Music as mirror in the care of elderly people with dementia
In this chapter I will consider instances of music making and listening to music as a music therapy response to the needs and sometimes wordless communications of people who are in the late stages of their life and have some form of dementia. Many people with dementia, carers and professionals alike have found it to be satisfying to make music in care and community settings, but the focus of this chapter is upon music making in and as therapy. The therapeutic approach, in keeping with the topic of this book, is psychodynamic. In the instance of music therapy, this means that the moment by moment process of relating through music is considered as central to the work, alongside ongoing observations that may include, where possible, some assessment of the impact of sessions over a period of time. I will examine how, through free unplanned music making, a sense of empathic ‘recognition’ between a person with dementia and a therapist can occur, providing some experience of what may be understood as a musical ‘looking’ and ‘seeing’. I will consider the processes and interpersonal relating in music as analogous to Winnicott’s view of psychotherapy that is ‘by and large … a long-term giving back of what the patient brings. It is a complex derivative of the face that reflects what is there to be seen’. I will discuss two case studies which illustrate work in day care settings but with very different themes. Whilst in both instances a substantial amount of music making took place and there is much that could be considered from the perspectives such as musicology or sociology about the act and content of the music making, the focus of my considerations of this work will be upon the interpersonal experience of the music that was made.