News & Blog
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.
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.
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
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
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.
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
