Conclusion
Based on observations, interview, and reflections the Rí Rá sessions demonstrated that an appropriate choice of live music and performance can change and/or amplify positive relationships within a care setting. This positive disruption of key relationships appears to change the culture in the care setting over the course of the intervention.
What does these mean? The Rí Rá sessions were created by a team of performers – musicians and dancers – with experience working in care settings, with a belief that what they did was valuable to the residents in a range of ways including physical, emotional, and psychological, and with a compassion for the residents and a passionate belief that the residents had a right to experience music and dance. The music programme was appropriate to the age and cultural backgrounds of most of the residents, that is to say that it was recognised by them.
The attitudes and behaviours of the performers in relation to the residents and the residents ability to relate to the programme of music and dance altered the wider relationships within the system of the care setting. What we mean by this is that it was observed that the behaviour of the residents changed (tapping feet, engaging with recognisable music, clapping, singing along, admiring and encouraging the performers, dancing, remembering lyrics, remembering events in their lives). It was reported that the relationship with the staff changed (staff and patients sat together enjoying the music, residents shared memories and stories that staff had not heard before, staff saw some residents in a new light – singing, playing harmonica etc., and residents saw staff singing and dancing. It was indicated that the relationship with the institution changed (some short stay residents delayed their discharge time so that they wouldn’t miss a session, others invited family to attend the session with them – the institution became more than a site of “care”, it became a cultural site, a place of sharing, celebration and new experiences and memories).
It appears that the Rí Rá sessions generated a high level of empathy within the key relationships. This claim is based on the number of stories shared about residents sharing details and memories with staff that they had not shared before, by the stories of connection with the residents shared by the performers, and by the observation of the behaviours of all players during the sessions. There is a growing body of research that indicates that “Greater empathy… is associated with better clinical outcomes and patient care experiences” (Nembhard, I.M et. al. 2022)
The Rí Rá Sessions also demonstrated Sacco’s (2011) claim that the impact of arts experiences on wellbeing indicators is exponential over the first three sessions and continues at a high level if the experiences continue. We have no data to support his further claim that the indicators drop rapidly if the experiences cease.
The Sessions also demonstrated that care homes are cultural centres and they thrive when they are built on more than one relationship (care) and its set of rituals. The new relationships generated by the presence of appropriate performers and music, by the presence of singing and dancing, by the sight of staff dancing with and for residents, by residents taking the “risk” to dance themselves, changed how everybody present related to the place, to themselves, and to each other. This change produced a surge in empathy and the positive health and wellbeing benefits associated with it. Most of all it reminded us that people live here. “This is their home! And we shouldn’t forget that” (staff member)
Recommendations
- Creative Wexford should build a partnership with the HSE, department of health, the care homes, appropriate artists, and an academic partner (e.g. SETU for research support) to design an ongoing programme of similar events.
- Consider appointing a programmer to work with care homes and other sites as cultural centres, programming regular events and inviting family and local community to them as appropriate.
- Use the partnership to ensure continuity of relationship between artist, staff, and resident over time.
- Future programming of live performance events should limit itself to two performances a day
- Build future programming of arts/health interventions on an EDI argument: people in care have a right to access appropriate arts and culture experience and therefore failure to make provision is a violation of cultural rights.
- Build future programming on an understanding of the idea of “appropriate”. Both the art and the artist/facilitator must be appropriate to the context.
- Build future programming on an understanding that the presence of arts in healthcare settings is an opportunity to positively disrupt institutional culture
Evaluation conducted and compiled by John O’Brien https://johnobrien.org/