Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Harmony and Healing: A Community-Based Research Project Deborah Clymer Grove City College I was first introduced to Ruth at the start of the semester. She was sleeping in her recliner in the hallway of the Grove Manor Nursing Home. Activities Director Sandy McConnell asked if she would like to meet me. She gave me a vexed look and said, “No I wouldn’t. Go away.” I nervously backed away from the chair. Sandy whispered, “Ruth is perfect for the project. I think the music could really help her.” Sandy informed me that Ruth had severe dementia and it affected her personality in such a way that caused her to be physically and verbally aggressive towards others. I was nervous to continue meeting with Ruth. However, I agreed with Sandy. If playing music could help her then we had to try it. A few months later, I was sitting next to Ruth in the living room. We had been listening to the piano for ten minutes. Her eyes were closed and I dared not disturb her. However, when the musician began to play “The Battle Hymn of the Republic,” Ruth started to sing under her breath. Amazed, I touched her shoulder. She looked at me and smiled. I started to sing with her, stumbling over the lyrics as she sang every line perfectly. “We used to sing that song in school,” she explained afterwards. “I was an elementary school teacher.” “Wow! That must have been a great job.” I replied, unsure of what to say. She smiled and nodded. This was the start of a conversation I had with Ruth that afternoon. She patiently answered all my questions. If she had not told me she had been a teacher, I may have been able to guess. Later, I told Sandy McConnell about the experience. Sandy’s eyes brimmed with tears. “You saw the old Ruth again. Only the music could do that.” Ruth was one of the residents with whom I worked while facilitating a community-based research project. During the fall 2015 semester, I took a course in research methods that culminated in designing a research proposal. I expressed an interest in gerontology to my faculty mentor Dr. Jennifer Mobley. She then introduced me to the work of Dan Cohen and the Music and Memory program. The organization is rooted in neuroscientific research and focuses on how music can touch the lives of those suffering from dementia. I studied the topic further throughout the course by examining the physiological and psychological effects of listening to music. I then worked with a local long-term care facility the following spring semester to orchestrate a project that consisted of both research and community service. This article will examine both aspects of the project by discussing the study I conducted as well as the communal impact of interacting with the elderly. Research My research question was “How does listening to music affect the emotional, behavioral, and cognitive state of persons with dementia?” Information was gathered through an ethnographic study, which involved volunteering at the Grove Manor Nursing Home and becoming a participant observer. I visited the nursing home on a weekly basis for two months before playing any music for the residents. Over these weeks, I spent time with the residents, gaining an understanding of the personalities, cognitive ability, and normal behaviors of each resident. After this, student musicians were invited to play for the residents every Friday Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 2 afternoon. A different student group performed each week. This allowed the residents to hear music from several instruments including the piano, guitar, flute soloist, flute trio, vocals, and violin. Their song choices consisted of hymns, classical, and generational music. The residents were recorded during the music sessions and interviews were conducted in order to gauge resident responses. Staff members and students were interviewed in order to gather their perspectives and observations. The study was conducted under Kitwood’s (1997) personhood approach. This view holds that every person has social and emotional needs regardless of neurological losses associated with dementia and should be treated with value and respect. Hence, the project also contained a community service aspect to promote interaction with and the wellbeing of those involved in the study. The project involved student volunteers from Grove City College who were seeking to serve their local community. My hope was not only to explore the power of music but also to build a relationship between the university and elderly populace of Grove City. Reaching Individuals through Music Increasingly, research suggests that music be used as an alternative treatment to pharmacological and physical intervention for individuals with dementia. Music has been proven to effectively prevent agitation, improve communication with caregivers, and aid in recollection efforts (Brotons, Kroger, and Pickett-Cooper 1997; Gerdner 1999; Raglio et al. 2008). By observing the effects of music on the residents of Grove Manor Nursing Home, I found that the music generally improved their disposition and memory. Music has been found to decrease aggravation and anxiety for persons with dementia (Cooke et al. 2010; Goodall and Etters 2005; Guétin et al. 2009). I observed this firsthand. A resident named Merle, for example, was impassive and inattentive before a flautist began to play “Amazing Grace.” Merle responded by looking up, clapping along, and smiling while his wife Emily watched him, beaming. Many residents responded to songs in a similar, alert, and enthusiastic manner by closing their eyes in appreciation or singing along. Overall, residents displayed behaviors indicating happiness and peace. Secondly, residents recalled past information after having listened to music associated with specific memories. Ruth, for instance, remembered being a teacher after she heard a song associated with this experience. A resident named Nancy began to sing the lyrics to the hymn “He Walks with Me” after having only heard the melody on the violin. Research supports the notion of music aiding in cognition. When familiar songs are played, individuals with dementia are sometimes able to recall memories that otherwise seem lost by triggering parts of the brain associated with emotion, motion, and memory (Sacks 2014). Dr. Oliver Sacks (2014) said, “The past, which is not recoverable in any other way, is embedded as if in amber in the music and people can regain a sense of identity.” Along with the benefits, I also saw that music could not heal everything. I recall a student volunteer asking me what her mother could do to prevent early onset Alzheimer’s as it ran in the family. I wanted to tell her to offer music as a solution, but that would not be correct. There is no way to cure or slow the progression of Alzheimer’s. That was a hard reality of this project. No amount of service would be perfect and no amount of time I put into this project would alleviat e all the suffering for the people with whom I worked. There were also times when the music did not positively affect the residents’ behavior or cognition. Some individuals asked to leave during the performances and others simply slept through them. The project was certainly not perfect and Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 3 I had to accept that. It was difficult to do so at first. However, I came to realize that I did not have to change the world. I could just focus on helping locally by working with a small group of residents and volunteers and promoting further contribution to music intervention. Sandy McConnell said, “I have seen music touch people in a way that nothing else can.” I have now seen it myself. Music reached the residents. It lifted their spirits and, in some cases, it brought back memories. While the music did not connect with every resident, I believe those who did not exhibit physiological or cognitive change still received the message: “you are worth playing for.” Cultivating Intergenerational Community It has been said that the elderly are “[t]he classics of our culture, the ‘Great Books’ of who we are” (Powell and Arquitt 1978, 421). If we stopped reading classical literature, it would be detrimental to our understanding of our history, beliefs, and culture. In the same way, losing relationships with the elderly can have severely negative consequences. In today’s society, very few children grow up with meaningful relationships with the elderly and the number is decreasing further. Families are becoming more fragmented, neighborhoods are no longer seen as support systems, and prejudice serves to separate the groups further (421). The segregation between the young and old negatively affects both generations. Without interaction with younger people, the older generation may struggle to “meet the needs of daily life.” They lack the “opportunities to make significant cultural and societal contributions” (421). Without interaction with their elders, young people do not gain valuable information about their “cultural heritage.” Further, “It may… lead to the development of unrealistic attitudes about older adults and the natural process of growing old” (422). My project focused on the elderly with dementia specifically, which is a disease that further isolates individuals (Rossato-Bennet 2014). McConnell explained that many of the Grove Manor residents did not receive daily visitors. She affirmed that the project brought some community between the two generations and fostered the building of relationships. One resident spoke of a student visiting her in this way: “I cannot think of the words to say. I haven’t spoken to anyone in hours. I haven’t done anything in days. And all of a sudden, sunshine walks into the room.” Most of the residents thanked the students repeatedly for coming and welcomed conversation. McConnell said, “The residents got used to you guys coming on Friday afternoons. They were really enjoying that. Very, very much.” The students also appreciated the experience. For instance, one student violinist was initially nervous that her performance would not meet their expectations and that she would not know what to say to them. She soon found, however, that the residents were receptive, warm, and welcoming. One woman squeezed her hand when they first met and said, “Thank you for coming. I love you.” The violinist later said to me, “That was such a blessing. I am really thankful that we had the opportunity to do it. It made their day and it made our day.” Several of the musicians expressed similar sentiments. A student vocalist approached me a few weeks after she had volunteered. She said, “When we were packing up to leave [after the performance] I started to cry. That was an incredible experience.” In the midst of mental decline, isolation, and illness, the residents touched the students with their hospitality, patience, and grace. Interacting with individuals of a different generation oftentimes has a transformative quality. It promotes respect, learning, and acceptance. The World Youth Report of the U.N. (2003) emphasized the need for intergenerational programs that “promote an interdependence Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 4 among generations and recognize that all members of society have contributions to make and needs to fulfill” (407). This project allowed for one generation to interact with the other. In doing so, both groups benefited. The residents shared their stories, advice, and hospitality with the students. In return, the students shared their music, time, and love. Challenging Cultural Misconceptions Amy Cuddy (2004) wrote, “Stereotyping of elderly people goes largely unchallenged and even unnoticed in the United States” (19). Cuddy’s study demonstrated that Americans stereotype the elderly as incompetent and “helpless” (11). While aging does cause physical changes to the body, society grossly exaggerates the negative consequences of such changes. Americans intrinsically view the elderly as less “valuable” to society than younger people and fear the aging process themselves. The fear is a reasonable one considering that a significant number of elders are treated worse in society because of their age. Isla Rippon (2014) found that 36.8% of persons over the age of 65 experienced age discrimination. Participants were considered to be discriminated against if they received poorer services in restaurants and stores, experienced lesser quality healthcare by providers in hospitals, were treated with less respect, considered to be less intelligent, or threatened and harassed. Throughout the semester, I spoke with students about their views on the elderly and geriatric care. In general, very few students offered positive sentiments towards elderly people. Many students expressed that they were worried about getting older. One student said, “[Elderly persons] are lonely because they don’t want to talk to people.” Students would speak of work with the elderly as charitable instead of a mutually beneficial opportunit y. Many students said they “would never want to live in a nursing home.” I too had preconceived notions about the elderly of which I only became aware after spending some time at Grove Manor. I did not expect to emotionally and psychologically benefit from the research. I also did not think I would enjoy the experience, anticipating seeing only hardships behind the nursing home doors. However, I soon realized the error in my thinking as I built relationships with the residents and was encouraged by every visit. Take, for example, my experience with June. June was one of the residents whom I had the privilege of visiting multiple times over the course of the semester. Upon meeting her and learning of her dementia, I thought our conversations would be one-sided and beneficial only to her. However, June’s sense of humor, appreciation for every day, and compassion for others changed my way of thinking. June’s first priority was to make sure I was keeping in touch with family, taking time for myself, and looking forward to my future. She asked me once, “What do you want to do after college?” I answered that I did not know. She said, “Do not worry. You have the rest of your life to figure out the rest of your life!” June shared continual wisdom and I received great joy from visiting her. There were subtle moments where I was acutely aware that the project broke down some of the cultural misconceptions for the other students. Towards the end of the semester I remember talking with a group of friends. One female student was lamenting the fact that she found a gray hair. Another student, who was very involved in the project said, “Hey! That just means you’re getting older and wiser.” The simple act of interacting with the elderly and educating people on cultural misconceptions can significantly decrease negative stereotypes towards aging (Yamashita, Kinney, and Lokon 2011). Kishita, Fisher, and Laidlaw of the Government Office for Science Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 5 (2015) wrote, “Evidence suggests that tackling anxiety about ageing by improving knowledge of ageing and facilitating positive interactions between younger and older people can reduce ageist attitudes among [the younger and older] populations” (16). Although the project was small, it was a challenge to the generally accepted premise that value is found in youthfulness and aging is associated with only negative consequences. The students and I were blessed by the residents’ wisdom, humor, encouragement, and hospitality. I believe that those of us who participated in the project developed a more realistic view of aging and have come to appreciate the beauties, amidst the challenges, associated with being older. Conclusion Community-based research gives students the opportunity to combine education with service in order to make a positive impact in the world. Service learning gives students an invaluable opportunity to engage with persons in their local vicinity, learning and growing alongside of them. While addressing a real need in the community, students are able to enhance their interpersonal skills and become better-informed adults. Chekhov (1860-1904) said, “Knowledge is of no value unless you put it into practice” (qtd. in Loid 6). Prior to and during the work with the nursing home, I gathered valuable resources about cross-generational barriers, aging, elder care, dementia, and music intervention. I then used this information to develop a plan that I thought would touch upon these issues and benefit the community. Becoming an active participant in research motivated me to want to learn more about the field. This gave me the opportunity to enter into relevant conversations with my peers and professors as a better-informed advocate for music intervention and intergenerational community. Just as research enhanced the service aspect of the project, service enriched my studies. I found a new passion and understanding for the elderly that I would not have had if it were not for this project. With every visit, I made new observations to analyze and discuss. By facilitating this project alongside the research, I was also able to maintain Kitwood’s personhood approach. It helped me to see that a person whose family member is diagnosed with Alzheimer’s disease would define dementia very differently than would a scholarly article. By staying grounded and focused on individuals through service, research became much more important and relevant. Dr. G. Allen Power (2010) wrote, “Music gives us something we hunger deeply for. Something we have pursued for thousands of years. Rewired our very brains for. We need music. It awakens in us our most profound safety… The safety of living in concert with each other, and our own selves.” My observations from the study support the notion that music helps individuals be “in concert” with themselves and others. Listening to familiar songs aided in the psychological challenge of piecing together the fragments of fading memories and feeling a sense of peace again. This research and community service project caused me to see an entirely different side to aging, dementia, and music. I now view aging as more of a privilege than a burden. I also have developed a different perspective on serving others. The project fostered an environment of learning, understanding, and growth for the students. The residents likewise received a message of love and were able to connect with others with the aid of music. As I ponder over everything I have learned from this project, from my research and the building of intergenerational relationships to the healing power of music for persons with dementia, I realize that my work has only just begun. Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 6 ~ I would like to thank my faculty mentor Dr. Jennifer Mobley for her support, encouragement, and guidance. Thank you for sharing in many long meetings, laughs, and inspiring conversations during this experience. It was a privilege to work with an individual who makes the world a little bit better every day. I would also like to express my gratitude to Sandy McConnell and her invaluable assistance with this project. Sandy’s selfless love for others was an inspiration. I am also indebted to the Grove Manor Nursing Home for welcoming us in graciously. Finally, I would like to thank the Grove City College volunteers who shared their time and talents with the community. Undergraduate Journal of Service Learning and Community-Based Research, Volume 5, Fall 2016 Clymer 7 References Brotons, Melissa, Susan Kroger, and Patty Pickett-Cooper. 1997. “Music and Dementias: A Review of Literature.” The Journal of Music Therapy 34 (4): 204–245. Chekhov, Anton (1860-1904) quoted in Bruce Loid (2009), “Power, Responsibility & Wisdom: Exploring the Issues at the Core of Ethical Decision-Making and Leadership.” The Journal of Values-Based Leadership 2 (2): article 6. Cooke, M.L., W. Moyle, D.H. Shum, S.D. Harrison, and, J.E. Murfield. 2010. “A Randomized Controlled Trial Exploring the Effect of Music on Agitated Behaviours and Anxiety in Older People with Dementia.” Aging & Mental Health 14 (8): 905-16. 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