Thank you Arts Council England!

We are celebrating a grant of £39,726 from Arts Council England to support our work with older people living with dementia in acute hospital settings!

The funding will support Rhythmix’s Wishing Well Music in Healthcare programme which brings live music making to the bedsides of people living with dementia while they are in hospital.

This new programme will enable our team, of Musicians in Healthcare, to bring their vocal, instrumental and technology skills right to the heart of healthcare. Making music with people at their bedsides helps to shine a light on people’s talents, creativity and life stories; it celebrates what people living with dementia can do and helps support wellbeing during the challenges of hospitalisation.

The Wishing Well Musicians in Healthcare are a team, dedicated to bringing creative experiences into hospital settings where music can have a profound impact on wellbeing –  get a glimpse of their work in our short films  here

Commenting on the grant Jane Humberstone, Vice Chair at Rhythmix, said:

‘’Wishing Well is one of the deepest experiences I have had when observing the impact of music on the brain. Music is part of our everyday life and we all know it is good for us. Many of us are lucky enough to have a life transformed by it. However, to have confirmed that it continues to have such positive effects even into late dementia truly uplifting. I cannot think of a better cause. Thank you to Arts Council England for their continued support for this work.’’

Positive Interactions with Patients and Families

Our team of “Wishing Well” musicians bring music-making right to the bedsides of children and young people in hospital, helping to create positive experiences at a really difficult time for families. 

Making music together provides a way of expressing and releasing stress; a moment of fun that has nothing to do with illness or the frightening things that hospitalisation can involve. It’s a very normal thing in fact; playing musical games or singing lullabies with your baby but in the extraordinary world of the hospital, music-making takes on many extra layers of significance.

One of the many challenges for children who are in hospital for long periods of time is that most of the adults they meet are medical professionals who need to carry out uncomfortable, sometimes stressful procedures and interventions. The youngest child will quickly associate “someone is coming into my room” with “something uncomfortable is going to happen” It can put children in a state of stress. Having musicians on hospital wards, as part of the multi-disciplinary team that supports children, can work towards redressing this balance by creating fun, safe, child focused interactions that ask “what can you do?” rather than “what is wrong with you?

One of our Musician’s writes:

“We gently played music by the door to a little boy’s room. A passing Doctor commented “he’ll cry if you go in!” but Mum caught our eye and waved to us. We very gently approached the little boy, crouched down near to him and started singing nursery rhymes, looking for a response to show us which one he liked. He was withdrawn at first, suspicious of what we might do but the introduction of our brightly coloured percussion was too much for him to resist. As he explored the sounds of the different instruments, Mum suggested his favourite lullaby and for a while, we all sat, singing and playing together, all anxiety forgotten and the rest of the hospital, a million miles away.”

Feel better in a better ward: Internal and external challenges in a children’s ward mitigated by music

The outcomes that Rhythmix work towards and capture have emerged in the course of work in children and young people’s healthcare settings. Our intention to reduce anxiety and isolation and increase self expression is widely supported by the healthcare staff who have helped to shape and guide our work right from the beginning. They recognise both the need to address these issues as part of the care they offer and the effectiveness of live music making in meeting them. In this two part series we explore internal and external factors affecting our work in children’s wards and units and mental health units.

We’ve all felt it. You’re going through your day feeling a bit grumpy, maybe a bit ill or sad, and then a car alarm starts blaring. It get’s into your head. You get irritable, agitated, angry, distressed. We take it out on others, and you go from feeling under the weather to suddenly feeling a whole lot worse.

This is the everyday experience of a child in the pediatric Critical Care unit of a hospital. Dealing with an illness or issue that requires hospitalisation, a child is already feeling anxious, sad and upset. Then they have to contend with beeping machines echoing on plastic floors, the sounds of other people being upset or crying, hurried footsteps and the frequent ominous alarms. The sounds around a person in hospital only make a person feel less at ease on a ward. Coupled with the monitors, wires and apparatus around a hospital bed Critical Care Practitioner Janet Lee of The Alex explains “even our beds don’t look like beds and our tables don’t look like tables. There is little here to make the children feel safe”.

But Rhythmix’s Wishing Well team is making a change to handle both the internal upsets and external factors that make a hospital stay difficult, unpleasant and at times traumatic. By bringing live, interactive music making right to the bedside we are helping improve the experience for children in hospital.

Internal Factors

Amongst the internal factors making a stay unpleasant, babies born in hospital who stay for a long period of time often find it difficult to create attachments to a primary caregiver. This can lead to a lack of resilience and mental health issues in later life. Disabled children spending long periods of their early years in hospital also learn to associate adults with pain and lack of communication due to often being spoken about instead of spoken to. Additionally, family bonds can become strained as there are few opportunities for activities that normalize positive family interaction and activities.

Helping disabled children in hospital develop even very preliminary music skills can help build internal strength. Our Wishing Well musicians help children make music, and families are encouraged to respond with mirroring or complimentary sounds and communication, and encourage and praise any self-expression.

Music making can also be instigated by child or parent as a way of reducing anxiety or loneliness in the long term by providing an ever-present tool that can be used at any time. This allows children to connect to their family in a way that can be carried on at home, or in the hospital when Wishing Well musicians are not there.

A medical student from Brighton and Hove Medical School who observed our work in hospitals in 2016 as part of a placement recognised the rebuilding of internal family bonds thanks to music, explaining “When we go into a room, quite often the family seem disconnected. Parents might be on phones, children are often watching TV but as soon as we start playing music, the family come together. They physically move closer and start to connect more. Parents start to encourage the child and respond to whatever he or she is doing. Laughter breaks out and sometimes tears. The family is drawn together by music”

External Factors

On the external factors, music can distract and ease the pressure from the hospital soundscape and can distract from treatment. Children and young people frequently have medical procedures done to them such as dressing changes or injections. Some of these are uncomfortable, painful and distressing. One staff member commented in the staff survey at The Alex “They played music and engaged with child when I had to do a potentially painful procedure. The child was compliant and it made the child feel relaxed and they were calm throughout making a difficult situation much easier for child and family and staff. “

But what impact is music having in the long term on the young people’s lives? It’s hard to tell. Some of the children we work with have a very uncertain future so the best we can do for them is to have an impact on their wellbeing in the moment of the interaction. We hope that the sense of human connection and calm will stay with them but it is very difficult to collect data that supports an outcome over time with these children. They may experience a sudden change in their health condition that understandably over rides the work we have done with them an hour or two previously. At least some of our work is best evaluated in the moment.

Importantly though, we have an overwhelming amount of evidence from participants, families and staff in feedback, film and surveys that demonstrates just how effective live music making is in reducing anxiety and isolation. When a child has a complicated picture of health, and the future is uncertain, any opportunity to make a period of time better should be relished.

When the external factors such as soundscapes and procedures are distressing, and internally family bonds and communication are weak, music is the tool that can address both of these simultaneously whilst forming happy memories and musical skills.

Musician’s Union “Inspiration” Award winner 2018!

 

We are over the moon to announce that Programme Director, Jo White was announced winner of the Musician’s Union “Inspiration” Award 2018 for her work with the Rhythmix, Wishing Well programme! In just 4 years Wishing Well has grown from a pilot project at The Royal Alexandra Children’s Hospital in Brighton, to a Sussex wide Music in Healthcare programme working in partnership with 6 NHS Trusts. Every week, our Musicians bring music making into hospitals across Sussex and Surrey to work as part of the hospital team, helping to improve people’s stay in hospitals and reduce some of the anxiety that people can feel. We receive such incredible feedback from the families that we work with about how music making has helped their child or an older relative through a difficult time; music really can reach places that medecine can’t and we are looking forward to many more years of making music where it is really needed.

 

24 hours for Wishing Well!

Programme Director Jo White is taking a 24 hour sponsored challenge for Wishing Well!

“The music starts…and it all comes flooding back”

We urgently need to raise funds so that we can keep bringing the extraordinary benefits of music making to people who are living with dementia.

So – I am organising a fund-raising, music-making, non-stop 24-hour jam in Brighton. I will play music for 24 hours pretty much non stop using my voice, my accordion, music technology, percussion and anything else I can think of from sunrise on the 25th until sunrise on the 26th November. I will be joined throughout the 24 hours by a whole load of musicians friends; community choirs, fiddle players, sing songwriters, experimentalists and improvisors. The event will take place in the exquisite Regency Ballroom of Angel House, right on the seafront in Brighton. I’m, slightly nervous…and very busy pulling together creative ideas and sorting logistics but I am very very excited!

I want to fundraise personally and creatively for people with dementia because every single day in our work we see the difference that music makes. The late great Oliver Sacks called music ” the past embedded in amber”. I think of it like this; when we make music with people that is meaningful to them, it’s like shining a light on who they are; personalities shine through and they are illuminated. They connect outwards again like a flower unfurling

Please help us support people with dementia

You can sponsor me through my JustGiving page here

Or TEXT  WWJO48 £5/£10/£25 to 70070

 

“The music starts…and it all comes flooding back”


 

We’ve been working with people with dementia at Arundel Community Hospital in West Sussex as part of a research study with Sussex Community NHS Trust. A few of the many beautiful moments of joy and connection shared between musicians, patients, families and nursing staff are captured here in this short film commissioned by Sussex Community Foundation NHS Trust and made by West Creative.

The study investigates how live music making helps people with dementia and their families feel less anxious and better connected during their hospital stay. Are musicians a valuable resource for busy hospital wards? Does making music help hospital staff to engage in meaningful ways with their patients? We’ll be sharing the findings later this year.

You can watch the film here

Personal reflections from the Wishing Well musicians in healthcare

To help us learn more about the impact of music making in hospitals on our team of musicians, the healthcare professionals they work with and the children and families they support we commissioned an evaluation from Dr Anneli Haake. Dr Haake carried out a thematic analysis of the reports that the Musicians write up as part of their reflective practice as Musicians in Healthcare.

Her independent study found results suggesting a number of things:

  • the Wishing Well programme has positive effects for patients, families and caregivers
  • a balance is needed between welcoming staff’s assistance in prioritising which patients should take part in the music activities and allowing the musicians to use their expertise when approaching patients, in order to achieve the most positive outcome for patients
  • opportunities for musicians to practice self-care are necessary in order to avoid “burn out” and emotional trauma
  • Building and strengthening relations with staff seems helpful for these types of music making programmes

Dr Haake writes, “The musicians all observed positive effects for the patients, consistent with research on the effects that music in children’s hospitals can have. These included enhancing cognitive abilities, communication skills, and physiological abilities. The parents/caregivers also responded positively to the music sessions, which is likely to have a positive effect on the child.”

The report highlights how effective music making can be in reducing the anxiety of children and young people in hospital:

One of the nurses told us we were needed in medical ward, and that a member of the medical staff had asked for us to visit a young person who was currently having a panic attack due to pain. We arrived at the bedside and the young person was visibly distressed, with shallow rapid breathing, visible tension in the face and body, and wincing vocal sounds. A member of the medical staff was on one side of the bed and mum was on the other. The medical staff was speaking gently to the young person to try to calm him, and saying “just focus on the music”. The young person’s’ breathing became slower and more regular, and their body visibly relaxed, until they reached sleep. The medical staff thanked us after, saying “that was perfect”.

The positive effects for parents were also shown to be widespread, from helping to build positive memories and experiences of parenting as part of a child’s end of life care to helping parents grow more confident in bonding and communicating with their children in a hospital setting.

Dr Haake explains the staff worked in synergy with the musicians, recommending their patients for musical interactions and briefing the musicians on the challenges the children and families were facing. Both musicians and staff found they could work most effectively to improve the experiences of children in hospital if they worked together.

To read the full report on how Wishing Well is making a difference to the lives of children and families in hospital, head to the Wishing Well website’s new evaluation section.

New film shows the musician’s side of working with people with dementia

A little while ago, our Wishing Well programme with people with dementia was featured on BBC South East. Shortly after, we received a very moving letter from the daughter of one of our participants, thanking us for, “giving me my Mum back, albeit briefly”. She had seen her Mum on the film, smiling gently and singing song lyrics with our musicians. Her response was subtle, but showed more engagement than her daughter had seen in many months. It brought her comfort to know that her Mum could still experience joy.

It takes skill to create a musical interaction on a busy hospital ward; to work with someone with dementia to find that song from their personal sound track that holds so much meaning for them it brings them back into the world. Our Musicians in Healthcare are all professionals. We have in depth training and a strong vocation to do this work as well as a deeply held belief that no-one is beyond the reach of music, based on personal experience of hundreds of interactions and a growing evidence base from the media and academia.

Our new short film, funded by Arts Council England and made by Sarah West of West Creative explores how we use music making to build a bridge across the anxiety and isolation that the condition causes and to help people connect with the world around them again. One Nurse described this as like “watching a flower unfurl”. I hope the film encapsulates that.

Jo White, Wishing Well Programme Manager

Giving disabled children the chance to take control: A mentee’s reflections

Our Musicians

We had a visit recently from the amazing, Sophie Partridge who is an actor, writer and workshop artist. She is currently taking part in a mentoring programme with Drake Music and her mentor is the equally amazing, Graham Dowdall who also works with us here at Rhythmix.

As part of the mentor programme, Sophie got in touch to ask us if she could come and see Graham working on our project at Chailey Clinical Services in East Sussex. This project is part of our Youth Music funded Wishing Well programme which takes participatory music making into healthcare settings across the county.  Chailey Clinical Service is a residential ward for young people with very complex health needs and disabilities. We were delighted to welcome Sophie to the project; here are her reflections (we have changed the names of the participants)


As part of my mentoring with Drake Music, I asked my mentor, Graham Dowdall if it would be possible for me to observe his sessions at Chailey Clinical.  Graham’s sessions involved him working 1 to 1 with a small group of disabled young people, who varied as much in age as impairment but other than that, I wasn’t sure what to expect.  That label of `profound & multiple disabilities’!

If I had a preconception about attendees of such a session at Chailey, it was that these would be disabled people who, with the best will in the world, are done “to” and  “for”.  Through working with Graham, I knew that the aim of the session was to provide an opportunity for people to do for themselves and that can only be a good thing.  When Ben woke up, his Support Worker said “Bet you’re wondering why you’re not in bed!” (with that cold I would have wanted to be!).

Our Musicians

This for me, this seemed an indication of how little control Ben and Jack have over their lives.  To be able to exert any influence at all over their environment and activities, even if `only’ activating sound through an app, is therefore  important.  It is a “can” amongst the “cant’s” of a disabled person’s experience. I have no problem with all the “cant’s” in my life but I very much value my “cans” and have a feeling so do Ben and Jack.  They asserted themselves in the session and through their own actions. It takes communication, trust and time between all those involved; Ben and Jack, Graham as `facilitator’ and the support workers to achieve that.

Both Ben and Jack, with what I felt to be considerable effort on both their parts, activated soundscapes through minimal hand movements across iPad screens.  Although unable to hold the more ‘traditional’ instruments, Graham used them to accompany their iPad soundscapes and music was made.

At the beginning of the session, it seemed we wouldn’t take up the allotted 2 hours as there were only 2 participants but even with the health challenges encountered, challenges that are everyday occurrences for both young men and those who support them, we reached the end of that time easily.

I enjoyed the session.  I think Graham, Ben and Jack and those that supported them did too.  When people are nonverbal, enjoyment and satisfaction are expressed differently; eye contact, hand gesture and a smile of recognition and appreciation of someone’s presence with joint effort to access music, say just as much as words.  And being able to initiate sounds & music of your own choosing!  No one need be powerless or without control, devoid of pleasure or expression what-ever their needs are.  I just hope Ben and Jack  have these opportunities increased.


Sophie’s observations really get to the heart of Graham’s work at Chailey. This is patient, frankly quite tricky work and Graham has devoted hours and hours into a building a relationship with these young men that enables them to be creative in their own way and that allows Graham to recognise the subtle signs of engagement, experimentation and creativity. Ben and Jack are full time residents at Chailey and their opportunities to engage with people, things and ideas from the “outside world” are more limited than any of us can really understand.

But once a week, Graham arrives. Graham is a community music legend who is responsible for training most of our team here at Rhythmix, myself included (he likes to remind me that I wasn’t the best student back in the day.) His commitment to finding a way to make music with Ben and Jack is extraordinary and he does it in a way that is completely appropriate to their musical tastes. It’s a bit uncomfortable to talk gender sometimes but it’s been important for these young men to have a male figure in their lives. The staff at Chailey told us a long while back that they are surrounded by female carers, nurses and support workers. They have no other men in their lives; let alone one with whom they could make a bit of dubstep.

Our huge thanks to Sophie for visiting our work and sharing her thoughts with us. You can find out more about her work here: http://sophiepartridge.co.uk


 

Jo White

Programme Director for Wishing Well

Rhythmix

 

A Paramedic’s Perspective

For one reason or another, I got to spend a little bit of time recently  in an ambulance with a paramedic from my local hospital.

I talked about how making music can help to reduce the boredom and anxiety experienced by children who spend long weeks and months in hospital and how the sound ecology of hospital wards can have a very negative impact on young people. I told him about some of the older people that we work with who are living with dementia; people who can’t remember who their own daughters are but who can sing along to every line of “Fly me to the Moon”.

I expected a bit of cynicism back or maybe a polite nod, but the Paramedic grinned and handed me his iPod. It was loaded with songs from the 1930s, 40s and 50s.

He said that he assessed a lot of older people in his job and that a lot of those older people were living with dementia and got understandably anxious about the journey to hospital. So he rigged up a speaker system in the back of the ambulance. He plugs in his iPod and plays music that he thinks might be familiar to the people he meets. He said it is just incredible how much it reduces their anxiety.  He’s a musician himself and likes to sing along. The music gives him something to chat about; it creates a connection.

I am so often struck by how many professionals I meet in the NHS who completely get why music is so important to the people they look after and who can articulate the benefits of either listening to or taking part in music far better than I can. And while proper evaluation and research is vital, in my experience, healthcare professionals do not doubt what they see with their own eyes. They absolutely know what a child experiencing the joy of music looks like. I am reminded by this meeting of how much we have learned as an organisation from healthcare professionals who seek to care for, as well as cure; who see the child beyond the health condition and who understand the place of music alongside clinical interventions.

3 years on I am still blown away by this statement made by Dr. Kamal Patel one of our “champion” Consultants at The Royal Alexandra Children’s Hospital.

“There is no medicine that I can give a child, that makes them light up the way that music does. Music…helps me be a better therapeutic agent for the children I look after”

As we drove along, the inevitable questions were asked about what I do for a living and I told him about “Wishing Well”, the Music in Healthcare programme I manage for Rhythmix.

Last year we were asked by the Brighton and Sussex Medical School to run an optional Music in Healthcare module for student Doctors as part of their third year studies. The eight-week module enabled the students to tap into their own musicality and to use this to create interactions with children in the High Dependency Unit at The Royal Alex. I was impressed by the students. They clearly grasped the skills needed to make music with very poorly children and could see how these same skills would help them be better Doctors. Skills like sensitivity, trust building, creative thinking, team work, self-reflection, mirroring and observation.

One student’s comment particularly struck me:

“I have finished my Paediatric medical training but no one has taught me how relate to children. I am in my early twenties, I don’t have any younger siblings, nieces or nephews. I have never actually picked up a baby. This course has given me a way to build trust and rapport with children and I feel much more confident for it.”

This year we are running our Music in Healthcare module again. Working with student-doctors gives us an opportunity to demonstrate how Musicians can be used as a resource in acute hospital settings, to advocate to a wider audience and hopefully to broaden students perceptions of how they can help their future patients in a wider, more holistic sense. They may end up working on a ward with a participatory Music in Healthcare programme where they can support the integration of music into the daily life on the ward. They may incorporate simple techniques and ideas into their own practice, using simple songs or percussion games to build trust or to distract an anxious child. Like the Paramedic who bothered to think about how he could use music to reduce anxiety. He didn’t need to run a clinical trial or raise thousands of pounds to do this. He loaded an iPod and bought the right lead with him to work.

Towards the end of our journey, as we approached the Hospital, the Paramedic said to me “There is no culture on earth that doesn’t make music. Its universal. I don’t understand why music isn’t integrated into hospital care”.

I thought “That sounds familiar” and said “No, me neither”