Steps to creating a community-based music

group for people living with dementia and

their carers

This guide is written for those interested in setting up a community

based music group. Every community music group will evolve

organically and be different, and each group will need to accommodate

individuals’ abilities and musical preferences. The authors have not

received any endorsements from companies or organisations

mentioned in this guide.

This booklet is freely available to those wanting more information

about running a community-based music group for people with

dementia and their carers. It should not be reproduced or sold.

If using the guide for academic purposes, please use the Citation

Reference. We are interested in knowing how this booklet is being

used, and therefore request that those wishing to use the booklet

contact the authors, not for permission, but stating circumstance of

use.

This booklet was funded by Dorset County Council’s ‘Inspired by 2012

Health and Wellbeing’ Legacy Fund as part of a wider project funding

the continuation of the BUDI Orchestra for people with dementia and

their carers from the local community.

Baker, A., Innes, A., Murphy, J., Pritchard K., & Reynolds, L. (2015). The

BUDI Orchestra Method: A Guide. Bournemouth, UK: Bournemouth

University Dementia Institute.

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About this Guide ................................................................. 2

Philosophy and Principles ................................................... 2

Positive Expectations .......................................................... 4

................................................. 5

Creating the Group Environment ................................... 5

Selecting a Team ............................................................ 6

Instruments .................................................................. 12

Music Selection ............................................................ 13

Styles of Music ............................................................. 14

......................... 16

Warm-Ups .................................................................... 16

Rehearsals .................................................................... 17

.............................................. 18

Location ....................................................................... 18

Layout .......................................................................... 18

Before the Performance .............................................. 19

After the Performance ................................................. 19

................................................................... 20

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Following the success of the original BUDI (“buddy”) Orchestra, we decided

to create a guide for those wanting to set up their own music-based

community groups.

This guide provides recommendations or ‘hints and tips’ that may be useful

when setting up a community-based music group. Although our previous

work has focused specifically on engaging people with dementia and their

carers, this does not mean that our approach will not work with other

groups of people. We hope this guide will provide the ingredients, rather

than the recipe, to create music groups that give pleasure, fun and a sense

of accomplishment to all involved.

The starting point for this guide to using music with people with dementia

is one of having fun, creating an opportunity for social engagement and

group learning. Core to our philosophy is person-centred care: each

individual participating in the group is celebrated as an individual and

welcomed and valued as a person. This approach creates the starting point

for a sense of community, bonding and social ‘togetherness’. These are

important values to promote life-long learning and a willingness to engage

in new learning.

The underlying assumption is that everyone who participates will benefit.

The aim of creating an orchestra or other musical ensemble is not just to

benefit people with dementia, even though they are central to the process.

Professional musicians, volunteers, academics/researchers and family

members are not just there as supporters or facilitators, but as co-

producers and collaborators in the experience. The idea is to create an

environment that is normal; rehearsing and performing together is the

norm for musicians from any genre. Music can be used as ‘therapy’ or as a

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‘group activity’; the intention of this guide is to move away from a more

simplified use of music to entertain, distract or pacify people with

dementia. Instead, our orchestra approach aims to create a high level

expectation of inclusive learning, progression, achievement and success.

While recognising that music may sometimes be a solitary pursuit with

individual benefits, a lot of music making and listening is typically part of a

social activity or with a collective purpose. Providing an opportunity for

people to interact with others from different backgrounds and life

experiences creates a forum for people to feel included and welcomed and

accepted for what they contribute and bring to the experience.

In this way, the musicians, volunteers and those watching the performances

are able to find out more about dementia, helping to demystify the

condition. Furthermore, the approach allows for diverse music making,

allowing exploration of different genres that may have been previously

unexplored by those new to music. In this way, the orchestra approach can

challenge perceptions, create new ways of thinking and generate

knowledge for all involved.

Adopting these principles will benefit all those in the group and not just

people with dementia and will encourage continued learning.

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It is important to remember many members of the group will be beginners,

and even those with experience of playing an instrument may be hesitant

to perform straight away. Each member of the group may learn in a

different way or have individual needs that may need to be considered.

Try to begin the group with patience and an open mind; it is important to

be able to adapt to the needs of the group when required.

Many musical mistakes were made on our journey,

both by the group members and the professional musicians

because at times musical patterns were just too complicated.

By simplifying those patterns it was possible to perform to a

much higher standard and, with that, the group were able to

gain a high sense of musical achievement.

Eventually a repertoire of songs and

pieces emerged that the group liked and

enjoyed being part of performing. The

main thing that soon became very

apparent was that the music and the

sessions had

to be fun.

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Allowing time to meet and greet, and for people to say a relaxed farewell,

as part of the rehearsal schedule is crucial for the success of the group

development. At the beginning of the rehearsals, everyone needs some

time to reconnect, relax with one another, chat and re-familiarise

themselves with the physical setting and with other members of the group.

Ensuring that time is allocated to build relationships, create rapport,

promote friendships and develop a social network cannot be

underestimated in the success of the group to work together. Name tags

offer a simple way for each person to be able to identify others, and may be

helpful when starting a group where people are unfamiliar with other group

members.

Creating a sense of social community encourages group cohesion and

ownership and belonging. If people enjoy the sessions, they will express an

eagerness to continue with the group and attend the rehearsal and

performance cycles regularly.

When selecting a venue, it will be important to consider the following:

Does the venue accommodate different abilities (physical and

cognitive)?

Is the venue on the ground floor, or does it have accessible lifts?

Does the venue have parking?

Do the facilities provide refreshments?

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Is there enough room for the music, instruments, people and other

equipment to be accommodated?

Is there space for the group learning environment and a space for

individuals if they require a break?

Food and drink creates the opportunity to socialise together. Starting the

session with time to have refreshments and chat will help people to feel

relaxed. Similarly, a break after intense periods of concentration will

reinvigorate and revitalise the group, and also promote bonding with

others. It is important to consider individual preferences when catering for

the group; not only to accommodate individual dietary needs, but to

demonstrate knowledge and value of peoples’ preferences.

The choice of players to facilitate the group is very important. The following

are key points to consider when selecting musicians to run the sessions:

Lack of negative pre-conceptions of people with dementia; for

example, players who feel relaxed rather than awkward, and are

accepting rather than feeling intimidated by people with dementia;

Personal skillsets including interpersonal qualities such as: energy,

enthusiasm, vision, musical diversity, flexibility, ability to improvise

and adapt, communication, openness to make mistakes, fun

outgoing, sociable and patient;

Experience of working in a community-based project;

Ability to work flexibly and improvise and/or adapt musically if a

particular piece is not working;

Musical understanding (and what could be achieved);

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Knowledge of the instruments that the people with dementia are

learning to play;

Understanding their personal value and contribution within the

project.

Having a team who get on will always help, as

will having skills that complement each other. Choosing

the types of instruments is important, for example, the

piano is an excellent instrument as it can provide

harmony, rhythm and melody, giving the other team

members freedom to weave in and out of the

arrangements as needed.

It is important to have a team that are willing to be

musically flexible and take on different roles so that it’s

not always ‘here’s the melody instrument, here’s the

harmony, or here’s the rhythm’. It is imperative that at

least one of the team knows the instrument being

taught to the members of the orchestra,

and that they are able to

demonstrate the technical

aspects of playing the

instrument, yet at the same time

providing assistance on an

individual basis.

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When I joined the BUDI Orchestra, I had very little experience interacting with

people with dementia and their carers, both professionally and personally. I did

have some experience of working with community projects, but not with this

approach. During the rehearsals, the other musicians and I would support

group members by helping with technical aspects of playing the instruments,

for example, how to hold the instrument, and by playing accompanying

arrangements; be that the tune or to help with pacing.

Through this experience, I have had the opportunity to explore different styles

of music, and develop my own musical skills through improvisation and the

(often impromptu!) refinement of the repertoire to accommodate the skills of

the group. As well as this, I feel as though my confidence to interact with people

has grown, and I am now able to be flexible in my approach to accommodate

individual group members’ needs.

This experience has opened my eyes even further to the power of music and its

ability to bring people together in a positive shared environment to celebrate

our skills and achievements. The sense of community within the group was

greater than we could have imagined; having the opportunity to play and make

mistakes together, and finding out about the rich lives of everyone involved has

inspired me to do so much more for people with dementia.

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Volunteers are important to provide one-to-one support to individuals with

dementia and their family members who are learning an instrument for the

first time. The volunteers can help to demonstrate how to physically hold

the instrument and how to follow the instruction to play a piece. There can

be tensions if a volunteer attempts to ‘take over’ the learning and ‘over-

correct’ the individual playing. Professional musicians need to be alert to

this process and intervene as required to allow for individual independent

learning to occur. Similarly, lack of support can be detrimental to the

learning process. Finding the right balance of encouragement and enabling

an individual to thrive independently will differ depending on the person.

Ultimately, the volunteer should enable and empower, rather than impose.

Volunteers require the capacity to listen and follow instructions and adjust

their input to accommodate the musical direction and challenges as they

unfold. The volunteer role is to guide those with dementia, reinforce

learning, but also to foster a sense of togetherness and learning alongside

one another.

It is also helpful if volunteers have knowledge of music, as the volunteers

can then input and feedback to the musicians on potential improvements.

However, previous knowledge of music is not an essential requirement.

Our team of volunteers were essential to the success

of the project. Being outgoing, empathetic and having a

willingness to learn was very important. Volunteers’ focus

should be to provide encouragement and assistance. Quite

often our volunteers would be like a mentor to the same few

people each week. Having that continuity and building a

relationship made learning much easier and fun.

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The primary purpose of creating a BUDI Orchestra (or similar music group)

is to celebrate the skills of those living with dementia. This may include re-

learning musical skills through a forum that previously did not exist. Equally

a music group provides the opportunity to learn new skills in a safe and

supportive environment.

Jack

Jack is a 78 year old ex-professional musician living with dementia. He played the double

bass. Jack’s confidence to perform with a group had been shattered by a number of

dismissals from previous bands due to his difficulties using some of the technical

equipment needed during performances. Jack found other community groups too easy,

and would often make mistakes on purpose to amuse himself. He frequently left these

groups feeling patronised and so stopped attending. Jack and his wife had tried to meet

other people in their local area for ‘jam’ sessions, but had been unsuccessful.

When Jack joined the group, he had not played around other people for a long time, and

his instrument was in slight disrepair. Despite this, he was encouraged to bring it with

him to the rehearsals. He did not enjoy singing or taking part in the body percussion

segments as much as playing his instrument, so he continued playing during these parts

to add an accompaniment.

The musician leading the group asked if Jack would like sheet music to use for each

song, but Jack preferred to improvise. Before each song, one of the musicians would tell

Jack which key to play and he would play along. To celebrate Jack’s skills, he was invited

to play in place of the lead musician during songs he enjoyed while the musician

encouraged others in the group. Jack would sometimes become tired during the

sessions and would sit out during some songs to rest.

As Jack’s confidence in playing grew, he was encouraged to perform a solo segment

during one of the songs in the performance to showcase his talents to the audience.

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Walter

Before Walter’s diagnosis of dementia, he had been sociable and outgoing with many

friends at a local sports club; he also loved to sing. As Walter’s diagnosis progressed, he

found his friends began to distance themselves, and trips to the sports club became less

and less frequent. His wife suggested he might like to join the group as they had enjoyed

going to a similar community group in their local area. He was hesitant as he had never

played an instrument before, but was happy to attend on the basis he could join in with

singing where possible.

As the rehearsals began, Walter found the body percussion segments difficult to keep

up with, though he enjoyed singing. His mistakes often frustrated his wife, as she tried

to encourage him to follow her lead or would take his hands to tap out the rhythm. A

volunteer suggested they try playing the violin together and, as the weeks progressed,

Walter found playing the instrument less difficult. The support from the volunteer

enabled Walter’s wife to play alongside Walter and engage with the music as an active

member of the group, rather than as an aide for Walter. She found she was able to relax

and enjoy the experience with him.

During one of the sessions, Walter suggested to a volunteer that he felt ‘scat singing’

(vocal improvisations that fit within a melody or rhythm) would work well in a particular

piece of music. The volunteer encouraged Walter to share this with the group, but he

was not comfortable to do so. The following week, he expressed the idea again, and the

lead musician asked if he would like to try. Walter did and the lead musician suggested

they could add this to the performance.

After the performance, Walter was pleased with all he had achieved and believed that

everyone in the group “had a professional part and did it very well indeed”.

Maggie

Maggie is 92 years old. She used to sing in a community choir and taught dance during

World War II. Music was an important part of Maggie’s life as she loved to sing and

listen to music. Her daughter believed Maggie would enjoy attending the group, but felt

that she would only be able to sing or engage with percussion instruments, rather than

play the violin, due to Maggie’s deteriorating eyesight.

The songs chosen were familiar to Maggie and she would often dance in her seat, sing,

hum or tap along to the tunes. A volunteer encouraged Maggie to use the violin and

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within a few brief sessions, she was able to pluck the strings with the support of a

volunteer. Her daughter was surprised at her mother’s abilities; she never thought

Maggie would be able to participate in this way.

During the performance, Maggie was nervous: it was an unfamiliar environment and

there were lots of people watching her. She did not want to stand from her wheelchair

to reach the stage, and so the volunteers lifted her in her seat. When she was handed a

violin, Maggie began to strum, and as the music started during the performance, she

played with the rest of the group, singing loudly and playing as much as she could. At

the end of the performance, while the group stood to take their bow, Maggie motioned

to a volunteer that she too would like to stand with her peers and receive her applause.

She walked down from the stage with the aid of two other people with dementia, head

held high.

When considering the instruments to use, the ease of

creating a sound is important. String instruments are

ideal in the sense that a beginner can produce sounds

that make an immediate contribution to a group piece.

In practice, this means selecting pieces that allow for a

variety of playing techniques and progression of

abilities as confidence grows. For example, selecting

music where open strings can be plucked at the outset,

but as the group becomes more comfortable with the

instrument, they may begin to develop more complex

skill-sets, such as increased concentration, dexterity,

co-ordination, as well as musical abilities.

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Some practical considerations when selecting the appropriate instruments

to use are:

Availability of instruments;

Previous musical experience e.g. if people already play an

instrument, encourage individuals to bring them along or if they

have enjoyed a genre of music this can be included;

Facilitator knowledge and ability to play chosen instruments;

Selecting one instrument (for example, the violin) encourages a

levelling between group members new to the instrument.

Choice of music is crucial to the experience of the group. The music should

demand an element of challenge, promote learning and enable a sense of

personal achievement.

When choosing the music the following points are useful:

Encourage group members to suggest pieces of music they enjoy to

promote ownership and involvement e.g. based on previous musical

preferences;

Select pieces that will ideally promote the opportunity to learn new

styles of music (e.g. jazz to opera);

Be recognisable to the group members so they feel a sense of

accomplishment when performing;

Use repetitive musical patterns to reinforce learning while allowing

individuals to regroup and join in again should someone lose their

place;

Ensure that professional players’ musical skills are maximised to

enhance the performance;

Be musically ‘flexible’ - to fit any instrument available;

Promote fun!

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A number of musical ‘styles’ can be

included when choosing the

repertoire: for example, including

pieces of music that allow for

singing and body percussion as

well as instruments. Group

members may be more

comfortable with a specific style of

music; therefore multiple styles

can promote a sense of inclusion

and provide individuals with the

incentive to showcase particular

skills.

Notation is a very important part of the process. Sibelius® software is one

way for experienced musicians to create parts and scores. The music scores

for the musicians leading the BUDI Orchestra groups were created using

Sibelius® software. This allows the opportunity to create parts for all

musical abilities from professional musicians to beginners. This software

allows group leaders to transpose and refine the music to suit the

instruments used by the group.

This song was originally made popular by Perry

Como in the early 1960’s and is likely to be familiar

to many people with dementia from the current

generation. Structuring the piece in a simple

repeated form, for example…

Introduction Verse

Chorus Verse

Instrumental break Chorus

Verse - sung as a ‘round’ Introduction

…can work well as the words are simple and

repetitive. Performing the verse as a ‘round’ allows

for a real sense of musical achievement.

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Simplifying the music to enable everyone to participate, regardless of their

ability to read music, is fundamental. To achieve this in our project, we

used a simplified guitar tablature-type method, for example: 8 x ‘D’, 4 x ‘A’,

to direct group members.

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It is very important to begin with confidence building exercises to promote

bonding between everyone within the group and encourage a relaxed

atmosphere. Musical warm-ups serve to prepare the group for the session

ahead; they can also be used to:

‘Break the ice’. This will be particularly useful when starting a new

group;

Enable the group to recognise a starting point to their music-making;

Physically warm up the body and vocal chords to promote well-being.

Warm-up exercises can be continuously built upon to become more

elaborate and complex as the group becomes more confident. These may

be integrated into the final repertoire where appropriate to add variation

to the music-making. Body percussion (for example, stamping feet, clapping

hands, clicking fingers) can also form part of the warm-up. This might be

integrated into the pieces later in the rehearsals if enjoyed by participants.

One example is highlighted below.

This phrase was spoken and each word clapped along to by members of

the group to emphasise the pace they were to play the violin in specific

music pieces (slow – slow – fast – fast – slow). This is demonstrated by

music notation below:

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Variation of the repertoire, accommodating individual preference, can help

to sustain engagement and concentration and is a cornerstone for

rehearsing. It is important to include pieces to build on learning and

demonstrate progression. Facilitators need to be able to improvise and

refine ‘in the moment’ to respond to group members’ reactions and

individual abilities. The rehearsal repertoire needs to build up to the

performance over time at a pace that meets the members’ progress.

Remember: the aim of the rehearsals is to create a fun and engaging

atmosphere that is focused on enjoyment, rather than achieving a

musical masterpiece.

Ravel’s Bolero was chosen as it is a one bar (three note) pattern, repeated continuously

over a very hypnotic drum pattern. The beauty of this piece was that whilst being very

simple to accompany, it is also very challenging to perform, as it should never get

boring in its delivery. Instrumental ‘blending’ could also be experimented with whilst at

all times being underpinned by Bolero’s three note pulse.

When the professional instrumentalists were not playing, they were able to choose

their own musical pattern naturally adding to the piece contributing to the rhythm or

the simple ‘C major’ harmony. Group members also had a choice of the notes they

could play, as there were more than one that would work. This also allowed the

opportunity for experimentation, confidence-building and to change their musical

pattern to maintain their interest.

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Performing is a normal part of participating in a group music activity that

can often be lost when running music groups for people with dementia.

This was a key feature of the BUDI orchestra as performances offer the

opportunity for participants to showcase their skills while also providing

pleasure for the audience.

Choosing a setting that may be familiar to members can promote an

environment to perform that is less pressured and more informal. It can

promote direct contact with the audience much more easily and encourage

performance energy.

It is important to select a venue that has sufficient room to accommodate

everyone (including any physical requirements they may have) and have

enough space to be able to play their instruments comfortably. Mirroring

the set-up of the rehearsal room is important to feel familiar and secure.

Sitting in pairs can be very helpful to provide support as required. It is also

important that everyone can see the lead facilitator during the

performance as this may promote a sense of involvement and group

cohesion. Music stands for the song sheets enable members to focus on

holding the instruments.

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Factoring in time to have a brief rehearsal immediately before the

performance promotes confidence and comfort in the environment.

Repetition is paramount to promote a sense of security and confidence

when performing without losing the fun aspect or spontaneity when

playing.

Providing the opportunity for group members to socialise together and

celebrate their achievements after the performance is important. Reflecting

on the performance collectively creates a bonding experience and a

willingness and enthusiasm to rehearse and perform in the future.

Provide refreshments to promote bonding alongside learning.

Choose music that is meaningful to the group and engages individual interests.

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Make it fun!

Treat people with dementia as people.

Create a social environment that promotes

friendship and belonging.

Draw on, encourage and showcase the natural and existing abilities of individuals.

Adapt the music to suit the needs of the group.

Embrace mistakes and go with the flow.

Don’t underestimate what can be achieved.

Develop a relaxed atmosphere to promote learning.