Advancing Music-Based Interventions for Dementia Care: Challenges and Opportunities

1. Sally Bowell Research Fellow International Longevity Centre – UK The Commission on Dementia and Music: Considering what works and how to influence change

2. ILC-UK Planning Tomorrow, Today • Think tank • Evidence based • Policy focussed • Balanced • Independent • Respected • Experts • Networked • International

3. The ILC Global Alliance

4. The Utley Foundation • A private family charitable trust, established in 2014 • Advancing social causes close to the heart of the trustees • Catalyst for funding and wider action • Areas of interest: • Music and Dementia • Veterans • Children • International Aid

5. Creating the Commission on Dementia and Music Context • Differing definitions of ‘music-based interventions’ • Sporadic and highly variable provision • Emerging understanding of effectiveness, but with significant gaps • Suspected low awareness amongst public, practitioners, policy makers etc

6. Quick facts – Dementia • 850,000 people with dementia in the UK – est. 1 million by 2025 • 700,000 unpaid carers for people with dementia – est. 1.7 million by 2050 • Annual cost of dementia to the UK is £26.3bn – est. £50bn in next 30yrs • Dementia costs more than cancer, stroke, and chronic heart disease combined

7. Quick facts – Dementia [2] • Delaying onset of Alzheimer’s by 5 years could result in £100bn saved between 2020 and 2035 • c.80% of PWD in care homes have behavioural and psychological symptoms of dementia (BPSD e.g. agitation, depression, anxiety)

8. Creating the Commission on Dementia and Music • Brought together 12 high-profile expert Commissioners, including: • Chair: Baroness Sally Greengross OBE, cross-bench peer and Chief Executive of the International Longevity Centre - UK • A Labour and Co-operative MP, and a Councillor • Leading clinicians and academics • Music therapists • CEOs and Senior Management from several charities

9. The activities of the Commission • Literature review • Site visits • Call for written evidence • Oral evidence sessions • Report and launch event • Media traction

11. Defining ‘music-based interventions’ We chose to use the phrase ‘music-based interventions’ throughout our analysis and report, to refer to what we discovered to be a very broad range of activity and approaches. As we explored in our report, reflecting on all of the evidence to hand, examples of ‘music-based interventions’ can include: • Listening to music • Personalised, recorded music • Learning and playing an instrument • Live music in care homes • Music therapy • Community-based musical performances and events • Community-based music groups

12. Current state of play – what did we find? • Sporadic – well-developed in some areas but minimal, or even entirely unavailable elsewhere • Lack of information about: • Availability • Locations • Delivery partners • Effectiveness • Cost

14. Benefits of music-based interventions • Music and the brain • Minimising the behavioural and psychological symptoms of dementia (BPSD) • Tackling anxiety and depression • Retaining speech and language • Enhancing quality of life • Impact on caregivers • Palliative and end of life care

15. Quick facts – Music-based interventions • Estimated 320,000 people with dementia in residential settings who do not have access to meaningful arts provision • Lack of data makes it impossible to estimate how many of the 566,700 people with dementia living in the community have access to music-based interventions • Weekly availability of music therapy = c.30 seconds per person with dementia. I.e. only a tiny minority of people with dementia have regular access to music therapy

16. Effective delivery – what to bear in mind • Important that music is not used indiscriminately • Making music personal • ‘Memory bump’ • Communication and listening

17. Barriers and challenges • Lack of real traction in the policy environment – nationally and locally • Data collation and centralisation • Funding • Challenge of defining incurred costs • Who pays? • Demonstrating cost-effectiveness and savings • Recognising the therapeutic potential

18. Barriers and challenges [2] • Instilling confidence, enthusiasm and belief • Reaching the hard-to-reach • Reflecting and promoting diversity

19. Opportunities • Funding • Personal Health Budgets and Integrated Personal Commissioning • Other funding options e.g. leveraging existing resources, trusts & foundations, music industry, innovative fundraising • Training • For ‘everyday’ use of music • For specialist and periodic interventions • Signposting and referrals

20. Opportunities [2] • Recent media attention • Broader dementia landscape • Evaluation • Technology

21. Conclusions • We see devoted advocates operating in a complex and poorly coordinated ecosystem • There is sporadic provision, currently delivered only to the few • The sector is supported by a promising emerging evidence base, which is gaining traction • There are minimal levels of funding – importance of developing cost-effectiveness research • The low level of public awareness needs to be addressed

22. Recommendations • Coordinate delivery and build intelligence • Develop the research base • Raise public awareness • Coordinate and grow funding

23. Next steps – updating the story • The Utley Foundation task force taking forward report recommendations • Ambitious target set for everyone with dementia to have access to some form of music by 2020 • Roundtable discussions with care homes • To understand barriers and opportunities for roll-out of music-based interventions • Grace Meadows grace@utleyfoundation.org.uk

24. Any Questions?

25. Many thanks! Sally Bowell ILC-UK SallyBowell@ilcuk.org.uk 020 7340 0444