Rachel’s Blog

The last few months have been busy, exhausting, energising and exhilarating for all sorts of reasons. I’ve done several things I’ve not done before; I’ve led singing workshops in new settings (Fairtrade events, Christian Aid fundraiser, in the countryside under a very dark sky next to a bonfire at a peace conference), I’ve led sessions with content that I haven’t shared before, drawing together ideas from the music therapy literature and from community development, social change, and nonviolence movements (which I will get round to posting here at some point!). I ran an unConference in April, and a week later attended training provided by The Alzheimer’s Society. I’ve performed 16th & 17th Century Spanish Polyphony for a Good Friday concert, and I’ve managed to squeeze in something of a social life too!

The other thing I’ve done which I haven’t done before is complete the application to train to be a Music Therapist on the Nordoff Robbins Master of Music Therapy programme. In January I sent in a video audition and written application form, and in March I had two auditions, the first an individual audition, and the second a group audition. I’m very happy to report I’ve been offered a place, which will start in London in September.

Obviously this has implications for my work, so I’ve created a newsletter which outlines my plans.

Download: May 2011 – Singing Newsletter

This is part two of the posts referring to the Alzheimer’s Society training day in Theale on 15th April 2011.

Aside from the song-share and the Communicating with People with Dementia presentation, most of the day was led by Mary King and Fraser Trainer.

The day began with an hour-long vocal warm-up led by Mary – and I’ve got to say it was a wonderful luxury; my voice felt good and free afterwards. It was a great refresher too – reminding me of technique I forgot I knew and helping to tighten it up again and think about my voice and vocals with renewed clarity.

This was followed by the teaching of two well-known spirituals – Wade in the Water and Sometimes I Feel Like a Motherless Child. The main point that came out for me here was the use of speech and speaking the words in rhythm – really thoroughly, and with no inhibition about repeating every last line multiple times – before introducing the notes. Not only did the time spent on this help very thorough learning of the structure and words of the song, it also helped everyone pick up the syncopation, something I struggle to convey to groups of singers who don’t naturally ‘feel’ syncopated rhythms.

A warm-up of the next session comprised circle games: passing the clap around the circle, passing the ‘shhhh’, passing them both in opposite directions. Another was for everyone’s little fingers to touch, and anticipate the clap of the leader, or the clap of two leaders… all about group awareness, and getting comfortable as a group.

Fraser then led the group composition. This was delivered in a number of steps:

1. A pulse was established

2. We were asked to think of a short phrase of 5-6 words.

3. say those words in a repeating rhythm

4. Sing the words in rhythm on one note (D)

5. Sing the words in rhythm using different notes (Dorian mode)

6. The sound was pared down to 6 phrases, forming small groups

7. Chose 1 phrase which everyone sings and harmonises.

What did the group composition feel like? Lots of repetition, and trusting the facilitator to mould the sounds, sculpt, so you could hear different parts. Was it our piece or was it Fraser’s piece? We all created our own unique chunk of it, though I imagine it would be possible to give everyone the ‘sculpting’ tools, as in drum circle facilitation. It was exciting and energising for us. I’d love to try it at a singing for the brain group, but only with lots of volunteers who have been primed!

After lunch Mary led us in the learning of several new songs including: Senwa de Dende, Tomorrow is Another Day and Travellin’. Her expertise in vocal technique was the real bonus here, and I enjoyed the use of Boal’s Games for Actors and Non-actors (the classic mirror, for example) and use of eye-contact with people around the room (something I often feel inhibited about). One exercise sticks out for me, which was in two circles to pass objects around, without looking down, whilst singing a song which is in cannon to the other circle, and then changing direction you pass the objects – lots of concentration and co-ordination required! Mary also touched on conveying emotions through song which again was very helpful – if we’re singing loud, why? or quiet, why? Thinking inside –> outside.

The whole day was incredibly inspiring and energising, from the input, but also because it was great to see fellow Singing for the Brain leaders and volunteers.

On the 15th April I hopped onto a train down to Theale for a long day of training with the Alzheimer’s Society. The training comprised of workshops on vocal warm-ups, health & hygiene, songs and rhythm, group composition, a song-share and an excellent presentation on ‘Communicating with People with Dementia’ by Marielle Kay, Specialist Speech and Language Therapist.

More of the rest in another post, but here are some of my learning points from Marielle’s presentation:

• “When you’ve met one person with dementia, you’ve met one person with dementia”
• Saying ‘lovely to see you again‘ can be unhelpful as the person may not remember and this can cause uncertainty.
• Watch for someone’s non-verbal communication – laughter can sometimes be a sign of uncertainty, a deflection of not understanding something – how might you react if I asked in all seriousness ‘have you seen the squarg?’
• When speaking, put things in chronological order – for example, do say ‘we will collect in the books and then we will finish our session with a song’, don’t say ‘before we finish our session with a song, we’re going to collect in the books’
• Idioms can be difficult to understand, and wordplay can exclude – but humour can be a gift.
• Don’t ask questions that require short term memory, or specific details
• Sometimes questions such as ‘would you like a cup of tea’ can be difficult – the person may not remember if they have recently had a cup already, or they may not want you to go to the trouble for them. Instead saying ‘I’m having a cup of tea, would you like one?’ gives permission.
• Pace – speak slowly with a clear vocabulary.
• Infantilisation – this can happen because often our main experience of caring is with and around small children, when we naturally speak in a higher-pitched voice. It’s important to reject the notion of dementia as a second childhood and recognise the person with dementia is an adult with a life-time’s worth of experiences.
• Look for the meanings behind the words: ‘I’m going to work now’ might mean I need something to do – ‘where’s my mother’ or ‘I want to go home’ might indicate feelings of insecurity.
• When these difficult questions arise through disinhibition or confabulation there are various options: 1. To correct 2. To distract 3. To validate 4. To fabricate
• When talking to someone who is becoming less lucid it is best to let them take the lead – listen to them and give them the full attention – read the non-verbal signs and repeat back key words that might prompt a memory.

Marielle’s presentation was incredibly rich, full of really practical tips about communicating with someone living with dementia. She finished by talking about Tom Kitwood’s book Dementia Reconsidered (1997). Tom Kitwood was a proponent of person-centred care for people living with dementia, and examined a variety of ways in which this could be undermined, including: outpacing, disempowerment, infantilisation, invalidation, imposition, ignoring… the list goes on.

This presentation really helped me reflect on how the Singing for the Brain is such an effective model for empowering and building the confidence of people with dementia, but also how easy it can be to fall into the traps of not always listening to someone, by not making an effort to be with someone who is less communicative, or by not taking the time to s-l-o-w d-o-w-n when speaking to someone with dementia.

The conference was fantastic – more than I could have hoped for. There was a great turn-out, and I so enjoyed meeting you all. It was also encouraging that no one knew everyone, at least to start with. We had great facilitation from @timdavies and wonderful facilities at Peace House, borrowed from the lovely Fellowship of Reconciliation (hopefully they did manage to get some work done in their office, and weren’t too distracted by our singing!). It’s great to see some people have already started to send content to the newly set-up wellsing.org.uk page, including documents, photos and audio recordings. You can post content using the email address wellsing@posterous.com, and include attachments – posterous is so clever, it will automatically turn your email into a blog post.

Thanks again, everyone who attended, everyone who wanted to attend but couldn’t, and to everyone who supported the idea!

There’s a care home, just around the corner from my flat that I visit roughly once a month. I really like this care home – it’s got really high staff ratios, it feels like a home (rather than an institution) and the staff treat all the residents with friendliness and respect. There’s a mixture of people here, but mainly people are here either because they have advanced dementia, or because their physical infirmities have become too severe to cope with in their own homes. I had a wonderful time singing there in April with Mrs. D. This isn’t unusual – she lives with dementia, is sweet natured, smiles and conducts, claps and taps along to the music, and I’ve been visiting the place for 6 months or more.

But I have never heard her voice.

Until that wonderful day in April. When I arrived she seemed radiant – the care worker explained afterwards she had, unusually, allowed the hair dresser to wash and set her hair. And she danced as I began to play, and then sat and sang along with most of the songs, commenting on them as we went, with various levels of lucidity. We finished with a hymn, and as I was putting away my guitar she came and sat next to me and explained that this hymn was important and meaningful, and had had meaning for her.