Worth remembering

Nora Ephron

Nora Ephron

If you’ve ever rummaged frantically through the accumulated rubbish in your brain for someone’s name at a party, you will relish Nora Ephron’s latest book, I Remember Nothing. Ephron, who wrote When Harry Met Sally, Sleepless in Seattle, Heartburn and, most recently, Julie and Julia (which she also directed) has published a new collection of blogs, columns and jottings, in several of which she addresses the depradations of age with her characteristic wit and verve.

The articles are of variable length and some seem rather more tossed off than others, but Ephron is incapable of being boring. The opening piece, which gives the book its title, is stylishly constructed and full of good jokes about the awfulness of losing your memory: ‘I used to think my problem was that my disk was full; now I’m forced to conclude that the opposite is true: it’s becoming empty.’ Ephron goes into a store to buy a book about Alzheimer’s Disease and forgets its name; she spots a woman in a Las Vegas Mall and wonders why she recognises her, only to recollect that she’s her sister, the person she is there to meet.

In one of the best passages, she describes attending an anti-Vietnam march in her youth – or rather, not attending it because she spent most of the day in a hotel room having sex with the lawyer she was dating at the time.

Norman Mailer wrote an entire book about this march, called The Armies of the Night. It was 288 pages long. It won the Pulitzer Prize. And I can barely write two paragraphs about it. If you knew Norman Mailer and me and were asked to guess which of us cared more about sex, you would, of course, pick Norman Mailer. How wrong you would be.

Ephron blogs for The Huffington Post and the pieces in the book reflect a wide range of interests – her love of journalism; the alcoholism of her parents; her online Scrabble addiction; and a moving piece about her identity having been defined for most of her adult life by the fact of being divorced. But it’s the pieces about ageing (Ephron is 69) that bookend the selection and give it resonance. ‘You lose close friends,’ she writes, ‘and discover one of the worst truths of old age: they’re irreplaceable.’ This is a particular, spiky, charming take on ageing, fiercely individual but very recognisable.Book jacket

Music making intense experiences for people with dementia

making musicOn a day when it has been reported that if Alzheimer’s were a company, it would be bigger than Wal-Mart, I’ve been to Wigmore Hall to look at a scheme that seems to be improving the lives of people with dementia and those who care for them. Music for Life is hardly on a scale to make a dent in the £388bn it’s estimated dementia will cost worldwide this year, but it does show how creative we may have to be in addressing what is being called the most significant health and social crisis of the century.

Music for Life involves three orchestral musicians taking their instruments into a care home every week for eight weeks, where they improvise with eight residents plus up to five staff. The group sits in a circle, allowing anyone to take the lead. Both the musicians and the care home staff report often being deeply affected by the work, while people with dementia often show changes of mood and ability to communicate. Their relationships with staff and each other can shift significantly.

People with dementia may experience depression or despair, intense anger, grief, anxiety, fear or boredom; they may be agitated or apathetic, frightened or bored, withdrawn or distressed. Many of those with whom Music for Life works have lost the ability to communicate verbally; to find another means of communication requires intense effort, sensitivity and responsiveness. There is increasing evidence that one way to do that, perhaps the best way, is through music. The musicians bring a variety of instruments: hand-held percussion, rain sticks and shakers of various kinds, plus some tuned instruments, such as bar chimes, all ‘selected to look beautiful and to make a lovely sound,’ says Kate Page, an oboist and the project manager. There are no rules. ‘You need 360 degree radar to see what’s coming out of the group and to improvise at the same time. The musicians try to keep the textures open so even the smallest voice can be heard, to pick up signals – body language or tiny cues of stillness or eye contact – and find a way to enhance and augment the communication. We’re looking for high engagement levels – really searching for that person on their own terms, not trying to impose on them, so that they know they are really being listened to and asked to contribute.’

Music for Life has been around since 1993, when it was founded by educationalist Linda Rose, drawing on work being done at the Guildhall School of Music and Drama with young people. Initially, the project was delivered exclusively in homes owned by Jewish Care, but has since expanded with Westminster NHS Trust and is about to start in Brighton. Management of the project was last year transferred to Wigmore Hall in partnership with Dementia UK, and there will be 10 projects this year, up from seven last year.

Sam* has dementia and was seen by the care staff in his residential home as aggressive and distrustful. He was liable to lash out, but staff couldn’t predict why or when, and that affected their behaviour towards him. ‘Music for Life gave the staff an opportunity to sit very quietly, being with him,’ Kate says. ‘It allowed them to explore other aspects of what being Sam might be like.’

There are challenges for all those involved: the musicians must strip away the ‘presence’ that characterises formal concert performance and have to learn to ‘sit on material for a while, to repress the urge to move forward, allowing people in the group time to understand it and find a way in. The sessions tend to have a really open, slow feel. We live in a very fast world and we have to remember that a lot of the people we’re working with are impaired and need time.’ In care homes where staff are often harassed and focused on getting through tasks, Music for Life offers a breathing space for thought and quiet assessment – not just in the hour when the music is being made, but the hour-long debrief that follows. ‘Care staff often don’t have a chance to reflect. This gives them an opportunity to think beyond the practical difficulties facing the people they care for, about their emotional wellbeing.’

Given the limited abilities of people with dementia to communicate, the work can be difficult to assess, although qualitative data from each project is evaluated and the overall programme reported on annually. This year Music for Life will be the subject of research by academics in the Netherlands.

Its aim is not to establish music in care homes, but to affect the emotions, practice and relationships of all three groups involved – musicians, carers and people with dementia. Kate Page believes that the musicians who participate – ‘it’s certainly not for everyone’ – are deeply affected by the relationships they form and what they learn about themselves and their playing. For care staff, ‘it is a chance to think in a less task-oriented, more experimental way.’ One carer has started greeting residents in her group by singing their names, cementing the bonds formed in the circle and finding a way to reach people differently.

Dementia is associated with loss. Music for Life focuses on what is still intact and can be reached, offering people with dementia something they almost never experience otherwise – the opportunity for teamwork and even to direct others, through conducting. ‘As sessions go on,’ Kate says, ‘you see that people look more and more across and around the circle, rather than just at the person next to them.’

The results have been persuasive enough to attract funding from the Arts Council, Barclays Capital, the Rayne Foundation, and a number of other trusts and individual donors. The programme requires intensive, highly personalised work by artists of high calibre, who are called on to lay bare all their sensitivity and responsiveness. Each eight-week project costs £6,500 to deliver, and Wigmore Hall is looking at different forms of collaborative funding to make it affordable for care homes.

With the number of people with dementia expected to double by 2030 and more than triple by 2050, Music for Life is unlikely to become a catch-all therapy. It may, though, offer some clues about ways to reach what is still intact in those with dementia, and to bring an injection of new energy into care, a way of relating. In settings where it is easy to feel ground down, Music for Life offers care home staff a chance to think and feel differently about what they’re doing. ‘The ends of projects can be very difficult,’ Kate says. ‘It’s hard to leave. You create deep relationships and bonds, because you have to go very deep to connect.’

*Sam’s name has been changed

percussion

The small society

Dorothy Runnicles

Dorothy Runnicles

I met the redoubtable Dorothy Runnicles at a conference a couple of months ago and have just read the report she published in February this year on voluntary groups run by and for older people. Her findings are encouraging – suggesting that there is far more community involvement than anyone officially knows anything about – but also concerning.

Runnicles is 86 and a campaigner for the greater involvement of older people in decision-making. As a member of Cambridgeshire Older People’s Reference Group, COPRG, an umbrella body for community groups across the county, she was involved in a year-long study of the role that these community groups (some of which are intergenerational) play in older people’s lives.

Her report suggests that untold thousands of local groups are operating under the radar of social services or the Charity Commission. Statutory and non-statutory bodies, she writes, are ‘failing to pick up huge numbers of small, dynamic, informal groups,’ that contribute to the well-being and quality of life of older people.

So the good news is that we aren’t living in an atomised society of competitive individualists in which neighbours are shunned. The not so good news, at least if you are trying to create a big society which works for everyone, is that a great many of these groups are specific to their locality.

One of the key findings of Runnicles’ report was how diverse groups were, reflecting a very wide range of interests. COPRG divided the 260 groups it studied in detail into three: those based around a locality; those linked to a faith group or a church; and those brought together by a shared interest, like caring or Alzheimer’s. The organizations in the first category often began as a spontaneous response to a specific issue, such as cuts in public transport, though their remit may have since grown considerably. They don’t seem, in other words, to be something you can simply pick up and plonk down somewhere else; their vitality derives from their organic, local quality.

Runnicles’ report is called Unsung Heroes in a Changing Climate, and it argues that in a time of increased pressure on public finances, it would pay policy makers to give greater voice to these groups. Ageism and prejudice, it implies, are among the main reasons why no one takes much notice of them. Many community groups are run by people aged 66-86 and over, and many of their members would be regarded as less than fully fit.

Nearly 10 years ago, the New Economics Foundation published a report arguing that there were thousands of what it called ‘micro social enterprises’ in Britain that were ‘unstudied and undervalued.’ Despite all the interest in social capital and user-led services and participation that there has been since – not to mention the current stir about the big society – it seems that, as ever, community groups run by and for older people continue to be seen as marginal.

The Turner Prize – why the daft age limit?

Installation by Susan Phillipsz

The Turner Prize shortlist has been announced, to the usual accompanying grumbles. Which is only to be expected; the prize was devised to get people talking about contemporary art and it would hardly be doing its job if it didn’t provoke controversy and complaint.

Some of this year’s griping has had a rather odd flavour, though. Where in the past the nominees have often been dismissed as too brash and scary and silly, there’s a sense that, this year’s artists, frankly, are all getting on a bit. All four are in their forties and one of them, alarmingly, is 49, which is as old as you can be and still be considered. ‘It’s odd that a bunch of quadrenarians should make up the entirety of the shortlist,’ writes Will Gompertz, the BBC’s arts editor. ‘What new development is any of this lot heralding?’

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