosophy has been to assist persons to reach
their fullest potential and improve their quality of life.
Thus finding creative ways to engage older adults with dementia