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With the Juno Awards taking place this past weekend, there has been a renewed focus on the role music plays in Canadian culture. It brings people together and creates shared moments. This same idea surfaced in a different context earlier last week. During the recent Ontario Long Term Care Association conference, a keynote from Mike Downie, Telling Our Story: The Power of Narrative to Inspire and Connect, reflected on the legacy of his brother, Gord Downie, and the impact of The Tragically Hip. One of the main insights of this reflection was a simple idea: music connects people. During the keynote, reflections shared from residents at Kensington Health offered a powerful reminder: Music is a common ground for community gathering It is not about what is lost, but what is still there Music that has meaning can bring us back, even if only for a moment Mike Downie also reflected on how the storyteller can become the story. This is a clear theme in the life of Gord Downie, who was known for storytelling through his lyrics and later became the story himself through his health journey. His later work, including Secret Path , also highlighted his advocacy for Indigenous communities and demonstrated how music can be used to share stories that might otherwise go unheard. In care environments, this idea shows up in different ways. Projects like The Green Bench create space for people to share their stories directly. Music can do something similar. It can bring forward identity, memory, and moments of self-expression, even when communication changes. These reflections may feel familiar to those who work in care environments. It may look like a resident quietly joining in with a familiar song, or a shared moment where a room shifts as music begins. Connection through music may appear as: A familiar song leading to singing or humming A moment of recognition seen in a glance or a smile A shift in the tone of the room when music is introduced These moments of connection are often described as spontaneous. However, they are not accidental. Music, when used intentionally, can support connection in everyday care. This might look like: Choosing music that is familiar and meaningful to the person Using music to support transitions or care routines Creating opportunities for shared listening or singing The legacy of Gord Downie reminds us that music has always brought people together. In care environments, through the intentional use of music, that same connection continues.
Professionally, I have continued to develop my skills as a hand drum facilitator, moving beyond technique into a more intentional, care-focused approach. Incorporating Music Care strategies into drumming has transformed how sessions feel and function, allowing rhythm to become a tool for connection, engagement, and emotional expression. One of the most impactful strategies I’ve used is picking songs for care contexts during drumming facilitation. Choosing familiar and meaningful music creates instant buy-in and excitement. Some of the most joyful moments have come from drumming along to ABBA and AC/DC, songs selected by both team members and residents. These shared musical choices encouraged participation, helped everyone catch the rhythm more easily, and created an atmosphere of laughter, movement, and shared energy. The familiarity of the music allowed participants to feel confident and included, regardless of their musical experience. To support inclusive and adaptable sessions, I intentionally assembled a Music Care Kit tailored specifically for drumming facilitation. My kit includes a variety of drums, some smaller, some larger, and others with handles to support different hand grips. I also include drumsticks of varying weights to ensure adaptability for different strengths and abilities. A speaker is essential for song-based drumming, along with facilitator notes that help guide session flow. Additional instruments, such as chimes, allow me to introduce moments of calm during drum washes, while a jam drum block supports call-and-response interactions. Even my portable tote has become an essential part of the kit, allowing me to easily transport everything from one community to another. This flexibility ensures music care can meet people where they are. Music Care has also become a vital part of my personal self-care. I intentionally use music while driving to work as a way to decompress from the previous day or to prepare myself emotionally for a compassionate and grounded workday. This simple practice has helped me manage stress and transition more mindfully between personal life and professional responsibilities. Beyond daily routines, music now shapes how I experience the world. As part of my personal Music Care Plan, every vacation I take includes music as a way of learning about culture, history, and identity. In Norway, I attended a midnight concert in a local church in Tromsø and sang along with an Indigenous Sámi man who shared a song about his grandmother. In Poland, I experienced a Jewish Kazimierz performance featuring violin, singer, and accordion. In Ireland, I listened to harp and flute music at the base of the Rock of Cashel and played the drums at the Ireland Rock and Roll Museum. My travels also included attending Mozart, Strauss, and Beethoven concerts in Vienna, visiting Mozart’s birthplace in Salzburg, and participating in the Silent Night Chapel service on December 24. Each experience reinforced how music transcends language and creates a sense of belonging across cultures. Looking ahead, my journey with music continues to evolve. During my hand drum facilitation course, I unexpectedly fell in love with the didgeridoo. The low tones and full-body vibration felt deeply soothing and grounding. Quietly, I’ve signed up to learn how to play. This instrument requires internal and circular breathing, something I find challenging due to ongoing lung issues, but I see this as an opportunity rather than a limitation. Learning the didgeridoo may support Motor and Respiratory Exercises (OMREX) ® , a core Neurologic Music Therapy technique that uses singing and wind instruments to build respiratory strength and control. Through diaphragmatic breathing, increased expiratory pressure, and improved breath control, this practice has the potential to benefit both my personal health and my future work in care settings. Music Care has reshaped how I drum, how I travel, how I breathe, and how I care for others and for myself. What began as skill development has become a way of moving through the world with greater intention, curiosity, and connection.
One important step in the process of change and change management is figuring out what roadblocks you might experience along the way. Barriers are things that interrupt the goal of lasting change, and by identifying them ahead of time, disappointment and curve balls may be mitigated. In the 3-year research project that provided the operational process and evidence behind MUSIC CARE CERTIFY , the enablers and barriers within 27 long-term care homes implementing musical integration were collected and evaluated. We found 4 key factors that became predictors of success or readiness factors. We called them factors because in some cases, the indicator was a barrier and in other cases the exact same issue, handled differently was an enabler. We call these 4 factors, predictors of success: integration, core staff, processes, and delivery. Integration refers to what it takes to incorporate music into the care setting. Strong, decisive leadership, oversight, and advocacy for music care from the top and from the music care site team leader is critical. When music is perceived as holistic, integral, fun and pleasurable, then it is a huge enabler. When musical care is valued, then there is ongoing financial investment in training and programming. Care recipients need to be involved in making decisions about what happens around music so that music is not done ‘to’ them, rather ‘with’ them. Having a certified music therapist as the site team lead, or on the music care site team is advantageous for musical and clinical expertise. Musical care coaching and mentorship through training and ongoing support through organizations like Room 217 gives caregivers the confidence to use music effectively and responsibly. Core staff means that there is a group of staff members responsible for music care delivery, and they are all using music as care. Using a relational, person-centred approach, staff is aware of care recipient needs, and knows when music is most appropriate to meet those needs. The workplace culture is predominantly a growth mindset where staff are encouraged to learn, try new things, and think outside the box. There is a drive towards continuous improvement, where evaluation is a best practice, including professional reflective practice. Staff is adaptable and can easily flex and adapt to a changing environment and care recipient needs. Processes comprise the internal operational procedures that impact music care delivery. When recruiting care recipients for music care, residents are prioritized based on their needs. Music care planning has sequential steps and determined accountabilities with resources such as physical space, technology, and musical instruments available for music care. The plans and processes are well communicated and mobilized with the team. Music care tracking and training are well in place and are regularly reported on. Delivery of music care is reflected by flexibility. Is the music care program or strategy adaptable to language for example, or group size? Having the confidence to deliver music as care does not depend necessarily on your perceived musical talent. Being confident in the process of what you are delivering is most important. When musical care is delivered with social bonding in mind, then inclusivity, whether that is about ethnicity, or socioeconomics, becomes a necessity. Frequency of music care programming or strategy may be an important indicator for success. Delivering music care with a cohesive team approach is optimal. When music is used as an agent of change, particularly as a change management system like MUSIC CARE CERTIFY , the organization benefits in a number of ways. There are business wins such as differentiation from competitors, strengthening unique sector strategies, showcasing the achievement of your team, boosting morale. There are staff gains. Staff feels supported with new learning, access to music care tools, strategies, training and ongoing support. Staff may feel more resilient by building some personal musical self-care strategies. And we’ve shown some of the measurable changes that music can help to make: improved sleep, improved appetite, greater engagement, safer transitions for example. There really is nothing more person-centred than music care. It is completely customizable. Most of all, the care experience changes – for everyone in the circle of care. Better care. Improved quality of life. Moments of joy. Empowerment. Human connection; those are the changes we need and are looking for.
I undertook the MUSIC CARE Certification program when I had journeyed through caring for my mother with Alzheimer’s. It was during my training, I learned how music works in terms of timbre, melody and rhythm and beat, music care domains and music care strategies. It helped me to support mom as the disease progressed. I continued to certify through Music Care and then I had the joy of teaching others the level 1 program Fundamentals of Music Care Theory and Context . I have loved coming alongside others in Long Term Care and using music to support giving voice of what is within one’s life, preventing isolation and loneliness, creating community. I enjoyed all it all. Then, I found myself once again in the Emergency Room with Tim, (my family member) as we were helping him home in his palliative journey. My “outside life” took a back seat and my inside hospital life began. Tim’s was failing and he was no longer able to open his mouth and swallow to obtain nutrient’s due to Parkinson’s . We tried various types of foods, textures and flavours, however, opening his mouth and swallowing remained inaccessible. Tim loved Glen Campbell and Rhinestone Cowboy . When he was a young man, he would repeated play this song until the LP was worn through. He was given a new Glen Campbell CD at Christmas and the song was welcomed back into our lives. There I was ,in my new environment on the tenth floor of the hospital, playing Rhinestone Cowboy. Tim sang along. He actually sang along! He moved his mouth, swallowed and sang along. We were able to get pureed food into his body. Later, the disease continued to ravage his body and Rhinestone Cowboy helped us connected with other such as the speech language pathologist, doctors, cleaning staff and nurses. We sang and danced together with the music and Tim smiled. He knew he was part of a community who loved him. As we knew the end was coming, I played music with a simple melody, 60 beats per minute and soft timbre on my harp to support Tim as he fell into sleep. Near the end, I used tonal music in simple phrases to support calmness matching his breath. Tim passed peacefully and gentle. Today, at his funeral our last song “Rhinestone Cowboy”. After hearing the importance of this song, all the people present joined in singing to honour the village of Tim that so lovingly cared for him. Music Care training has become a natural rhythm in my life to use with aging and sick family members, supporting young children’s learning and providing self-care when I was tired after intense caregiving.
Innovative leaders in health and social care are always looking for evidence-based, scalable solutions that can meaningfully improve care. Music care is a transformative approach that’s making measurable, sustainable change in care settings. Several years ago, the Room 217 Foundation developed a Theory of Change (ToC), a framework designed to document how a program works, why it works, and the impact it creates. ToC is a concept rooted in program evaluation from the 1990s. The value of ToC lies in its structured approach to making complex change programs clearer, more accountable, and more effective. Room 217 had already created logic models for our various programs. ToC took us deeper—helping us think through not just the program’s activities, but the underlying assumptions, the necessary conditions for success, and the long-term benefits for all involved. Our basic assumption was simple: Music can be a powerful agent of change within a caring community. Through our research in 82 long-term care homes and 84 hospices in Canada, we saw firsthand the effects of music. Music improved people’s moods, changed the atmosphere, fostered hope, and built a sense of community among caregivers and patients alike. The ToC process allowed us to ask: How can we measure and sustain these effects on a broader scale? This question led to the creation of MUSIC CARE CERTIFY (MCC)—a quality improvement program that integrates music into the culture of care organizations, turning music into a core, measurable component of care. There have been clear advantages to developing a ToC. Leveraging a comprehensive program rationale has clarified our assumptions, assessed the merits of our standardized quality improvement program, and explained the activities and processes that contribute to change. We have established a shareable vision of the program and identified enablers and barriers to success we can explain to others. We discovered that ToC design methodologies vary. Yet each method typically addresses several key areas which include: Identifying a problem or opportunity that requires a program response, the root causes and effects of the problem and who is affected Scoping the objectives of a program solution and the foreseen impact Naming stakeholders who would likely be a part of the solution Enumerating measures of success Listing assumptions about why, in our case, we think MUSIC CARE CERTIFY will work. The visual metaphor we used to guide our ToC was a tree. We placed the causes of the problem at the roots, the effects as branches, and then focused on the leaves and fruit as the solutions. The imagery helped us map out how music could grow within a care environment, eventually becoming a deeply embedded part of the care culture, a visible and lasting solution. Through this process, we became even more convinced of music’s role in solving the quality of life issues that so often affect caring communities. By integrating music care systematically and sustainably—through the components of MCC—we provide a realistic, scalable solution that’s both affordable and replicable. Imagine care settings where music is integrated into the culture, where quality of life improvements are not just hoped for, but proven. This is the future we’re building—one where music becomes a key player in revolutionizing care.
Jazz Walia is a third-year undergraduate student in the Bachelor of Health Sciences (BHSc) program at McMaster University. During the 2023 winter academic semester, she participated in the Room 217 Research Practicum course generously funded by FAVDTR and wrote this blog post as part of her coursework. When I was in my first year of university, just before my first undergraduate assessment, our professor’s only piece of advice was: “Just put on some Mozart 30 minutes before and you’ll be grand.” I initially thought the advice was completely random, but I was convinced it was a hint for a question or even bonus points. Not so shockingly, there were no Mozart questions on the test, but I did end up typing “Mozart” on Spotify 30 minutes before our test and listening to the first classical music playlist I saw. Two years later, my Spotify and YouTube recommendations are filled with playlists called “Calming Music for 12 Hours” or “Classical Test Music.” Music has always provided me with great comfort; however, it is the soft melodic tones of classical music that have transformed my "pre-test ritual." For me, this type of music has always had a calming effect on me whenever I feel stressed, but especially when it comes to mitigating performance anxiety. A quick search on the internet will yield you thousands of results of people searching for the same thing—"calming music"—on various streaming services. Millions of people listen to the likes of Mozart , Bach , Chopin , etc., on platforms such as YouTube and Spotify, begging the question: why exactly does it work? Over the past couple of decades, research into music listening has inspired further exploration into the use of music as an intervention for reducing anxiety. In a recent survey by the Centre for Addiction and Mental Health (CAMH), 25.1% of survey participants expressed feeling moderate to severe anxiety. In addition, 24.0% of Canadians indicated needing some sort of mental health services but were unable to access them, highlighting the need for accessible services and systems. It’s estimated that only 20% of people experiencing anxiety receive formal interventions , illustrating the need for evidence-based resources. Previous research suggests that music can have a significant effect on endocrine function and autonomic activity, enhancing parasympathetic activities—your body’s "rest and relaxation" state—and reducing respiratory rate and heart rate. In a study by Ubmrello et al ., featuring about 960 critically ill patients, 15 to 60 minutes of music therapy were shown to have a significant effect on reducing anxiety and stress. In a recent review of 21 studies conducted by Harney et al., it was discovered that listening to music had an overall large effect on reducing anxiety. This study was the first of its kind and highlights that while we can see a link between music listening and anxiety, more research needs to be done into important aspects such as music selection, length, setting, and dosage when looking into this relationship. Even if you’re not a fan of the classics, both "fast" and "slow" music have been shown to improve mood. In a study by Darki et al. , 98% of fast music listeners and 99% of slow music listeners reported that music helped manage stress. The study also showed that listening to slow music decreased heart rate and both systolic and diastolic blood pressure . Fast music, on the other hand, increases heart rate and both systolic and diastolic blood pressure. Fast music was seen as "uplifting," while slow music was seen as "calming." These feelings of calmness when listening to slow music help showcase why it might be helpful to listen to music in an anxious state. Of course, "slow" music isn’t restricted to just the classics, which arguably can be "fast" at times, but rather music that often features a relaxed pace, a slower tempo, and a simple, repetitive rhythm and melody. Our relationship with music is extremely subjective and unique to our own experiences. It has been shown that music has profound effects on both our physical and mental health; it can serve as a significant non-pharmacological resource to help mitigate anxiety and stress. The internet—most notably YouTube, Spotify, and Apple Music—is filled with playlists specifically for mood. Music and video streaming websites are a great place to start when selecting music that works for you and exploring different genres and playlists! Author’s note: Spotify , YouTube , and Apple Music are audio streaming services that can be accessed through the internet or through cellular devices. Creating an account is free and on YouTube, an account is not needed to listen to music.
Articles
Askham, J., Briggs, K., Norman, I., & Redfern, S. (2007). Care at home for people with dementia: As in a total institution? Ageing and Society, 27(1), 3-24.
Burrows, T. (2009). Music as a therapeutic medium for engagement: Training to support the well-being of caregivers as well as their cared-for patients. Working with Older People, 13(3), 25-28.
Duggleby, W., Williams, A., Holtslander, L., Cunningham, S., & Wright, K. (2011). The chaos of caregiving and hope. Qualitative Social Work, 11(5), 459-469.
Duggleby, W., Williams, A., Wright, K., & Bollinger, S. (2009). Renewing everyday hope: The hope experience of family caregivers of persons with dementia. Issues in Mental Health Nursing, 30, 514-521.
Engstrom, G., & Hammar, L.M. (2012). Humming as a potential tool for facilitating feeding situations between persons with dementia and their caregiver: A single case study. Music and Medicine, 4(4), 231-236.
Gotell, E., Brown, S., & Ekman, S. (2009). The influence of caregiver singing and background music on vocally expressed emotions and moods in dementia care. International Journal of Nursing Studies, 46(4), 422-430.
Graneheim, U.H., Johansson, A., & Lindgreen, B. (2014). Family caregivers' experiences of relinquishing the care of a person with dementia to a nursing home: Insights from a meta-ethnographic study. Scandinavian Journal of Caring Sciences, 28(2), 215-224.
Lilly, M.B., Robinson, C.A., Hotzman, S., & Bottorff, J.L. (2012). Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada. Health and Social Care in the Community, 20(1), 103-112.
Magill, L. (2009). The spiritual meaning of pre-loss music therapy to bereaved caregivers of advanced cancer patients. Palliative and Supportive Care, 7, 97-108.
McClendon, M.J. & Smyth, K.A. (2013). Quality of informal care for persons with dementia: Dimensions and correlates. Aging & Mental Health, 17(8), 1003-1015.
Books
Clark, D., & Emmett, P. (1998). When someone you love is dying. Minneapolis, MN: Bethany House Publishers.
Figley, C.R. (Eds.). (2002). Treating compassion fatigue. New York, NY: Brunner-Routledge.
Macmillan, K., Hopkinson, J., Peden, J., & Hycha, D. (2004). A caregiver’s guide: A handbook about end-of-life care. Ottawa, ON: Canadian Hospice Palliative Care Association and The Military and Hospitaller Order of St. Lazarus of Jerusalem.
Rio, R. (2009). Connecting through music with people with dementia: A guide for caregivers. London, UK: Jessica Kingsley Publishers.
Links
Caregiving Matters
www.caregivingmatters.ca
A Place for Mom
www.aplaceformom.com
North America's largest senior living referral service, having helped over one million families since 2000. Unique in that they have Senior Living Advisors who offer personalized one-on-one guidance to families as they search for the right care for their loved one, at no charge to them. Check out their Caregiver Toolkit.
Canadian Homecare Association
www.cdnhomecare.ca
Caregiving Matters
www.caregivingmatters.ca
Offers support and education to those coping with the declining health or death of a parent.
Family Caregiver Alliance
www.caregiver.org
A U.S. based online help site for caregivers including support groups, resource guides and disease-specific information.
Simply for Seniors and Those Caring for Seniors
www.myuxbridge.info/seniors.htm
The Careguide Online
www.thecareguide.com
On Grief and Grieving
www.davidkessler.org
Quality of Life Publishing
www.QoLPublishing.com
Specialists in gentle grief support offering books, booklets, and interactive workshops. Quality of Life Publishing also offers a speakers bureau featuring authors and experts in grief and bereavement.
Robert's Press and the Grief Resource Centre
www.robertspress.ca
The Association for Death Education and Counseling
www.adec.org
A useful site for those interested in teaching or learning more about death, dying and bereavement.
The Centre for the Grief Journey
www.griefjourney.com
Dr. Bill Webster's comprehensive site providing practical support and advice for those individuals who are grieving after a significant loss.
