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Greater Resident Engagement and Quality of Life through A New Twist on Sing-Alongs -- Part One

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This is Part 1 of 2 spotlighting Songs by Heart, a twist on resident sing-alongs that combines performance and music therapy for senior residents, especially those in memory care. In this part, Pam McDonald, Senior Housing Forum -- The Podcast Producer and Co-Host interviews Jenny Cook, board-certified music therapist from the Songs by Heart Foundation, who describes the program and its many benefits. Listen to the podcast HERE. 

PAM: Can you please introduce yourself? Give me your name, your title, your organization and then we’ll go from there.

JENNY: So, my name is Jenny Cook. I'm a board-certified music therapist with the Songs by Heart Foundation. 

PAM: That's a nonprofit isn't it? 

JENNY: Yes. 

PAM: And, what exactly do you guys do? 

JENNY: So, we go into, usually, memory care facilities and we provide interactive sing-along programs for the residents just to give them more socialization . . . another activity to do. We think that music and art, in general, is better and the more that we can provide, the better quality of life they have. 

PAM: Okay. But you didn't mention the word music therapy. Is there some reason for that? 

JENNY: So, I'm a board-certified music therapist, but not everybody at Songs by Heart is a board-certified music therapist. So, we're sort of combining a little bit of a performance and then also music therapy and activity. So, it's kind of a combination of all of those things. 

A Program that Combines Performance and Music Therapy

JENNY: And we wish that we had thousands and thousands of music therapists who had classically trained voices, but we just don't. What we try to do is give some tips to the singers on how to interact with the residents and have an effective program and use music as a therapeutic tool to make quality of life improve and work on other goal areas as well. 

PAM: How does it become a therapeutic tool? Communities have sing-alongs all the time, what makes it therapeutic?

JENNY: So, we try to address non-musical goals. So, we are looking at physical goals, we're looking at social goals, communication. We're also looking at improving quality of life and so we do these interactive things like mirroring, a lot of dancing, movement, filling in song titles, filling in lyrics, giving people solos. So, it's a little bit more interactive than your typical sing-along experience. 

And we try to prompt increased engagement as much as possible. Sometimes we tend to be a little bit more invasive, I would say, in a good way, than other programs. So, giving a lot more prompting and a lot more encouragement for people to participate. So, it becomes an active participation thing rather than a more passive experience. 

PAM: Cool. I believe that when we were setting this up, you were told that we needed to get some general tips on things people could do besides just using your program, uh, to make this a more beneficial experience for the residents themselves. Do you have some of those? 

Tips for Making Sing-alongs More Interactive

JENNY: I think they could use more movement. Movement is sort of the foundation of the music. We are born to experience music. We're all animals. So physiologically we are attuned to music and so it's really important to kind of sync up with the rhythm. So, I think that's kind of the first thing, a fundamental thing is rhythm. So, synching up bodies to rhythm, clapping, tapping toes, movement, mirroring gestures to encourage more of that. So, I'd say movement is kind of the first big category in terms of that. 

And then you can also talk about the music. I think music is a common language that we all have, even if our language facilities are not what they used to be for some of our residents. The music, a lot of times will prompt increased language. So, talking about songs, sharing memories about songs. A lot of times music will prompt that emotional memory and bring them back to a place and a story that they may have otherwise forgotten. And so that's kind of a cool segue too for more socialization and communication. 

PAM: Yeah, I'm sure. That's very interesting. What . . . I understand that you guys are all performers, you even said it. Why performers? 

JENNY: I think what's really important, especially in a lot of our memory care work, is meeting the residents and the clients where they are and going along with what their needs are rather than sort of trying to orient them to our reality. So being a performer has been really useful in improvisation and kind of acting and going with the flow. 

In addition, there are focus issues with these groups. A lot of times they don't know, if they have multiple stimuli coming in, they don't know which one to kind of focus on. And so, we all have big personalities, big gestures, big visual cues, and then that's really helpful I think in kind of getting them to pay attention and to focus. 

PAM: So, we can't ignore you, huh? 

JENNY: Well, yeah, exactly. (Laughter.)

PAM: Okay, well, how is it that you work at Kenwood? 

JENNY: So, Songs by Heart has a program at the Kenwood, I believe. I'm based in Chicago actually. I believe most of our communities are in Chicago, but we've got communities all over the country. So, they're getting a little taste of Songs by Heart over there. 

PAM: So, in general, and I mean you still are doing it for communities, is that correct? You personally? 

JENNY: Yes, me personally. Yes, I am.  

The Effects of Songs by Heart on Residents

PAM: What do you see in terms of how residents respond? What results or benefits can you physically see? 

JENNY: I mean, it's across the board. I mean, I see decreased agitation. So, if we're looking at more, you know, stereotypical kind of negative emotions and things like that where we're looking to decrease agitation. Also decrease pain and decrease isolation. So, some of those things that are pretty common with some of our residents.

We like to provide an emotional outlet. A lot of times what we see is if somebody is really agitated and we give them a really cranky song, like, “Oh, How I Hate to Get Up in the Morning” or a marching song where they can physically let out those emotions, then we usually see a positive response with that. 

Increased communication, increased socialization. That's one really amazing thing about our program I think is that we're building kind of communities within communities. A lot of times people will move into a community and feel isolated and so it's a great way to kind of break the ice a little bit and get to know other people. And, we try to provide a safe place for people to express emotions as well. 

I think that there are lots of things that our residents are going through, sadness, a lot of times loss. They're grieving the life that they used to have. And so, we're trying to provide a safe space for them to kind of let out some of those things and express themselves. And music is a great way for them to become performers as well and kind of let their creative juices flow. 

PAM: Yeah, sounds nice. How about family members? Have you had experiences where they come in to join the sing-along?

JENNY: . . . uh huh . . .

PAM: . . . and how did they respond? 

JENNY: Well, I think family members respond by communicating more with their loved ones. So again, music is sort of the common tongue between all of us. And so, it's really amazing to see family members come in and, you know, maybe their loved one is asleep or not really engaged prior to a session. But then we start singing and the music really prompt stimulation and engagement. And then they can start to interact with them.

And a lot of times that is through the music. So, they start with the music as kind of the facilitator, but we've seen a lot of, yeah, increased engagement with family members and socialization between the two of them.  

Verifying Results with Northwestern University

PAM: Does your organization try to keep track? I mean, are they doing anything to get scientific evidence? 

JENNY: Yeah, we did a pilot study when we first started the program and we were in three communities. We just took observational data and saw a big improvement in engagement, communication, quality of life, mood. So that was sort of more observational. But we're starting a study with Northwestern University in either late June, early July to kind of get more quantitative evidence of the benefits of our program. 

PAM: That is fantastic. I asked that specifically because I have a friend here who has a program where people with dementia, the caregiving couple or the care partners, do some work with horses, but it's just, you know, taking them around the corral and it has amazing effects between the couple. I'm lucky because I get to hear about a lot of these innovative programs. 

JENNY: Yeah 

PAM: Yeah. And they really focused first . . . they wanted to get evidence-based results and I really like evidence-based results. So, it's great to see that you're going to be working with Northwestern. She worked with UC Davis and Stanford. 

JENNY: Okay.  

Prompting Greater Independence

PAM: Some pretty cool stuff. Again, I want to go back to the communities themselves. You mentioned doing a lot more movement, talking about the music itself. Are there any other tips that activities directors might be using right now with their memory care residents? 

JENNY: I would say a lot of times what we find really useful is when we're singing a song to let them cover a solo or to speak through lyrics because that tends to trigger more communication and more language from our residents. So, if they can do like fill in the blanks, give people solos.

I like to give people dance solos and singing solos because I think it prompts increased independence, which is a big thing that a lot of our residents lose when they move into a community. And so, we just want to keep them independent and strong. 

And we also have a lot of performers in our communities. I've met several opera singers and former dancers and things like that, so we try to focus on getting them, kind of, doing some of the same things. I mean, they might be altered slightly, you know, in some cases, but getting them doing some of the things that they used to do.

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