Feature: Rhythm & Reflection

Mike Mesham is an activity coordinator in Bristol who specialises in activities suitable for people living with dementia. He is also the voice behind his freelance business – Rhythm and Reflection, providing music sessions for groups and individuals in care homes in his local area. He tells The Daily Sparkle how he uses music every day in his sessions, to connect with the residents and get them talking.


“I recognise the value of music in promoting reminiscence. I always work with residents, staff and relatives to make my music sessions person-centred, fun and interactive.”

I use music in numerous ways in my role as activity coordinator – and over the past two years, playing everyday, while at work, my repertoire has grown considerably. I usually play to small groups of around ten people within the lounge, and in between each song we talk about the artist who recorded it and what year it was in the charts. I find that the residents reminisce about the song and describe that period during their lives – it may remind them of their early courting days, or days when they had young children. One resident found that a song bought back happy memories of when they worked in their father’s flower shop in Bristol. Their memories are varied, eclectic and personal – and each song provides a chance to reflect on their emotions. I like to learn a few facts about each tune so that we can talk about the background and history related to the song or artist. For example, residents are often intrigued by a song recorded in the year they were born, met their spouse or when they got married.

Their memories are varied, eclectic and personal and each song provides a chance to reflect on their emotions.

Joining In
The people I work with seem to really value this information, and the chats we have between the songs can be as important as the music. This is something I’ve notice The Daily Sparkle also focuses on in their newspapers, which is an invaluable resource to me. As music is so interconnected with our memories, it can promote a myriad of conversation topics. The added benefit for me, playing the song in real time, is that, unlike a record or song on the radio, I can stop playing and listen to what a resident has got to say there and then. To establish their thoughts, right in the moment, and not to lose what was on their mind at that point. This can be important when encouraging reminiscence with adults who live with dementia.

What I find most surprising and rewarding is that, even residents who live with progressive dementia can still be stimulated and respond to the music. Recently I have started mixing residents from our nursing side of the home with residents from the dementia side, which has helped stimulate others into engagement and involvement. Once a few individuals begin to join in and sing, it spreads to others – music is infectious.

Working One-to-One
During my working week, I also like to visit those residents who are more isolated and unable to leave their rooms. I begin by chatting and suggesting a song on my guitar. Sometimes this is declined, residents may want to be left alone because they are in pain or confused. This can be a challenging part of my role – it is difficult to not feel rejected in these circumstances, but I often persevere over a number of days or even weeks.

Occasionally a positive response can come from nowhere, and it is an uplifting experience to connect with someone.

I recently had a breakthrough with one resident who I work with on a one-to-one basis. He can only respond or communicate with a whistling sound due to his dementia, and his frustration is visible. For many weeks, I was unsure of his awareness while singing and playing for him, or whether he even liked it. I would ask after each song ‘Did you like that one?’ and this would predominantly produce a whistling response. However, last week I asked the same question and he responded out of the blue with: ‘Loved that one.’ It was a wonderful, surprising moment – and most importantly, confirmed my conviction that people so often appreciate the music sessions, even if they are unable to respond verbally.

Taking My Time
Over time, I have learnt not to make assumptions about a resident’s cognitive awareness and ability to still enjoy music. I also work with an elderly man who has spent many years in psychiatric institutions and displayed negative behaviour a lot of the time, mostly through his language. Initially, when I attempted one-to-one music sessions in his room, he would swear and say he was not interested. The nursing staff asked me to try again, but without saying too much as I came into the room. I tried this approach, and during each song he was silent, but then reverted back to swearing when I had finished. Eventually after a few visits, he began to ask for requests – ‘South Of The Border’ or ‘Buttons And Bows’. I set about learning his requested songs and played them for him – it didn’t take long for him to join in. Singing with this resident has become such a rewarding experience, despite his initially negative response. Over time, a reciprocal and positive engagement has grown and been nurtured.

Playing music to people living with dementia can be incredibly rewarding. I enjoy it so much that I have also now begun playing freelance at other care homes throughout North Somerset. Music can be a powerful way to change a person’s mood; it encourages social interaction and can help people with dementia express their feelings. My song list continues to grow; each song has the potential to unlock memories and emotions.

Find out more about Mike here.