The Music, Mind & Movement (MMM) Program

Transcription

1 The Music, Mind & Movement (MMM) Program A therapeutic group music program for people with mild cognitive impairment and dementia Olivia Brancatisano, Joanne Cook, Amee Baird & William F. Thompson

2 The Music, Mind & Movement (MMM) Program A therapeutic group music program for people with mild cognitive impairment and dementia Copyright 2018 Olivia Brancatisano, Joanne Cook, Amee Baird & William F. Thompson

3 Contents Project overview a) Why Music? b) The 7 attributes of music... 1 c) Development of the MMM program... 2 d) Aims of the MMM program... 2 e) Who is this program designed for?... 3 f) This manual Getting started g) Equipment... 4 h) Participant information...4 i) Program facilitators j) Setting up The 7 MMM Sessions k) Overview Block l) Session m) Session Block n) Session o) Session Block p) Session q) Session Block r) Session References and Further Reading Contributors Appendix 1: List of Songs Acknowledgements

4 a) Why music? 1. Project Overview Music is a powerful stimulus that can have a range of beneficial effects on both healthy people and those with neurological disorders such as dementia, stroke or Parkinson s Disease (for reviews see Altenmuller & Schlaug, 2015; Baird & Samson 2015; Thompson & Schlaug 2015; Wan, Ruber, Hohmann & Schlaug, 2010). For example, musical activities can improve mood and behaviour by reducing symptoms of depression and agitation. It can also improve cognitive or thinking skills such as memory. Music is uniquely effective at stimulating personal memories and emotions, and in doing so it can enhance a person s sense of self. It can provide a means of non-verbal communication, even in those who have lost verbal communication skills. b) The 7 attributes of music How does music have these positive effects? In their review of the current scientific literature on the therapeutic benefits of music, Thompson & Schalug (2015) propose 7 attributes of music that make it an ideal stimulus to use as a treatment tool to address various symptoms of neurological disorders. Music is engaging and persuasive; it stimulates people s attention and motivates them to take part in the activity. Music elicits physical movements such as foot tapping and clapping. It encourages us to synchronise our movements in a precise and repetitive manner and to coordinate our rhythmic movements with others when in a group setting. In this way, participating in music activities is social and can stimulate physical and verbal interactions between participants. Familiar and favourite music can stimulate personal memories and emotional responses.

5 c) Development of the MMM program The MMM program has been developed as a therapeutic group program which involves 7 weekly sessions that are based on the 7 attributes of music (Figure 1). It aims to incorporate both active and passive music activities that engage the individual, stimulate physical movement and encourage communication, such as sharing memories evoked by favourite songs. The MMM program has been piloted with people with a diagnosis of dementia at Warabrook Baptist aged care facility (Newcastle). The results of this study forms part of the forthcoming PhD thesis of Olivia Brancatisano, supervised by Dr Amee Baird and Professor Bill Thompson. d) Aims of the MMM program The MMM program aims to target specific domains of functioning which are known to benefit from the positive effects of music (Figure 1): 1. Cognition (e.g. memory and attention)- Familiar, personally preferred music can access autobiographical (personal) memories. Further, listening to and engaging in musical activities can enhance attention and facilitate expressive language. 2. Motor skills (verbal and motor fluency)- Rhythmic music and synchronising physical movements with others can facilitate movement. 3. Psychosocial functions (mood and identity)- Favourite songs promote reminiscence which can enhance the sense of self. 4. Behaviour (agitation and social withdrawal)- Being part of a group music program encourages individuals to socialise. In addition, employing musical exercises that facilitate social interaction, such as playing music in synchrony with each other, allows for social bonding.

6 MMM Program 7 Attributes of Music: 1. Persuasive 2. Engaging 3. Emotional 4. Personal 5. Physical 6. Synchronous 7. Social Outcomes Cognitive (memory & attention) Psychosocial (mood & identity) Motor (verbal & movement fluency) Behavioural (agitation & withdrawal) Figure 1. Therapeutic Music Capacities Model detailing the 7 attributes of music and outcomes.

7 e) Who is this program designed for? Anyone can participate in the MMM program, but it has been specifically designed for people with neurological disorders such as dementia or Parkinson s Disease. Individuals with a hearing or language impairment may have difficulty participating. f) This manual This manual is a step-by-step guide of how to run the MMM program. It details the types of music activities to include to maximise the effect of the 7 music attributes. Activities and equipment can be modified, omitted or added to suit the participants needs. PowerPoint (PPT) slides have been developed as a step by step guide for each session. These accompanying slides can be displayed during the session as a guide for the facilitator (listed in green on the left-hand side).

8 a) Equipment 2. Getting started Musical Instruments - Egg Shakers (1 per participant) - Bucket drum and 2 sticks (per person) Optional other equipment - Colourful streamers - Small bean bags - Balloons Technology: - Speaker and mp3/cd player (essential) - Laptop (optional) - Projector (optional)

9 b) Participant information Before starting it is important to find out some information about the participants e.g. any mobility issues, one or two favourite songs/artists/ genre of music. If they are unable to provide this information there are some options in Appendix 1. Songs from when participants were aged years (also known as the reminiscence bump or the time of a peak in autobiographical memories) are most effective at stimulating memories so choosing songs from this time period is suggested. c) Program facilitators Any recreational officer (RO) can facilitate the MMM program using this manual as a guide. They do not need to have any formal music therapy qualifications, music training or experience. The number of facilitators required depends on the number of participants in the group. The ideal group size is 8-10 participants. Ideally there should be 2 ROs to facilitate each session. This allows for one to run/explain the activity and the other to work the PPT slides and assist participants engage in the task. d) Setting up Place seats in a half circle to face the projector screen where the PPT slides are displayed (if available). It is best if one facilitator sits at the front by the projector screen and the other approximately half way around the circle so that they are equally spread around- this enables a social environment rather than a teaching style environment. Set up the bucket drum, sticks and shaker in front of the participants so that they are easily accessible.

10 3. The MMM Sessions There are 7 sessions in the MMM program which are categorised into 4 blocks. Each block focusses on the 7 specific attributes of music that make it an ideal treatment tool: - Block 1 (sessions 1 & 2), focusses on the attributes persuasive and engaging - Block 2 (sessions 3 & 4), focusses on the emotional and personal attributes - Block 3 (sessions 5 & 6), emphasises the social, physical and synchronous attributes - Block 4 (session 7), draws upon all the attributes and involves live music playing (such as music students from the conservatorium). The duration of each session is approximately 45 minutes. This allows approximately 10 minutes for each activity. The timing of each activity can be extended or shortened as desire, and there is an optional activity outlined in each session if there is extra time. Each block is comprised of activities which are repeated and extended in the following session. This is designed to give the participant a sense of familiarity and mastery and to build on skills that they learn.

11 4. Block 1: Sessions 1 & 2 Music is Persuasive and Engaging How is music persuasive? Music has the capacity to influence us and has been used historically as a tool to reinforce, change or inspire beliefs. For example, messages in advertisements are highlighted and enriched by music. Music is engaging in a multitude of ways; it engages multiple networks within the brain simultaneously and it is pleasurable, which tends to increase motivation for participating in treatment. The first 10 minutes of Session 1 should be spent welcoming the residents, introducing the facilitators and the participants to the program (detailed below and in the PPT slides). Session 2 extends the activities of session 1.

12 Music is Persuasive and Engaging Session 1 Activity Description Notes to Facilitators Initial description (PPT slides 1-10) 10 mins Introduce the MMM program as per the slides Describe the 7 attributes of music and show short videos (1 and 2) Discuss videos and how the participants think music is therapeutic Discuss their experience with music: Do/did you like to sing/dance? Have you ever play a musical instrument? It is important here to emphasise the 7 key attributes of music, explaining each one and giving examples (see the descriptions at the beginning of each block or the article by Thompson & Schlaug, 2015 The Healing Power of Music for more information). Activity 1: Introducing each instrument (PPT slides 11-13) 15 mins First introduce participants to the shakers. Give a brief demonstration Describe the sound to them e.g. gentle/fast/loud/soft Choose one song for participants to shake along with Do the same introduction with bucket drum and streamers When playing along to songs encourage participants to vary how they play the instrument (based on each individual s ability): For the sticks and streamers- with hands up high/ low, to left/ right, in front/behind, around in circles in front of them and then even switching hands to increase mobility. For bucket drums- tap middle, edge, side of drums; tap sticks at same time or alternating; slow/ fast, loud/soft; tap sticks together low/high; tap the floor.

13 Activity 2: Learning names to music (PPT slides 14-16) mins Start with saying an example of the instructors names emphasising the rhythm of the syllables (e.g. JO-ANNE, O-LI-VI-A). Say one name and sound it out with the rhythm (voice only), then say the name and play it to the rhythm on egg shaker first (e.g. JO-ANNE is 2 shakes, O-LI-VI-A is 4 shakes) Then begin by introducing My name is JO-ANNE and shake on each syllable (e.g. 5 shakes) Ask a participant can you try it with your name Go around room saying rhythm to names Extend to melody- start on a higher pitch/note and then alternate between a high and low pitch follow a pattern such as My name is JO-ANNE e.g. * * * * * The idea behind this is that learning a name to a rhythm or melody provides an external framework to help them remember it, so emphasis should be placed on enjoying saying their name to a rhythm (first), then melody later, and if successful combine rhythm and melody. Activity 3: Game: Guess that advertisement (PPT slides 17-23) 5 mins Explain advertisement activity we are going to listen to old advertisements with and without music and guess what they are conveying Play audio of first ad (see PPT) Match to photo It is important during this activity to convey the message of why advertisements use music; e.g. because the tunes are catchy, memorable, and music persuades the listener. Optional Activity: Which advertisement is more persuasive? (PPT slides 25-31) Play the first video advertisements without music Then play the same advertisement with the music Ask participants which advertisement is more convincing and why? It is important to choose advertisements with a catchy, memorable jingle that emphasises the message of the advertisement (see examples on PPT slides). As an option, after a few minutes you can show the last slide displaying pictures of each item advertised and ask which do you remember the most clearly?

14 Music is Persuasive and Engaging a) Session 2 Activity Description Notes to Facilitators Activity 1: Familiarity with each instrument (PPT slides 32-33) First play the song with ribbons for a warm up Then play a second song with the shakers Finally, a third song with the buckets This is to ensure familiarity with the instruments. Again, when playing along to songs encourage participants to vary their movements (see Session 1, Activity 1). 15 mins Activity 2: Game: What is that song advertising (PPT slides 34-40) 5-10 mins Explain activity we are going to guess what these old advertisements are trying to sell by listening to the song only Play audio first and let participants listen twice if necessary Ask them what do you think it is advertising and why do you think that? Reveal answer and discuss In this activity, we want to get across that the ads use songs that match and emphasise the meaning.

15 Activity 3: Learning names and what you like (PPT slide 41) 15 mins Familiarise participants with what was done last week. Recap with example of the instructors names- saying the names firstly with the rhythm, then with melody, then with both. Go around the room and practice this again Then introduce a new sentence Tell us something you like e.g. your favourite food My name s Jo and I like chocolate - sound it out with the rhythm (voice only), then say and play rhythm on egg shaker (e.g. cho-co-late would be 3 shakes) Ask a participant to try it with their name and one thing they like (e.g. my name s Pam and I like pudd-ing Extend to melody- start on a higher pitch/note and then alternate between a high and low pitch follow a pattern as in Session 1 Follow the same steps as in week 1- begin with vocal/saying rhythm, then play rhythm/syllables on egg shaker, then melody/singing with the rhythm. Encourage all participants to try even if they are only able to focus on one aspect (e.g. rhythm or melody only). If participants are feeling confident with this activity, you can omit the last word and play only the rhythm/melody as a guessing game to see if they can remember the last word through only the rhythmic or melodic clue e.g. My name is Jo and I like... (3 shakes). You can also extend the rhythm to playing on the bucket drum instead of shakers Activity 4: Game: Where does this song belong? (PPT slides 42-50) Play approx. 30 secs of song whilst showing 2 pictures from different contexts Ask participants which setting do you think best matches with the music and why? Discuss reasons Again, this game emphasises how music enhances meaning minutes Optional Activity: Old advertisements (PPT slide 52) Singing and playing to old advertisements Pick some old famous advertisements and sing along to them

16 5. Block 2: Sessions 3 & 4 Music is Personal and Emotional Music is personal through its ability to reinforce our sense of self. Music that is heard repeatedly during significant or pivotal times in our personal development eventually signifies that time of life. In this way, music is a powerful stimulus for autobiographical memories. One of the most significant purposes of music is to convey emotional meaning. Music plays an important role in re-gaining access to emotions and memories. Specifically, singing and instrument playing has an innate power to express intricate emotions and can be a simple way to foster a sense of security and bonding. Music in this session should include the participants favourite songs as well as songs that were popular during the time the participants were aged years of age (their reminiscence bump as described earlier). The aim of this block is to encourage discussion about personal memories and emotions evoked by music.

17 Music is Personal and Emotional a) Session 3 Activity Description Notes to Facilitators Activity 1: Game: Who sang that song? (PPT slides 53-57) 10 mins Play approx. 10 seconds of a famous song- then pause and ask participants to guess the name and artist of the song. Ask the participants does the song bring to mind any personal memories (e.g. a person, a time in their life)? Discuss any memories evoked Once they guess correctly you can continue playing the song and they can sing along. Activity 2: Music and our emotions (PPT slides 58-59) 10 mins Explain how basic musical elements can make us feel a certain way e.g. loud and fast music might trigger feelings of excitement or anger, while soft and slow music can make people feel calm or sad. Play examples of loud, soft, fast and slow music with participants on shakers and bucket drums. Then go around the room and ask the participants how would you play the instrument if you were feeling.? a certain emotion. Examples of how to play certain emotions are: Slow and soft: sad, tired, exhausted, hopeless Slow and loud: angry, annoyed Fast and soft: happy, nervous, silly Fast and loud: excited, rushing Activity 3: Game: Which movie does the soundtrack belong to? (PPT slides 60-66) Play approx. 30 secs of song whilst showing 2 pictures from different movies Ask participants which movie scene do you think best matches with the music? Why? Discuss reasons Encourage discussion about why the song conveys this emotion. Use the elements discussed (slow, fast, loud, soft). Does it sound happy, sad? Participants may also enjoy discussing if they have seen the movie. 5 mins

18 Activity 4: Reminiscence (PPT slides 67-72) 20 mins Listen to approx. 1 minute of one participant s favourite song and then ask that individual: Why is it your favourite song? Do you have any personal memories associated with the song? Are the memories positive/negative and vivid/not vivid in your mind? Does anyone else have memories triggered by the song? It is important to encourage discussion of personal or autobiographical memories (rather than just details pertaining to the artist, although any discussion is beneficial). Direct reminiscence questions to the participant who identified the favourite song, then encouraging other participants to join in. Optional Activity Reminiscence Continue with reminiscence as described in Activity 1

19 Music is Personal and Emotional b) Session 4 Activity Description Notes to Facilitators Activity 1: Game: Who sang that song? (PPT slides 74-77) 10 mins Repeat Activity 1 from Session 3: Play approx. 10 seconds of a famous song- then pause it and ask participants guess the name and artist of the song. If they are unsure play a bit more and guess again Ask the participants does the song bring to mind any personal memories (e.g. a person, a time in their life)? Discuss any memories Choose different songs to the previous week. Activity 2: Music and our emotions (PPT slides 78-79) 5-10 mins Refresh the idea of how basic musical elements can make us feel a certain way (as in Session 3 Activity 2) Play examples of loud, soft, fast and slow with participants on shakers and bucket drums This time, go around the room and ask the participants to play how they are feeling right now. Facilitators give examples first If they do not seem to wish to engage in playing how they feel you can instruct them to play in a way to reflect a certain emotion that you describe (see Session 3, Activity 2, for examples).

20 Activity 3: Finish the next line of the song (PPT slides 80-94) 10 mins Play the start of a song with accompanying lyrics on the PPT slide Pause song just before you get to the last line of an obvious section See if participants can sing the next line of lyrics without prompting You can do this for the first minute or so of the song and then afterwards let participants sing along to the rest of the song if they wish. Encourage reminiscence with songs. Activity 4: Reminiscence (PPT slides ) 20 mins Repeat Activity 4 from Session 3: Listen to approx. 1 minute of one participant s favourite song and then ask that individual: Why is it your favourite song? Do you have any personal memories associated with the song? Are the memories positive/ negative and vivid/not vivid in your mind? Does anyone else have memories triggered by the song? It is important to ensure that by the end of this session, each participant in the group has had their favourite song played. Optional Activity Reminiscence Continue with reminiscence as described in Activity 1

21 6. Block 3: Sessions 5 & 6 Music is Physical, Social and Synchronous Music is inherently a very physical stimulus. It is hard to separate the experiences of music and dance; when we hear certain types of music we get a strong urge to move our body. Pairing music and movement encourages exercise which benefits cognition, mood and behaviour. Music has a dual purpose; it acts as a catalyst for bringing people together and also enhances group experiences. The social nature of music may be beneficial in boosting the healing process via cohesion, collective enjoyment and a sense of support for one another. We have an instinctive ability to synchronise our body s movements, and speech, to music. Simply moving in time with one another to music has many positive therapeutic benefits, for example, in synchronous drumming there is a release of endorphins and neurochemicals which elicits social bonding, empathy and trust. Try to choose music in this block that is physical (e.g. has a strong beat or rhythm), as this will maximise their motivation to be active (e.g. Glen Miller In the Mood ). It is important to also encourage the participants to play their instruments in synchrony with each other and to engage socially whilst doing so (as you will see in the partner activities below). This type of social engagement will promote the most benefits.

22 Music is Physical, Social and Synchronous Session 5 Activity Description Notes to Facilitators Activity 1: Warm up movement exercises- synching to slow songs (PPT slide 102) 10 mins Demonstrate upper body movements (as below): Warm up upper body to slow song (ear to shoulder, arms- out to the side, out in front, rotating and up in air) Demonstrate lower body movements (as below): Warm up lower body to slow song (heel lifts, toe points, walking motion, point to front and side, left and right) Warm up both upper and lower body faster song (combination of movements for upper and lower body) With each movement start slowly and increase speed if they are able to. If participants demonstrate that they do not want to/are not able to, encourage them to just feel the music with their body and do small movements (e.g. foot tap, head nod, clapping, body swaying). Song ideas for warm up may include: - My Bonnie, Blue Danube waltz (slow upper body) - Por Una Cabeza (slow lower body) - In the mood (faster/ upper and lower body)

23 Activity 2: Game: Does the song match the dance style? (PPT slides ) 10 mins Show video 1 of dance style with music that does not match Ask participants why doesn t the music match the style of dance? Show video 2 with correct style of music Ask participants why does the music match the style of dance? Continue for 3 or 4 dance styles You can use this game as a way to break up the instrument playing/ movement in Activity 3 as participants may get tired and need to rest. Activity 3: Instrument playing & movement (PPT slide 112) 25 mins Optional Activity Instrument playing Select 4 rhythmic songs and play along with: Bucket drums first (tapping Try to make sure that participants are slow, fast, side of the drum, playing in unison with one another sticks together, sticks up and the music. high) Shaker (high/ low, to left/ right, in front/behind, For bucket drum and partner around in circles in front interaction encourage eye contact. of them and then even Switch between facing left/right. switching hands to increase mobility) Bucket drum and shaker (incorporate both) Bucket drums or shaker and partner interaction (participants turn to one another in a pair, and tap each other s sticks at eye level, play the shakers at eye level or play each other s drum, then turn to person on other side). Continue playing or singing in synchrony

24 Music is Physical, Social and Synchronous a) Session 6 Activity Description Notes to Facilitators Activity 1: Warm up movement (PPT slide 115) 10 mins Repeat Activity 1 from Session 5: Warm up upper body to slow song (ear to shoulder, arms- out to the side, out in front, rotating and up in air) Warm up lower body to slow song (heel lifts, toe points, walking motion, point to front and side, left and right) Warm up both upper and lower body faster (combination of movements for upper and lower body) It is important to choose different songs to those played in the previous week. As they are repeated movements from the activity from the previous week, you may be able to increase the complexity/ difficulty by moving slightly faster or combining movements. Activity 2: Game: Match the dance song to the photo Show 2 photos of dance style and start playing music Ask participants which dance style does the music match? Why? Discuss reasons Again, you can use this game as a way to break up the instrument playing/movement in Activity 3 as participants may get tired. (PPT slides ) 10 mins

25 Activity 3: Instrument playing & movement (PPT slide 120) 25 mins Repeat Activity 3, from Session 5: Select 4 rhythmic songs relevant to their era. Play along with: Bucket drums first (tapping slow, fast, side of the drum, sticks together, sticks up high) Shaker (high/ low, to left/ right, in front/behind, around in circles in front of them and then even switching hands to increase mobility) Bucket drum and shaker (incorporate both) Bucket drums or shaker and partner interaction (participants turn to one another in a pair, and tap each other s sticks at eye level, play the shakers at eye level or play each other s drum, then swap pairs). As this is the second session within this block, you can introduce more complex combinations of movements and also increase the speed if they are comfortable. Optional Activity Instrument playing Continue playing or singing in synchrony 7.

26 8. Block 4: Session 7 All 7 attributes with live music a) Session 7 The final session is intended to incorporate all 7 attributes. It involves musicians performing a live version of the participants favourite songs. Live music will be especially engaging for participants and musicians. The use of preferred and familiar songs will bring back personal memories and provide a rich emotional experience. Participants will be encouraged to respond to the music with physical movements and by singing along, allowing them to synchronise their movements and voice with the music, and with other participants, ensuring that they have a powerfully social experience. By combining all attributes, Session 7 emphasises the many benefits of the treatment, making it both persuasive and motivating. Throughout Session 7, participants should be encouraged to interact by: Moving Singing along Playing instruments Reminiscing and Engaging with the musicians

27 References and Further Reading Altenmuller, E., & Schlaug, G. (2015). Apollo's gift: new aspects of neurologic music therapy. Prog Brain Res, 217, doi: /bs.pbr Baird, A.D., Abell, R., Thompson, W.F., Bullot, N.J., Haertsch, M., & Chalmers, K.A. (2018). Group singing enhances positive affect in people with Parkinson s Disease, Music & Medicine, 10, Baird, A., & Samson, S. (2015). Music and dementia. Prog Brain Res, 217, doi: / bs.pbr Baird, A. & Thompson, W.F. (2017). The power of our song, the musical glue that binds friends and lovers across the ages. The Conversation. Published March 17th. Baird, A., & Thompson, W.F. (2018). The impact of music on the self in dementia. Journal of Alzheimer's Disease, 61, Baird, A., & Thompson, W.F. (in press). When music compensates language: A case study of severe aphasia in dementia and the use of music by a spousal caregiver. Aphasiology. Accepted March 2nd, Baird, A., Umbach, H., & Thompson. W.F. (2017). A non-musician with severe Alzheimer s Dementia learns a new song. Neurocase. Thompson, W. F., & Schlaug, G. (2015). The Healing Power of Music. Scientific American Mind, 26(2), doi: /scientificamericanmind Wan, C. Y., Ruber, T., Hohmann, A., & Schlaug, G. (2010). The Therapeutic Effects of Singing in Neurological Disorders. Music Percept, 27(4),

28 Contributors Dr William Forde Thompson is a Distinguished Professor of Psychology at Macquarie University, where he runs the Music, Sound and Performance Lab. He is Chief Investigator of the Centre of Excellence in Cognition and its Disorders, and founding Director of the Centre for Elite Performance, Expertise and Training. His publications include Music, Thought and Feeling (2014) and the Encyclopedia of Music in the Social and Behavioral Sciences (2014). He was elected Fellow of the Association for Psychological Science in 2015 and is currently President of the Australian Music Psychology Society. Dr Amee Baird completed a PhD and MPsych (Clinical Neuropsychology) at the University of Melbourne and has worked as a clinical neuropsychologist for 15 years in both clinical and research positions overseas and in Australia, including the National Hospital for Neurology and Neurosurgery in London and Salpetriere Hospital in Paris. She is an Associate Investigator with the Australian Research Council Centre of Excellence in Cognition and its Disorders at Macquarie University, and is currently funded by a National Health and Medical Research Council/Australian Research Council Dementia Research Development Fellowship for the project Can music mend minds? Investigating the mechanisms underlying the beneficial effects of music in persons with dementia. Olivia Brancatisano completed her MSc in Music, Mind and Brain at Goldsmiths, University of London. She is currently undertaking her PhD at Macquarie University under the supervision of Professor William Thompson and Dr Amee Baird, investigating the therapeutic value of music for individuals with dementia. She is a member of the Music, Sound and Performance Lab and the ARC Centre of Excellence in Cognition and its Disorders. Jo-anne Cook has been teaching music to children for over 20 years both in a classroom setting and private studio. She completed a Bachelor of Music Degree at Newcastle University in 2000 then went on to complete a Diploma in Education (Secondary) in Since 2004, Jo has been working in primary schools as a music specialist, teaching students the concepts of music through performance, conducting concert bands and choirs. In 2017 Jo branched into the nursing home setting with the aim of using music to mentally challenge the brain of the elderly, keeping them active and being social through bucket drumming and learning the ukulele.

29 Appendix 1 List of artists and songs 1. Glen Miller- In the Mood 2. Glen Miller- Chattanooga Choo Choo 3. Judy Garland- Somewhere Over the Rainbow 4. Gene Kelly- Singing in the Rain 5. Nat King Cole- Too Young 6. Doris Day- Whatever Will Be, Will Be (Que Sera Sera) 7. Doris Day- Black Hills 8. Dinah Shore- Buttons and Bows 9. Bing Crosby & The Andrews Sisters- Don t Fence Me In 10. Bing Crosby- Swing on a Star 11. Bing Crosby- White Christmas 12. Perry Como- Catch a Falling Star 13. Frank Sinatra- Come Fly with Me 14. Little Eva- The Locomotion 15. Buddy Holly- Peggie Sue 16. Sam Cooke- Cupid 17. Ella Fitzgerald- A-Tisket, A-Tasket 18. Bill Haley and his Comets- Joey s Song 19. Elvis-It s Now or Never 20. The Beatles- Hey Jude 21. South Pacific- Some Enchanted Evening 22. My Bonnie Lies over the Ocean 23. Oklahoma- Oh what a Beautiful Morning

30 Acknowledgements Thank you to all the residents and staff at Baptist Care Warabrook, for their participation in and facilitation of the pilot studies. In particular, we appreciate the support of Emma Chesterfield for supporting the study. Thank you to the Hunter New England and Central Coast Primary Health Network for the funding to establish this program (Collaborative Health Innovation Project Funding), and also to Scott White for facilitating this funding opportunity.