What We Have Found.
We have found that Music can be used as a tool to elevate stress, reduce self-harm, build confidence, develop communication and interaction, and improve mental health and wellbeing for people with profound multiple learning disabilities.
We take our services to various different care homes and use the arts therapeutically and creatively to support others in achieving personalised outcomes. We provide both 1-2-1 and group support, use various techniques and resources, and offer various levels of support depending on the individual need. However, in this case we are going to focus on how we have used music as a tool to improve the quality of life for an individual with profound multiple learning disabilities (PMLD) in a group setting.
What Does Profound Multiple Learning Disabilities (PMLD) Mean?
The NHS states that a person might be diagnosed with PMLD if they have more than one disability, the most significant one being a learning disability. People “diagnosed with PMLD will also have a sensory or physical disability, complex health needs, or mental health difficulties. People with PMLD need a carer or carers to help them with most areas of everyday life, such as eating, washing and going to the toilet.”
Want to see Jessica’s case Study? click here (pseudonyms have been used to maintain confidentiality).
Jessica is an individual who has profound multiple learning disabilities . Jessica is non-verbal and has a wheelchair, she lives in a care home where we now visit her weekly. Her Story highlights the power of music and creativity. We have been visiting this care home for many years facilitating creative expressive workshops. Jessica was not always part of the group; however she would sometimes join the group if she was unable to go out. On these days, Jessica seemed very distressed to be in the room, it was out of her ordinary routine. Jessica seemed overwhelmed and would express this by hitting her head, screaming and scratching herself. In one of our staff members’ very early reflections, it was questioned whether she may also be blind as she never made eye contact. Jessica did not like touching anything and did not like anyone or anything being near her.
We always tried to welcome Jessica into the group in the best way possible. To begin with this was difficult as her attendance fluctuated a lot and was inconsistent. We then found that Jessica seemed more relaxed when a rhythm was played. Self-harm and distress reduced. We reflected that perhaps the rhythm provided a constant in her life, which was often changing. Koen (2008) states “One plausible theory is that music can simultaneously stimulate many areas of the brain and trigger organising effects on behaviours. Furthermore, the organisation structure of rhythm may provide sufficient predictability that it brings comfort and familiarity that assuage stress and diminish or eliminate the push to a fight or flight response.” The rhythm made her feel safe and secure. Jessica then started joining the group more and more and we arrange a review meeting with the care home manager and together created some personalised outcomes for Jessica which were to:
- Improve wellbeing and happiness and reduce stress
- Develop interaction
- Become more tactile
The Result: The Power of Music!
Jessica started joining the group consistently. Using rhythm we slowly introduced new things to Jessica but in a way that made her feel safe. Koen (2008) also discusses how music is often associated with child-hood memories, being sang to, held and rocked in rhythm is often provided as comfort to a baby or child. Adults often retain the association between calmness, safety and comfort with music and rhythm throughout their lives.
The facilitator would hold the space using rhythm and tapping on a boom-wacker, Jessica enjoyed holding the boom-wacker and feeling the vibrations. Her carers seemed amazed as they had never seen her hold anything before. We gradually used this technique to introduce various things. Jessica now loves playing musical instruments, she laughs and smiles and enjoys hiding under a big symbol. She will hold more things such as puppets and sensory resources. She joins in with group activities such as parachute games. She likes people to be close to her and will hold carers and facilitators hands, massage their hands and bring them close for affection. Jessica shows she is happy by making eyes contact, smiling laughing and blowing raspberries.
We can now understand Jessica a lot more, she is encouraged to express herself, make decisions and choices. We know when she wants space or closeness and we know whether she wants to be loud or quite, she has a great personality and is given the opportunity to express it.
The facilitator uses rhythm to hold the space and allow individuals to express themselves in the group through sensory storytelling, music, movement, and art. This technique is used in the group to tackle taboo topics and develop personalised outcomes.Music is a great tool to use to enhance well-being and quality of life in various ways. Rhythm is innate; we have found that it creates a unity and a bond between people from all different areas, backgrounds, cultures, religions, abilities, races, and ages. That is why it is such a great tool that should not be overlooked when working with groups.
(Koen, B. (2008) The Oxford Handbook of Medical Ethnomusicology. Oxford University Press, USA)