Music for a While BLOG
BSO Associate – Neil Valentine
Entry 3, 25/07/15
BSO Associate Neil Valentine is working acute older peoples wards in Poole, Portsmouth and Hampshire Hospitals. He will be visiting the each ward once a week for 6 months.This is a collection of his thoughts, feelings, impressions and experiences.
In one setting we have been getting a regular group meeting together, sometimes with the same patients and other times with different ones. The main thing that is great here is that the level of staff allows us to see what is happening. I am often so involved in musical interactions that I am unable to step back and notice small and subtle changes and developments. But with the right experience some of the Staff from the hospitals can do just that.
One particular conversation with a Dementia specialist nurse has stuck with me. We were talking about the ways in which you can diagnose dementia and its different stages. We also discussed how it can be confused and difficult as there are often multiple conditions manifesting at the same time. For instance a patient may have Parkinson’s, or literacy may be an issue, or perhaps English is not a first language so can often a barrier.
She spoke so passionately and clearly about when, during a musical interaction, she was able to see new things going on. A new movement, or a movement not seen for many weeks. A new behaviour, or a change of behaviour. Or perhaps the same behaviour despite a particularly involving musical passage when you would expect a change in reaction.
One particular patient struggles with the English language, is almost completely illiterate and repeats the same stories over and over. These factors make diagnosis of her dementia very difficult. But during the musical interaction, which is to say a new stimulus was presented directly to her, one would expect a variation of behaviour (however subtle) that would let a trained person see that the level of cognition was at a particular stage. However with this patient, despite this quite direct and powerful musical interaction there was no variation in behaviour. It was put to me that it was lack of change in behaviour that confirmed she was stage 3 dementia. Had she been able to process this musical interaction and engage with it she would be diagnosed as stage 2.
It appears that the right musical interaction might allow a trained person to see a patient in a different way To see them interact on another level that is not based on conversational or physical tests. As most methods of dementia diagnosis are based on talking or cognition based activities, music may takes them outside of this and onto a different path. It might allow them to be observed in a new place and in this case produced a window into the patient and helped the dementia nurse to be surer of her diagnosis.