Music, relationships and social integrations

Saramai Leech in conversation with Liam Merriman (Professional musician, hospital musician with Kids Classics /Waterford Healing Arts Trust and trainer with Training Notes)

‘We connect to music. We connect to the sound of the human voice. We connect to musical sounds and everybody has a soundtrack to their life’

It has become widely accepted that music connects where other forms of communication fail. This is especially important for a person living with dementia. There are lots of videos online illustrating this including the now famous video of Gladys Wilson showing the breakthrough that sacred music allowed her to make. Also this popular rendition of Quando Quando Quando by Teddy Mac and his son shows the way music is allowing their relationship to flourish despite the father’s Alzheimer’s and inability to recognise his own family. 

Researchers have been carrying out studies in an effort to understand from a medical and scientific standpoint what many carers and family members are experiencing in the everyday care of their loved ones. Once such publication was titled ‘Using Music to Develop a Multisensory Communicative Environment for People with Late-Stage Dementia’. It describes a 2019 project funded by the NHS and the Wellcome Trust. They found that ‘Nonverbal communication in later-stage dementia may be overlooked or underestimated by busy care staff and families. Using music as an interactive way to communicate can help develop mirroring and turn-taking which has been shown to improve quality of life for people with communication impairment, increase their nonverbal communication and allow for a connection to be built between people.

To shed some more light on the area of music, relationships and social integrations, I had a chat with Arts and Health expert Liam Merriman. I asked Liam about his perspective on this topic as a professional hospital musician delivering music in healthcare settings:

‘It’s inherent to the human species. We connect to music. We connect to the human voice. We connect to musical sounds and everybody has a soundtrack to their life and it carries with you right through your life. So, in later years and particularly going back to your formative years, by opening up a musical conversation … with somebody in later stages of dementia and Alzheimer's, you connect with a person who's inside, who's locked inside the body, that's trapped in the Alzheimer's condition. You connect with them and they respond which is the really big deal. We're talking about people that [...are in the] later stages of Alzheimer's who don't recognize their own family, who cannot have any kind of a coherent conversation, but yet if you can go to the music soundtrack of their formative years particularly and perform or sing or try and use a piece of music, you can literally see the light coming back in their eyes. Now it's not like flicking a switch. It might take a couple of visits for the connection really to be fully formed.’

Liam shared a moment where he witnessed this connection happen after repeated music sessions:

‘The first time I was in an Alzheimer's unit, and it was quite a large unit, here in Ireland … after the first week, there was two of us playing, we came out afterwards and I was completely exhausted. We had tried you know. We played music. We tried to connect individually and collectively, because there was quite a large number of patients there, some of whom had their family members with them. I remember one particular gentleman who was so deep into the Alzheimer's condition, his wife was always there with him. He didn't know who she was. He … was a professional man who had retired and you would know by looking at him, he was a very well-educated man, a gentleman and … yet he was at the stage where he was using filthy language, saying absolutely obscene things which were completely out of character with the man and I remember his wife saying to us that Danny Boy was his song. So we sang Danny Boy and there was some little chink of recognition there which is lovely to see, because what you want to achieve is that he will be himself for a moment. He will go back to being himself and for his family that is such a big, big thing even though it's a small thing. But anyway you know we worked away. After the first week we felt ‘God you know this is so tough working with a group like that’, but it got to the stage where after about three weeks I remember, we walked in the door and that gentleman turned around in his chair, he was strapped into a chair, and when he saw us walking in, he looked over and he went: [sings] ‘Oh Danny Boy’, which was absolutely incredible. His wife could not believe it. He had made a connection. You know there was something there. He connected. We were the ‘Danny Boy people’...and we'd been trying for weeks. It doesn't happen instantly but when it happens it's extraordinary and it's remarkable and then of course that changes everything because it gives the staff if you like another tool that they can use to perhaps encourage or to calm.’

I asked Liam if because of a moment like that, whether the relationship between this man and the staff and his family might improve? 

‘Yes I do because now his wife had news. She had news to tell the rest of the family: Dad sang Danny Boy again. That was Dad's party piece. That is, that was, the trademark Dad we knew whenever there was a sing-song throughout his life and all that had shut down but through the live music and through connecting and when I say connecting, like you really are connecting... You’re there for him. You're there with him’ 

We also talked about some practical tips for family members and carers.

‘You know to take one thing away from this conversation, I would say for somebody like that with Dementia, Alzheimer's, to find out about their music from husband or wife, from a son or daughter and to explore that possibility of singing the songs, particularly focusing in on the formative years or somebody say who loves musicals. Maybe take a song from Oklahoma; ‘Oh What a Beautiful Morning’ and try that and see is there a connection because I mean it is ... a fact that that part of the brain that retains the music is one of the last outposts that the Alzheimer's doesn't even necessarily reach. You know, it remains intact. That recollection is deeply embedded in the brain and so you can find the person, the real person and reconnect with them, even for a brief moment and connect with who they really are and that is important for them. It's really important for family and it's also important for medical staff and support staff, care staff…’

Liam made some helpful musical suggestions for anyone looking to start this musical journey:

‘You Are My Sunshine, ballads, folks songs, even a piece of classical music, Somewhere Over the Rainbow, some of those universally known tracks or even indeed songs that maybe somebody learned as a child, children's songs or for many people spiritual songs, hymns, Christmas carols - songs that have a strong association - they will make a connection you know. But, as I said it's not like flicking a switch. You work on this. Be patient. You find the space.’

Many thanks to Liam Merriman for his time and valuable insight.

Here are some links to help get you started with finding out what music may have been part of someone’s formative years. The formative years can be loosely defined as the music a person was listening to between the ages of 10 to 25 or maybe even later.

Be there for an older loved one, from anywhere.