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Live Concerts Break Through Resident Isolation

September 1, 2003
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LTC residents benefit in numerous ways from live musical performances BY SUSAN E. MAZER
Live Concert Break Through Resident Isolation

The author's company brings residents and musicians together, up close and personal

BY SUSAN E. MAZER Musician Vince Guaraldi once said, "When I walk into a room, I make a noise so that I won't feel alone." For most of us, sounds may cut through the momentary loneliness imposed by silence, but isolation caused by age, illness, hearing and visual impairments, and other diminished capacities is not so easily rectified. Although described, documented, and acknowledged as a risk factor, involuntary solitude remains pandemic among the elderly. For the institutionally confined elder, the visits of the postman or delivery truck driver, seeing long-term neighborhood acquaintances, enjoying fellowship at church, and other activities that bring people together contribute to a quality of life that is no longer available. Despite media rhetoric about addressing the aging population's needs, long-term care residents and the facilities in which they reside are subjected to individual and collective isolation. The community at large, preoccupied by the busyness of living, marginalizes population segments that are unable to fend for themselves. A sense of community beyond that contained within the walls of a long-term care residence is important to improving the quality of life of the confined elder. Within the facilities themselves, individuals meeting for the first time under stressed circumstances live (and die) under one roof, eat in the same dining room night after night, and experience publicly their frailties, habits, and daily struggles. While residents may become united in the progression of the aging process, the inevitable changes are seldom positive. Residents stay until either they become acutely ill and transfer to another facility, or they die. In either case, progressive loss is ongoing and probably expected. Without a community presence relieving the isolation, the culture of illness and debilitation overtakes a culture of living.

One of the many benefits of music is to bring people together and act as a socializing force-a way to change isolated individuals into a group of people whose commonality is created in the moment by a shared experience. Furthermore, the relationship between a musician and audience adds another component of social and personal enrichment. A musician coming into their "home" to perform is seen by residents as a sincere form of intention and attention.

Research studies and anecdotal reports have verified the profound value of live performance, and studies in the fields of gerontology and music therapy have shown that, among other physiologic outcomes, appropriate music can alleviate depression, reduce agitation, increase cognition, and stimulate memory. Furthermore, the music also benefits family members who may be present, and the professional caregiver's day-to-day work life is likewise enhanced.

Integrating live music into the culture of long-term care also invites, if not creates, other rituals that optimize the experience. These may include snacks (before or after a performance), social activities designed around the event, an opportunity to dress for the occasion, programs to further introduce the event, and preparation on the part of both the musicians and the facility.

Performers in Facilities
Throughout the country, many organizations provide entertainment for the elderly. For example, Bread and Roses, a nonprofit organization in San Francisco, has been providing concerts for the institutionally confined (including hospitals, correctional facilities, and others) since 1974. The Music Therapy Association of British Columbia has active resources to support music for the elderly. Major musical performers, such as Wynton Marsalis and Bobby McFerrin, have made performing at hospitals and long-term care facilities part of their professional missions. Other volunteer groups and musicians in numerous communities across the United States provide music for the ill and elderly. All of these events are most effective, most generously provided, and much needed.

The Elder Care Concert Series
Recognizing the need for and benefits of live music for the elderly, Healing HealthCare Systems-a company that produces environmental programming for patient television-funded the first Elder Care Concert Series in its community of Reno, Nevada. With administrative assistance from the Sierra Arts Foundation, Healing HealthCare Systems' goal was to bring artist and audience together, specifically to enrich quality of life by providing live music for the confined elder. This was not meant to be a one-time event, but to be provided on a regular basis, so that the music becomes part of each facility's culture, and equally part of each resident's life. Achieving the goal was expected to provide long-term benefits, rather than short-term gains. It was also hoped that staff members would be able to use the events to further enhance their ability to serve the psychosocial needs of residents and families.

The initial seed funding from Healing HealthCare was $5,000, which drew matching funds from the Reno Arts and Culture Commission. The administrative costs of managing the series-$2,200-covered scheduling performances, contracting for facilities and musicians, collecting data, and attending each event to ensure quality. Fees for the musicians are $90 for a soloist or ensemble leader and $60 for each ensemble member. With an average cost of $50 per event for administration, the total expense for each event is approximately $140 to 270, based on the number of musicians performing and a local performance payment scale established by the musicians' union.