Evan Dawson

Evan Dawson, Executive Director of the national charity Live Music Now, discusses the report 'Live Music in Care', which has broken new ground in studying the impact of participative music programmes on whole care environments – including older people and employed care teams. 

Throughout the world, improvements in medicine, hygiene and nutrition have led to much longer life expectancies. This is a huge achievement for our species. However, it has placed greater strains than ever before on the social systems that support older people, particularly those living with dementia.

On top of this, a career in adult social care can be very challenging, and staff ‘churn’ adds significantly to the difficulties placed on care home management. Under such circumstances, many care home managers might reasonably resist the suggestion that they prioritise introducing a new music programme. However, those care homes that have embraced music have seen significant returns on their investment, leading to better living and working conditions for everyone. 

Live Music in Care is the result of a research enquiry that has been supported by 35 national organisations in the social care and arts sectors, working together since 2015 under the banner A Choir in Every Care Home, initially funded by the Baring Foundation. They are united in their vision to inspire and support care homes throughout the UK to introduce more and better music engagement for older people.

Over the past three years, the group surveyed the many creative ways that older people engage with music, and explored why the majority of care homes do not regularly offer this opportunity. They uncovered a wealth of evidence supporting the use of music for older people, particularly for those living with dementia. This work earned recognition as a finalist in the Health and Wellbeing Awards 2017.

Despite the wealth of published evidence, they also found there was only limited evidence available about how music programmes can impact on a whole care home. So, from June 2017 to August 2018, Live Music Now and the University of Winchester worked in partnership with MHA (Methodist Homes) and The Orders of St John Care Trust to investigate the impact of music on residents, staff and the whole care home environment.

This project sought to evaluate an intervention comprising an 11-session interactive weekly music programme, including training for staff, in five care homes in the UK. The programme was delivered by Live Music Now. The programme focussed on singing and the use of voice, led by pairs of trained professional musicians for 45 minutes each week. A mixed methods approach was used, with favourable ethical approval for the study received from the University of Winchester Ethics Committee.

Data were drawn from 15 observations of the music sessions in the care homes guided by the Arts Observation Scale (a tool for the evaluation of performing arts activities in healthcare settings). Five reflective interviews were also undertaken with members of the care teams involved, also conducted by a member of the research team.

Both data sets were gathered by a member of the Live Music Now team, and in addition, data were gathered using staff questionnaires, and online questionnaires for those musicians taking part.

Thematic analysis identified six themes, leading to the following five conclusions:
  1. Participating and delivering a music intervention to residents in care homes can provide positive social experiences as well as creative engagement, fun and a sense of achievement. 
  2. Musicians can play an important role in nurturing the wellbeing of elderly people in care.
  3. Regular music making can enhance the working and living environment for care home residents and staff.
  4. Music interventions can play a crucial role in awakening a sense of identity and empowerment for care home residents, facilitated by musicians and care teams working together.
  5. Strategic planning at the outset establishes an essential structure and definition of tasks that provides a framework for the music programme.
These led to a series of recommendations, the main one being:

“Carefully delivered music can provide significant benefits for older people, care staff and care settings, contributing to person-centred care. We recommend that regular participatory music programmes be considered essential for all UK care homes.”

The report was published this week, and presented at the National Care Forum and Care England conferences and is available for download (in full and summary forms). As well as presenting the evidence about WHY participative music should be used more widely, it also described practical steps about HOW care homes can embrace this opportunity.

The reaction so far has been very positive:

“The excellent Live Music in Care report is a big step forward in showing what live music can do. This is much more than simply entertainment. If done well, live music can help care homes achieve all the key indicators of quality person-centred provision that CQC inspectors are looking for.”
Andrea Sutcliffe, Chief Inspector, Care Quality Commission

“We have known for some time that carefully delivered music activities can provide significant benefits for people who live and work in care. At last, this important report presents rigorous evidence showing how music can impact on whole care settings, not just on individuals. There should no longer be any excuses - live music programmes should be essential for all UK care homes. This report shows why, and what practical steps care homes can take to embrace this.”
Professor Martin Green OBE, UK Govt Dementia Champion, CEO of Care England

“At Live Music Now, we provide thousands of evidence-based music workshops for older people each year, throughout the UK. This report shows that we need to go even further, supporting those many care homes who have not yet had the opportunity of seeing the benefits of participative live music, and helping them to rise to the challenge. I hope you will join us on this important journey.” 
Sir Vernon Ellis, Chairman of Live Music Now

“The University of Winchester is pleased to have been able to work together with all our partners to design and evaluate this participative approach to live music making. These findings add to a growing body of evidence and provide key recommendations as to how music making can implemented in care homes. The report offers an effective, sustainable approach to providing meaningful and beneficial activities that can enhance the quality of live in care for both the residents and the staff.”
Dr David M Walters FRSPH, Director of Centre for Arts as Wellbeing 

Main project partners and funders