Opera for those living with dementia

 GELLER INSTITUTE OF AGEING AND MEMORY
​Dementia Friendly Opera – The Last Siren  
Date: 30th August 2023
Location: Lawrence Hall, St Mary’s Road Campus

by Dr. Andy Northcott, Senior Lecturer in Sociology of Medicine, University of West London
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​Dementia Friendly Opera is a collaboration between the Geller Institute of Ageing and Memory (GIAM), the London College of Music (LCM) and The Music Troupe. From the performance we hope to develop and refine a toolkit for putting on Dementia Friendly Opera and Dementia Friendly Performance at venues across the country, particularly those underserved by the Arts and for whom attendance at such events would require arduous planning and travel, laying the foundations for work beyond the London College of Music and The Music Troupe, allowing any production to become accessible and dementia friendly.

The idea of the Dementia Friendly Opera came as a shared solution to separate problems being discussed between Edward Lambert of The Music Troupe and Andy Northcott of the Geller Institute of Ageing and Memory. The Music Troupe was established in 2014 as a means for Edward to return opera to its roots, moving away from the grand halls and lavish productions that it has become associated with and moving back to the story telling tradition, with contemporary chamber performances tailored to smaller, intimate spaces. The Music Troupe wished to expand outside of well-worn theatre venues to find new audiences for Opera outside of its established base. 

At the same time Andy and his partners at GIAM, a research institute that focusses on improving the life of people living with dementia, were looking to address a pressing issue of their own. They had found that while there was a huge body of research showing the benefits of music as a therapeutic tool for people living with dementia, in practice the music chosen often made assumptions on the preferences on older people which could be wildly out of step with their individual taste. Too often musical choices in hospitals, care homes and community events were selected for their safeness, on an assumption of what would be acceptable or inoffensive to an audience, often based on a projection of older people years if not decades out of step with actual older people, while homogenising what will naturally be a range of idiosyncratic likes and dislikes.

There is a well established body of research and practice on the use music as a therapeutic tool for people living with dementia, with a body of evidence suggesting that engagement with music can minimise distress and agitation associated with dementia. (Vink et al 2003, Alfredo et al 2008, McDermott et al 2012, Wall and Duffy 2013), although there remains debate over how this is best delivered (Koger et al 1999). There is supported by a further significant body of research showing how music can be used to promote reminiscence, using music to strengthen memory, recall (Brotons et al 2000, Larkin 2006) and even recital (Baird and Sampson 2009). For those caring for somebody living with dementia seeing them remember old times can be hugely valuable, but, for those living with dementia, reminiscence is often a test they are sabotaged to fail. Even when successful, this means spending your later years in a cycle of nostalgia, living in a past that for the person living with dementia is increasingly difficult to remember. Instead we wanted to create new memories for people living with dementia and loved ones, enabling them to keep living in the now, engaging and re-engaging with the arts they previously enjoyed or to experience them for the first time, and to create these memories in a genuine setting rather than in a watered-down version of the real thing. 

Allowing older people to remain engaged with their communities, local events and the arts is important to what we do at GIAM. We are all living longer, with enhanced knowledge of well being and nutrition coupled with continuing leaps in medicine and surgery mean many of us will live well into our eighties and beyond, but society has not adjusted to support this. For too many people ageing means an end to social involvement, something hugely exacerbated when an individual or partner has dementia, even if they remain largely independent. Research (Rafnsson et al 2020) has shown that maintaining social connections and participation in activities are crucial to avoiding loneliness that can greatly exacerbate the impacts of both ageing and dementia. At GIAM we have been looking for ways to promote this, bringing diverse communities together to experience new performances, new mediums and new people as a means to promote not only living longer, but living fun and fulfilled lives.  

Our solution is the Dementia Friendly Opera, starting with a performance of The Last Siren held at Lawrence Hall at The University of West London in Ealing. The Hall is located in one of the world’s great cities for the arts, but access to these world leading performances is perceived as impossible for many older people, which we hope this performance will address. The performance itself is an unabridged version of a brand-new opera, but the auditorium itself will be set up to be dementia friendly. This will not be the first time opera has been used in conjunction with improving the lifes of people with dementia. Studies using Chinese Opera have shown its benefits as a therapy for people living with dementia (Chen et al 2020), but previous attempts at such engagement using western opera have made dementia and memory loss the topic of the performance (Fuller 2012, Wheeler 2023), rather than offering an escape from it.

​Key to what we aim to achieve here is that this is a new experience, a new production shown in its original form, rather than repurposing familiar material in diluted formats. The production itself will be shown as it would to any audience, a chamber opera performed in its entirety by professional musicians and singers. Unique to this performance will be the safety of the venue, which will be staffed by trained dementia friends experienced in working with people living with dementia and their friends and families. The auditorium will be set out to minimise fall risks and the audience will be permitted to move around, speak and leave without admonishment. We will have quiet areas prepared for those who do not enjoy the performance, or cannot sit through the whole production, and provide light refreshments, and volunteers will be on hand to assist with guidance to toilets and other facilities as needed. At its core we are not providing a safe or neutered performance, but instead a safe place for people to experience the arts they previously enjoyed or are coming to afresh.