In this case study, Forget-me-not Chorus Artistic Director Kate Woolveridge and Administrative Director Sarah Teagle reflect on how they have engaged people living with and alongside dementia in singing and what makes their model so successful. 

What we do: engaging older people living with and alongside dementia in singing

Forget-me-not Chorus uses the power of song to make a real difference to those living with and alongside dementia. It is thought that one million people in the UK will have dementia by 2025 and there is – as yet – no cure, so there is a crucial need for services that help people to live well with dementia. That’s where FMNC comes in! 

Our approach and our sessions are deliberately different from other organisations as they are designed to support people with dementia PLUS their families, friends and formal carers. Before the pandemic, we ran ten weekly choirs across Wales and reached over 300 people in the community, in care homes and in hospitals. In response to the pandemic, we realised that our services are needed more than ever, and quickly adapted to offer sessions via Zoom as well as offering online filmed resources accessed for free on our website. When restrictions and weather allowed, FMNC also provided outdoor singing sessions in care home/hospital car parks and gardens. As there are no geographical limitations on our ‘virtual’ service, we will maintain this aspect of our delivery alongside in-person sessions. We now have over 1000 care homes across the UK accessing our online resources and all our in person services have fully recovered and expanded.  

Although the impact of dementia can be devastating, FMNC sessions are far from sad. Joy and laughter are the norm with each session providing a little relief from the often relentless everyday caring routine. One chorister described FMNC as ‘a spa for the soul’ which sums it up perfectly. 

 

Project examples:

Digital Threads

Location: St David’s Hospital, C&V UHB 

In Spring 2021, as research revealed people with dementia were being disproportionately affected by the pandemic, we launched Digital Threads – an online music and poetry programme aimed at keeping inpatients with dementia cognitively active and socially connected. Across Wales, family and friends were unable to visit inpatients with dementia, and health care staff were overwhelmed.

We used interactive singing and movement sessions to help inpatients with dementia tell their personal stories artistically, keeping them cognitively and physically active.  We ran our three 10-week block of sessions on Zoom for 70 patients. They would sit on the ward with a Mental Health Matters staff member in front of a screen, and, from our homes, we would take small groups through a warm-up session before encouraging each to talk about themselves. This would lead us into song.  Our musicians and singers would lead the session remotely, incorporating simple physical movements to keep patients active within their limitations. 

Artists and poets Louise Osborn and Emma Jenkins silently observed off-camera to create poetry inspired by the stories shared.  In total, we worked with approximately 70 patients, favouring quality of experience over quantity, and have witnessed a positive impact on people. 

One patient, a folk band singer, was initially sceptical and disengaged. However, he opened up after we played a song called ‘An elephant never forgets’.  We also worked with a man from Hong Kong who spoke little English when we met. He didn’t respond to our sessions until we sang him a traditional Chinese folk song from his country. He sang along for the first time in his native tongue, which was a powerful moment of connection.   The poetry produced by the project has inspired artwork by renowned Welsh artist Nathan Wyburn. This and an audio reading of the poems by ‘It’s a Sin’ actor Callum Scott Howells can be found on our immersive website.  The artwork will also be displayed at the hospital for staff and visitors. 

Singing in the community 

Location: 4 groups in Cardiff, Vale of Glamorgan, Newport and North Wales. 

FMNC  supports those living with and alongside dementia in the community through groups that meet in Cardiff North, Vale of Glamorgan and Cardiff South, Newport and North Wales.  We run three 12 week projects a year where people living with dementia and their partners/ carers/ family members meet weekly for 2 hours to sing and share the joy of music within a safe, supportive community. Our innovative approach is not about bringing back memories by singing old songs, but we use music as a tool for communication and engagement in the present. By inspiring and encouraging everyone to participate to the best of their abilities, our work re-connects communities, nourishes relationships and improves health and wellbeing of everyone involved. 

It is crucial to use a dementia friendly, accessible venue at the heart of the community to encourage attendance and support our participants.  

 

With Joy My Soul Sings

Location: Online

Our tenth anniversary commission, With Joy My Soul Sings was a celebratory project which provided an opportunity both to look back on our achievements and to look ahead to future endeavours, whilst reflecting a world changed by the global pandemic.

Over 50 members of the FMNC family, including current and former choristers, engaged with us creatively for this project Members of local choirs and the Self Isolation Choir (a virtual choir with over 12,100 subscriptions to its online service from across the world) supported FMNC to celebrate the power and joy of song for all, forming a massed choir of over 150 singers.    This composition was recorded to the highest quality with professional instrumentalists to ensure the work has a lasting artistic legacy. 

 

It is available on our website and through our social media channels: www.forgetmenotchorus.com/projects/10th-anniversary-celebration/

 

Singing Strong Care Home Chorus

Location: Online, Cardiff, Vale of Glamorgan, Rhondda Cynon Taff, Blaenau Gwent, Bridgend, Newport, Gwynedd, Conwy, Cornwall

FMNC Singing Strong Care Home Collective (SSCHC) supports those living with and alongside dementia in the care home community across the UK through the power of song. Inclusive sessions, online and in-person, improve the health and wellbeing of residents and staff, offering an opportunity to share a positive and uplifting experience together. 

 

As a member of the SSCH Collective, a care home receives 3 Zoom sessions and 1 in-person interactive singing session for staff and residents per month. More than a simple singalong, all sessions are led by an expert music team and designed specifically for people living with and alongside dementia, connecting loved ones, carers and residents by building communities. We use music to communicate, to encourage movement, engagement and interaction. It’s more than singing old songs, or bringing back memories. We’re about creating a ‘spa for the soul’, living in the moment and bringing joy to all. 

 

Pre recorded singing sessions – Sing with me, dance with me & If music be the food of love, play on

Location: Online – nationwide

We want to tackle the loneliness and isolation experienced by so many impacted by dementia, and the inequality of access to high-quality arts activities particularly if unable to access in-person. The numerous challenges dementia put a huge strain on the physical/mental health of all affected as they often face a lack of support, and difficulty in accessing activities.  So we have created a series of high quality films, designed for care homes to use to encourage residents to engage physically and mentally in a creative activity.  These sessions have been made available to care homes throughout the UK and we currently have almost 900 engaging with this service.  

On of our latest films, Sing with me dance with me, is led by Kate Woolveridge, Artistic director and features  professional dancers.  It has also been created in the welsh language.    If music be the food of love, play on, is led by Kate Woolveridge and features vintage Pathe footage, encouraging viewers to eat and drink through strong visual and musical themes.

Recruitment

Community engagement

Forget-me-not Chorus runs sessions in the community in Cardiff, Vale of Glamorgan, Newport & North Wales.  FMNC has a member of staff who concentrates on the engagement of participants in the charities services.   FMNC work hard to ensure we are connected with support workers, community connectors and other support agencies in each area that we operate.   We also run a series of taster sessions with other support organisations, such as memory cafes, friendship groups and with day centres.   We are well established in South Wales with all sessions currently operating at capacity.  Further recruitment work is being concentrated on our North Wales choir to ensure all that are able can access the sessions.  The charity has a very high retention rate, with people staying with the service throughout their dementia journey.

FMNC Calon is a new offering for bereaved people. This is a unique service currently in its pilot stage and running in partnership with Cardiff & Vale UHB. 

Care home engagement

Our services to care homes have evolved over recent years. The same core offering is provided to all care homes although as some have different needs (and available funding) we continue to offer a variety of  pathways for care home service delivery, namely:

 

• Forget-me-not Chorus has made a library of seven pre-recorded singing sessions, available to all care homes for free via streaming services, downloadable links and via DVD.   
• Singing Strong Care Home Chorus & Zoom (this entails 1 monthly in-person session plus access to a weekly zoom session)
• SSCHC Forte (as above but with an extra 2 weekly in-person session paid for by the care home)
• FMN Care Home Chorus (weekly sessions paid for by the care home)
• Singing Strong Zoom Care Homes (this involves weekly zoom sessions only)

 

Hospital engagement

Our services in specialist Older Person’s Mental Health wards ae currently run in partnership with Cardiff & Vale UHB.  We have engaged with physiotherapists and occupational therapists in order to use music as a pathway to exercise engagement, and to assist with nutrition and hydration needs.  Attend allied health professionals meetings, including physios

Artistic/ Special Projects

One of the things that sets FMNC apart from other charities is the fact that it produces projects of high

artistic quality year-on-year. Artistic projects offer FMNC choristers a meaningful creative voice to share with the wider community, provide a sense of purpose, and instilling pride.  2023’s project sees the charity partner with Welsh National Opera to commission a new piece of work based on the newly commissioned opera, Blaze of Glory.  

 

Fundraising

We passionately believe that Forget-me-not Chorus should be free at the point of access and work hard to fundraise to support our core activities.  Fundraising activity generally falls on our Head of Development and Comms who works with the Executive Team to create and implement a Fundraising Strategy.

Evaluation

FMNC works closely with independent bodies to provide evaluation advice and methods specifically suited to people with dementia, their carers and families. This includes quantitative statistics and extensive qualitative evaluation. We use a variety of means of collecting information to ensure everyone can contribute in a way appropriate to their needs, including online surveys and verbal interviews. In addition, our team observes and participates in sessions to witness participants’ reactions and subtle but significant changes in abilities to communicate and engage. Information is collated and shared, and feeds directly into planning. Committed to ongoing learning, evaluation provides the opportunity to respond with creativity and innovation to best serve participants. We hope to contribute towards a changing mindset across arts, health and social care, as those impacted by dementia engage with arts organisations to meet the needs of all. Robust evaluation strengthens our ability to present a case for longer term funding as we have a tried, tested and fully evaluated offer. We regularly commission independent evaluation reports; to ensure continued excellence of service delivery, to identify areas for growth and development and to achieve sustainability. Recent evaluations include those by Dr Martin O’Neill (2019) and Dr Rebecca Fish & Alison Wilde (2022).

Staffing

Crucial to the success of our service, all FMNC musicians are experts in their field, offering artistic excellence combined with the skill-set needed to empower, enable and inspire a vulnerable group to engage and sing. We are able to adhere to our core value of excellence by ensuring that our music team is fully trained and then supported to deliver sessions the ‘Forget-me-not Way’: training includes how to engage those living with and alongside dementia using song as a communication tool in the present, not just as a tool for reminiscence. Kate Woolveridge, FMNC Artistic Director has collated a music library of over 100 songs, advising on bespoke arrangements to ensure that the material is fit for FMNC participants to ensure maximum benefit. Our music team expresses unconditional positive regard for each and every member, alongside the motivation to stretch our singers in a safe and validating environment. 

 

We have recently partnered with Royal Welsh College of Music and Drama to work with their Postgraduate Opera students to offer 3 music leader internships.  

 

Arts and health ethos

By inspiring everyone to participate to the best of their abilities, our work re-connects communities, nourishes relationships and demonstrates the transformational power of song. Innovative artistic projects are designed to take choristers on a journey, showing that a good quality of life can be achieved despite the challenges of living with dementia. Collaborating with other organisations allows us to better understand community needs in addition to enhancing and diversifying our own artistic experiences and ongoing practice.

 

Participant benefits 

We have many stories about effective and deep engagement with participants.  

Frank* had been in St Davids Hospital for over 3 months and Covid restrictions meant that he had received no visitors. Frank was unhappy, depressed and confused and didn’t understand why he couldn’t go home. During our weekly zooms and through 1-2-1 conversations with patients, we discovered that Frank had led a folk band and had toured the UK for many years to great acclaim. After singing with Frank, his demeanour altered entirely and each week he would sing us a song from his album to the amazement and delight of the staff and himself.

 

The observed and articulated benefits were related to psychological, physical, quality of life, and social factors, as follows:

• Receiving personalised interactions brought about feelings of joy and belonging
• Improvement in mood, reduction in anxiety
• A demonstrated will to participate
• Prompting memory through reflection and reminiscence via personalised interaction
• Feelings of inclusion and camaraderie
• Reconnection of past with present and future
• Validation of identity, autonomy and opportunity for personal growth 
• Continuity between sessions, reflecting on previous sessions
• Increased confidence, making contributions to conversations, 
• Physical exercise, use of voice and breathing, and therefore the potential for rehabilitation outside of physio sessions

 

I’ve seen patients who are, you know, just before the session, earlier in the day, where they are in bed, and they are, you know, not really moving and not really talking much. And as soon as the session happens, they just start interacting. You can see that mood change with some of the patients and, the ones that will see Kate regularly, they love to see her and it’s such a nice thing to see them just change and interact. We’ve had a few patients really come out of their shell from doing the project. (MHM)

 

• Benefits to families – recounted benefits were:

 

• Gleaning new stories from family members
• Reassurance that family member is taking part in meaningful activities
• Family member is represented holistically, separate from medicalised talk about dementia

 

• Benefits to health and social care staff – observed and recounted benefits were: 

 

• Deeper understanding, interactions, and relationships with the participants
• Better capacities to serve patients’ needs, hence an amelioration of workload
• Greater knowledge of patients’ conditions
• Wider skill set
• Connecting with staff from different specialties and areas.

Despite the constraints imposed by the pandemic, one of the MHM workers described how the singing sessions had become more important to the participants’ lives than before. They described the sessions as:

… nuggets of joy in between the tedium and boredom. (MHM)

 as an activity that:

… brings back the person within the person. (MHM)

The MHM staff found the sessions transformative, ‘opening up conversations and avenues that we can then look at in the weekly activities with patients, to return to’ (MHM). 

They also found that it fed their own creativity and developed their skills to ‘think on our feet’. 

 

What do diversity, equity and inclusion mean for FMNC?

FMNC is committed to the promotion of equal opportunities through the way we manage our organisation and provide services to the community. We develop, promote and maintain policies that are conducive to the principles of fairness, openness, inclusivity and equality. We want as many as possible, from all backgrounds, to enjoy and participate in our work. Our core work supports those with dementia from all walks of life and ethnicity and we include music from a huge range of cultural sources. Participant-focused, we continue to respond musically to the diversity ‘in the room’, reflecting and celebrating choristers’ heritage with diverse repertoire. We are committed to ensuring that everyone has a voice within our choir settings and regularly monitor programme content. 

Partnership working allows us to better understand community needs in addition to enhancing and diversifying our own artistic experiences and ongoing practice. FMNC’s origins lie in a successful joint project involving Welsh National Opera and Cardiff & Vale of Glamorgan Alzheimer’s Society and we have a diverse track record of successful partnership working across the Arts & Health sectors.

 

Inclusion is paramount in our choirs – we make a positive effort to include people with all forms of dementia, male/female, any age, of all abilities, and their carers/families.  Dementia does not discriminate; it can affect anyone. Sessions offer a shared experience where everyone is a ‘singer’ first and foremost, rather than labelled as carer, family or resident. We do not use song sheets, so as not to disadvantage those who have lost the ability to read/recognise words. This commitment to equity strengthens community, resilience and relationships, allowing participants to share the activity together. 

 

We address the inequality of opportunity for care home residents and staff to participate in high quality creative activity by offering different ways to engage. Sessions provide a change of focus from daily challenges, and reduced feelings of isolation for all result from these improved connections.

 

Instead of saying…	We prefer…
Sufferers / suffering with	Those living with and alongside dementia OR those impacted by dementia
Dementia Choir	Choir for those living with and alongside dementia
Forget-me-not Charity or Choir	Forget-me-not Chorus
Carers	Families and friends OR loved ones
Disease	Condition

 

www.forgetmenotchorus.com

 

Further Information

• FMNC was born out of a joint project with Welsh National Opera and Vale of Glamorgan Alzheimer’s Society in 2010
• FMNC is not about bringing back memories by singing old songs – we sing a huge variety of repertoire, and regularly commission and perform new pieces too
• All music leaders must participate in the FMNC training and ongoing mentoring programme – the first of its kind in Wales. Current music leaders include Royal Welsh College of Music & Drama and Royal Academy of Music Alumni
• FMNC Artistic Director, Kate Woolveridge was named ITV’s Woman of the Year in 2012
• Our patrons are ITV’s Lorraine Kelly, Classic FM’s Anne Marie Minhall and international conductor, Maestro Carlo Rizzi
• Currently, we have nearly 600 care homes rights across the UK engaging with our virtual service