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Four Things I’ve Learned. My First Two Years Of Practicing Music Therapy With People With Dementia


In 2023, I finished my MSc in Music Therapy at Queen Margaret University in Edinburgh, and swiftly – and fortunately – found myself in post across the Forth at NHS Fife, working in the inpatient mental health team. In truth, it felt like a pretty rapid life change – I’ve taken to calling my decision to retrain a “pandemic induced whim,” but in reality I’d been trying to find a way to centre my life more around music for a while, and lockdown was the first moment I had to actually think about how I might achieve that, and what that might look like. Now, I’m over two years in, with a significant portion of my clinical work dedicate to people with dementia. Here’s four things I’ve learned in that time.

There’s no “one size fits all” music

Music is a very personal thing, and yet still sometimes we fall into the trap of suggesting that someone feeling stressed or agitated listen to something “soothing” or “relaxing.” The problem is, what soothes or relaxes one person may really annoy someone else. I think we all know this from our own experiences – I’m sure the music that plays as we wait on hold is intended to keep us calm, but if it works for you, you’re a stronger person than I am – but it’s important to always hold it in mind. The upshot is: because music is so personal, it’s also a fantastic way of getting to know someone, and quickly building a relationship with them. By working harder and understanding the preferences of the people I meet, you can really tailor the sessions to meet their needs.

Reminiscence is not neutral

We’re often told that while people with dementia may lose memories, they’ll still be able to remember song lyrics and the memories associated with them – there’s a particularly beautiful example of this at the end of the documentary Finding Jack Charlton, where he sings the English folk song Blaydon Races. However, I’ll never forget one of the first things a person said to me when I went onto the ward. She kept asking me if I could play any songs I’d written myself. I was surprised by this, and maybe a little embarrassed. Why would she want to hear them? Wouldn’t she want to hear something from her youth? Her response was simple: “Songs from that era do remind me of when I was growing up…but those memories aren’t particularly happy ones.” It reminded me that my role isn’t to be a jukebox, or even necessarily to lean on nostalgia, but rather it’s to find out what the person needs and use music to address that.

There’s no better sound than group singing

We’re born singing. I tell this to everyone I meet who tells me that they can’t sing, or they’re not good at it, or that they’re tone-deaf. Before we learn to talk, we communicate musically, and learn to relate to people that way. Our ability to do that never leaves us. So often in the groups I run there will be a moment where I will let the guitar go silent and hope that people’s voices rise up to fill the space, and I’m always delighted and moved when it happens. Whether it’s in key, or in time, it doesn’t matter. It’s the sound of people relating to each other.

Music therapy works!

I’m sure every therapist has that moment when they think “ok, but is this really making an impact?” I know I thought that a lot when I started. Thankfully now, I feel this less. Part of this comes from the fact that at the beginning of this year I evaluated an open music therapy group I run and was able to identify a reduction in stress and distress behaviours in 93% of people who engaged. But also, part of it comes from the feedback I’ve received from nurses, people with dementia themselves, and their families. It reminds me that often though we may not see change, that doesn’t mean it’s not happening. Of course, these are just four of hundreds of things that I’ve learned – and keep learning – over the past couple of years, and I’m sure there’ll be hundreds more to come.

  • What are some of the first things you learned after working with, or caring for, someone with dementia?
  • And can you think of a moment when music helped you relate to someone in your life?

Contributor

Harry Harris is a music therapist working in the mental health team in NHS Fife. His work covers adult, older adult and forensic inpatient wards. You can find out more about music therapy here

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