Tag Archives | music therapy

7 music strategies for people living with late-stage dementia

Last year for the holidays, I wrote about 4 Rhythma-tastic Holiday Goodies for Facilitating. Check the bottom of that post for additional holiday tips from other music therapists!

Those tips are awesome to use with all sorts and types of clients. But when I wrote it, I had residents in independent living in mind. You can certainly adapt and modify the tips according to the needs of your own clients.

Activities for seniors

Today however, I would like to address spending the holidays with people who are in mid-late stages Alzheimers/dementia. The topic of engaging with those in late stage dementia came up a lot at the American Music Therapy Association conference. (By the way, did you know that you can win a free membership in AMTA by Dec 20?)

I’m listing 7 awesome strategies to make music with those in late stage dementia. Of course completing a proper assessment and treatment plan are a must! Also, make sure to consult with a board-certified music therapist in your area. You can find them all listed here.

And these are great tools, but most importantly, speak, interact, touch, dance, and sing with your clients in late stage dementia regularly. That’s what matters…. the relationship and environment that YOU help to create.

Don’t forget to include the family in the assessment. They will have some great insight for you as you design the treatment plan.

I also adopt the philosophy of “Less talking, More experiencing” when working with people who have Alzheimer’s. Words may get in the way. However, I use words to speak clearly in preparing my client for what’s to come. For instance “Betty, these are bells. May I have your hand?”

These strategies have a very quick learning curve, so dig in!

1. Hand-over-hand drum sliding. Animal skin feels so nice if you have an authentic drum. But also rubbing someone’s hand over a synthetic drum head creates a calming ocean-rain sound. Perfect song: Silent Night

2. Hand-over-hand drum-tum-tumming. You must be gentle to avoid bruising. Even just guiding the fingers tips in tapping the drum. Perfect song: Winter Wonderland

3. Hand-over-hand drumming with a mallet. Sometimes drumming becomes easier when mallets are used. Watch my review of the adaptive mallet cuff. If your client needs assistance with grasp, then the mallet cuff is right up your alley. Perfect song: 12 Days Of Christmas (with 12 drummers drumming) or Little Drummer Boy

4. Velcro-strap jingle bells. Another type of assistive instrument. I especially like these because they have a nice round sound, and they are the perfect weight. You can velcro these to wrists and ankles, then do some hand-over-hand Rockin Around the Christmas Tree!

5. Ocean drum. This drum provides a great tactile experience. You can place it in a lap, or share it so there are four hands holding it. Sway it back and forth. Swirl it round and round. Perfect song: Do You Hear What I Hear (Change the lyrics according to the in-the-moment experience.)

6. Cabasa. Tactile, tactile, tactile. Roll it to the beat. Roll it for ambient sound. Make sure to prepare your client by saying “I’m going to roll this cabasa up and down your arm.” Start with a gentle touch. Perfect song: Festival of Lights for Hanukkah

7. Hand-over-hand tambourines. Roll the hand over the jingles, rub the hand on the drum head. Perfect song: We Three Kings

I use chimes, triangles, and toning bowls cautiously for this population, unless I’m absolutely sure that it’s a good fit for the individual. With the proper preparation and demonstration, these tools would be perfect. But avoid any instrument that might startle your client.

And remember: The brain is active. The brain is receptive. Introduce yourself. Allow the opportunities for the individual to vocalize back and forth in conversation.

My friend Natalie Mullis wrote recently about Alzheimer’s and Divorce. Also, my friend Rachelle Norman wrote about using an ocean drum with her clients living with late stage. Both are great reads!

Off to the Jingle Jungle for me! 3 holiday sessions back-to-back this morning. Did I ever mention this is the best job EVER?

What do you do for your clients living with mid-late stage dementia?

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VIDEO: Mashup for Drumming with Older Adults: Ayub + Opera

Ayub Rhythm + Habanera from Bizet’s Carmen = Successful Older Adult Drumming and Singing

Here’s a fun way to drum with older adults in your music therapy or group drumming sessions. I particularly enjoy introducing something new by way of something old and familiar. (Granted, the Ayub rhythm is much “older” than Carmen, it will probably be “new” to most groups in the US and west.) So, get your doumbeks warmed up and play!

The YouTube link follows: http://www.youtube.com/watch?v=Dv-ZjmGSuF0

Got any more group drumming mashups? Got any thoughts to share? I’d love to hear your ideas!

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VIDEO: Drum with Older Adults

I wrote a description of this song intervention in No Worries, No Hurries, and No Wrong Notes. Now you can see it in action! I am using Blue Suede Shoes as a guided music-making experience with improvisation. Because Blue Suede Shoes is a standard 12-bar blues, you can use any song with the same form. Other songs I use include Rock Around the Clock, Hound Dog, Elvis selections, Eric Clapton selections, and more.

When drumming with older adults, remember that people take comfort in synchronicity and familiarity. With that in mind, I always start the group session with a greeting song that includes everyone’s names, check-in exercise, orientation to others in the group, movement, and breathing. Then I can assess whether or not the group is ready for drumming.

Once I hand out drums, I start out with some simple familiar exercises that you can watch in the post Make Music with Older Adults. Then, I invite all the participants turn to their neighbor and say “Wow! You’re a good drummer!” As soon as the participants are comfortable making some music on the drums, then I suggest using this guided experience with improvisation.

I also use Arthur Hulls bunny hop technique found in the Drum Circle Facilitation book: I start with big visual and vocal cues, then gradually taper down and disappear, providing the basic chordal and rhythmic supportive structure in the background of the players. The focus is on the players, not the therapist or facilitator.

After the session, I always document the group’s behavioral and psychosocial responses. Have fun!

PS There are a million and one variations to the directions that I lay out in this example, so be sure to to adapt, change, and transform for your own groups.

What do you think? Is this similar to your drumming experiences with older adults?

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9 Great Self-Care & Music Therapy Posts in the Past Week

There has been an explosion of great blog posts in the past week, and I want to share them with you. They have enhanced my every day practice of self-care, wellness, and music therapy.

Self-care & Wellness

1. Rest and Recovery from the Art of Non-Conformity. Chris describes how to manage energy instead of time. Our energy is something that we can be aware of, something that we can convert, something that we can refuel. Whereas, we have can’t change the pattern of time.

2. The Zen of Doing from Zen Habits. Explore ways to engage in everyday tasks with a deep feeling of inner peace and appreciation.

3. Making Art Instead of Setting Goals from Agile Living. Goals = Future. Art = Now. Give living in the here and now a try between your goal-achieving sessions.

4. Live Your Life as if Everything is a Miracle from Make It Happen. Life, love, the body, nature, creativity. Modern science has not been able to figure out these phenomena. Miracles are everywhere!

5. How to Make your Drumming More Meaningful by former Rusted Root drummer Jim Donovan. Jim describes how to connect drumming patterns to your body and mind by way of movements, breathing, and intentions.

Music Therapy

6. Functional Neuroscience for the Clinical Music Therapist handout by Kimberly Sena Moore, MT-BC

7. Middle Eastern Idiom for Guitar Improvisation by Dr. John Carpente, MT-BC

8. The Mindful Music Therapist’s handouts for Taboo Topics by Roia Rafieyan, MT-BC

9. Book review for Bella’s Blessings by Rachel Rambach, MT-BC

One more for music therapists that you’ve got to check out if you work with kids who have special needs is More with Music. Free songs for music therapists!

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Drum Circle Facilitation and Music Therapy

After a meal and an evening of music-making with three amazing women drummers last weekend, I was inspired to write about drum circle facilitation and a program that connects all four of us: Remo’s HealthRHYTHMS®.

Mary Tolena and Jú Linares of ZaBoomBala Drumming Works stayed with me in San Diego for 2 days and told me stories of their recent Drum-About across the United States and through Brazil. Christine Stevens of UpBeat Drum Circles joined us over the weekend, and we four shared music and touching stories about our experiences in our work.

The following paragraphs should clarify the difference between a music therapist (MT) and a drum circle facilitator (DCF). There are MTs, there are DCFs, and sometimes people are both MTs and DCFs (like myself and Christine Stevens). DCFs are not considered therapists, but facilitators, coaches, teachers, and/or mentors. Music therapy is an allied healthcare profession established in the 1940s, while drum circle facilitation is a relatively new field. DCFs come with diverse backgrounds: professional drummers, social workers, music therapists, healthcare professionals, wellness consultants, corporate trainers, and more.

Music therapists ~

  1. Use evidence-based music interventions to accomplish individualized goals within a therapeutic relationship (American Music Therapy Association, 2010)
  2. Are required to obtain a degree (bachelors, masters, PhD), attend a 6-month internship, and pass a board-certification exam.
  3. May be members of the American Music Therapy Association in the US.
  4. Are all formally trained musicians.

Drum circle facilitators ~

  1. Utilize a variety of techniques to make an interactive music experience easy, fun, and meaningful for participants (Drum Circle Facilitators Guild, 2010)
  2. May attend a training program. They vary between 4 days and 2 weeks. HealthRHYTHMS is one such training program. I’ll be writing about more DCF training programs soon.
  3. May be members of the Drum Circle Facilitation Guild in the US.
  4. Are not necessarily formally trained musicians, but some are world-renowned musicians.
Drum Circle Facilitation and Music Therapy

MT is an awesome path if you are a formally trained musician and would like to work in the medical, psychiatric, educational, or wellness fields. DCF is a wonderful opportunity for people interested in empowering others to make music in a recreational setting, without having to obtain a degree or become proficient on an instrument. DCF is also great for those already on a healthcare or corporate career path, looking to supplement their current services.

For those interested in continuing education with regards to wellness, the HealthRHYTHMS® training program is a good option because the program focuses specifically on health and wellness through group drumming. The HealthRHYTHMS® research over the past ten years has helped to bridge the gap between the ancient art of healing and modern science.

The body of music therapy literature is prolific, spanning 5 decades of quantitative research that focuses on a variety of techniques with a variety of populations. For instance, I have posted a snapshot of the MT research on infants in a NICU here. MTs are formally trained with regards to the importance of the therapist-client relationship, how to build rapport with the client, how to follow systematic steps for successful client transformation, how to apply these steps with a variety of populations using an enormous variety of music interventions.

Read more about music therapy…
Learn more about drum circle facilitation by joining the DCF’s Yahoo Group…

Although I was never lucky enough to meet legendary music therapist, Bongo Barry Bernstein, MT-BC, he left his mark in the music & wellness world through his years of service, creative rhythmic interaction, and creating the bridge between music and science. In this video, you may notice that the spirit of Bongo Barry lives on in both the music therapy field and drum circle facilitation.

Image courtesy of Lucas Lee.

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