Recently, I've been thinking a lot about ageing and social visibility.
I work with long-stay older patients in orthopaedic rehabilitation units, intermediate care centres and in complex care wards, where patients may be living with dementia in addition to other health problems.
I deliver my Music for Health & Wellbeing programme on behalf of Birmingham Community Healthcare NHS Foundation Trust's Charity (BCHC Charity). The Charity provides Patient Experience enhancement and additional non-clinical services across the Trust.
Music for Health & Wellbeing is a live music duo visit, not clinical Music Therapy, and is designed to promote relaxation, engagement, distraction from the clinical environment, and a sense of wellbeing.
The patients I meet have much to share and the sessions feature enjoyable conversation and reminiscence. This is invariably prompted by a response to something we have played. Patients say things like 'you just took me away to another place- a long time ago'. This is how our conversations begin.
Listening to the piece of music brings back memories of people, places and events associated with hearing it in the past. These are often very vivid, even for those with dementia. The stories I hear concern places in Birmingham and across the world, family members, workplaces, neighbours, friends and acquaintances.
I meet a great many older people who are vibrant, funny and resilient, who have been living independently up until the accident or health event which brought them into hospital. Some will be able to return to independent living, perhaps with new social services in place, and some know that they will be moving into residential care.
People almost invariably tell me that "I can't get out like I used to...", "I used to go to all the dances...", "I used to play in a band...," "We used to sing while my Dad played the piano," "I used to sing at my place of worship."
When you start to think about "used to" it implies a lot of things. That these fondly, often passionately recalled events are firmly in the past, that they happened in a 'Before' time, that they are somehow distant, that a gap has opened between life in the present and the past, and that these things aren't expected to happen in the future. There's no getting them back in a tangible way.
These personal and social histories will, in time, be lost. We have much to learn from them.
Recognising and accepting that support is needed and that some activities have become near impossible must be a difficult place to find yourself. Patients are so very keen to talk and to ask questions that the loneliness of some is painfully apparent.
One of the brightest aspects of BCHC Charity's commissioning of our Health & Wellbeing service is that it allows patients to engage with a very high standard of responsive performance, delivered by friendly full time professional musicians who make time for individual interaction. People enjoy the quality of conversation and of music, and say so.
Health & Wellbeing's repertoire meets a broad range of tastes and includes old-time songs, classical items and popular music from 1880 onward. It's growing all the time as I respond to suggestions and requests from the patients themselves, adding new material. We don't set a playlist before we arrive, but are guided by the comments, conversation and mood of each ward as to what to play next.
This brings me to visibility.
As we meander through the repertoire, we're creating a Playlist for that ward, for those individuals, in that place at that time. A distinctive document of them as people. But it's really a document about another time which they shared in. They were visible in that time, earlier in their lives, but I was not.
I know old songs because older family members sang them to me, sometimes substituting the real words for something funny when they had been forgotten or mis-remembered. They weren't being played on the radio when I was a child. They had 'been and gone' already.
Sessions pass quickly when you are delivering them and I am frustrated by my inability to capture and record the playlists, personalities and anecdotes fully.
Through Music for Health & Wellbeing sessions I'm creating a library of music which embodies the collective remembering of a particular generation, of people born between about 1925 and 1940. They are making themselves visible, and audible, to one another in the music they respond to collectively, their requests, and in their suggestions. Their responses to the music often bring about conversation between themselves, "Do you remember him? He was in all the big films..." "Who was your favourite singer?"
My oldest songs are older than my patients, not songs that were new when they were teenagers or adults. Good music persists in a kind of collective consciousness and, for this generation, it's human and not digital.
It seems that an enforced reduction in social contact and all the sharing which comes with that is almost inevitable for the oldest members of our society, as it is currently structured.
As the population ages, more of us could become less visible. That's an inequality and an irony in a Visual Age of digital media, to which very few elders have access.
Should we secure and maintain the knowledge, anecdotes, common sense and musics of the elders of our communities? How might we go about this?
There is a spontaneous global recording and dissemination of Youth Culture/s and very little recording and dissemination of Elder Culture/s.
The musical enthusiasms of an earlier generation exist in the collective knowledge of the elders I meet. Lots of them tell me "My mother used to sing that to me" and "It was my father's favourite song".
Though the singers of these songs are lost to us, invisible, we can still forge connections with them in the moment of live music.