This article was written by Chelsea Mao and is part of a series provided by upper year Health Sciences students at McMaster University. Everywhere at the End of Time by The Caretaker is the alias of English electronic musician Leyland Kirby. This is a 6-album series in which they use loops of sampled vintage jazz music, featuring tracks such as “Heartaches” by Al Bowlly and “Say It Isn't So” by Layton & Johnstone. The product depicts a slow and harrowing progression, as it is a piece of haunting experimental music and noise. The albums were released from 2016 to 2019 in 6-month intervals to convey the passing of time, rendering themes of decay, melancholy, and confusion through this abstract 6-hour series. The first album is simply a compilation of samples of 1930s jazz music, noting that those living with dementia today have most likely lived through that era of music. As we progress to the second and third albums, the music slows down but is still recognizable, similar to how life slows down with time, but we still possess memories of the past. The music becomes distorted and eerie, and the sounds of the vinyl record crackle, symbolizing the waning of one’s memories with hints of confusion. It almost sounds like the realization of memories fading away with an incohesion of the past. The fourth album is when it feels like it’s practically an entirely different album. Songs and instruments start and stop playing randomly, exemplifying the memories becoming entangled and repetitive. The fifth album brings a level of fear to this 6-album series. It made the unfamiliar sounds of album four sound familiar, caked with a layer of confusion. The last album is a depressing depiction of uncertainty. The sounds of this album are so quiet that they seem loud . There are many misconceptions about what dementia is defined as , but generally, dementia is an umbrella term used to describe diseases that cause abnormal brain changes. Most commonly, people living with dementia struggle with cognition and experience a range of behavioural and psychological symptoms like agitation or depression. Although it’s found that Dementia often impacts people over the age of 65, some can still experience it at an earlier age, as early as their 40s and 50s. So, it’s crucial to grasp the symptoms of dementia and find ways to mitigate such symptoms to ease your loved ones with dementia. This is why I chose Everywhere at the End of Time, as music is a universal language that we can use to communicate with each other, no matter our background. The album helps us, the caregivers, to recognize the distressing and frightening reality of people living with dementia. For my entire life, I’ve always loved to drink Coca-Cola, and I think part of it was conditioned by my grandma. She always had a can of Coca-Cola, whether she was watching TV or playing board games with me. A few years ago, she was diagnosed with Alzheimer’s disease. It took a toll on me because we had always been really close, and with her living in China, I felt useless because I wasn’t able to be there and care for her. She's at the stage now where she hardly recognizes me. I understand that her memory of me and herself is fading, but I know that she is still there because even when she is having trouble eating food, she will always have a Coca-Cola with her meals. Although it’s hard for me to watch someone who essentially raised me (alongside my mom) suffer through this, I can’t fathom the pain and confusion she has to endure with dementia. I think many caregivers struggle to help patients experiencing dementia, and it can even have an adverse effect on their personal mental health and flourishing. However, music can be used by the caregiver or anyone to connect with those living with dementia, and I think it’s such a powerful tool for overcoming barriers between caregivers and their patients. Whether we use music for communicating with others or for regulating emotions, it’s pieces like Everywhere at the End of Time remind us how closely related music and health are.

Bono once said, "Music can change the world because it can change people." Many of us have experienced how music can shift our mood, perspective, or even deepen our sense of connection. For some, it’s a song that lifts them from a low point, for others, it might bring them closer to loved ones. In healthcare settings, music can transform not only the atmosphere but also the quality of care itself. I learned this firsthand when, during my father’s final days, my family used music to support him. We sang together to create a sense of calm, even as his medications dulled his awareness. The music allowed us to communicate and connect in a way that words alone could not. It softened the clinical nature of the hospital environment, making it a space of comfort rather than just medical procedure. Those moments had a profound impact on me, shaping my career and commitment to integrating music in healthcare spaces. For over 20 years, I’ve been dedicated to improving care through music as part of the Room 217 Foundation. We work to empower caregivers - whether paid professionals, family members or volunteers - to use music in a way that enhances the care experience. Initially, we created music tools designed to target specific care outcomes. Over time, we expanded to include training for caregivers, helping them incorporate music into everyday practice. Our latest initiative, MUSIC CARE CERTIFY (MCC), goes a step further. MCC is a comprehensive program that integrates music into the organizational culture of health and social care environments. By embedding music as a core component of care, we ensure it is sustained and becomes part of the organization’s long-term operations. One of the most powerful aspects of MCC is its focus on quality improvement. We don’t just introduce music into care settings—we measure its impact. Change isn’t just hoped for; it’s demonstrated and quantified. One standout example is the Alzheimer Society Peel (ASP), the first Canadian organization to receive MUSIC CARE Certification. This community-based organization, which serves individuals with Alzheimer’s and their families, sought to improve its acoustic environment as part of a broader commitment to enhancing care. Through a series of collaborative sound-based interventions, ASP implemented four key sound goals, evaluated through pre- and post-assessments and staff surveys. The results were compelling: Client engagement in activities increased by 75% Client wandering decreased by 40% Staff stress levels were reduced by 50% The success of this initiative underscores the tangible, measurable benefits that music can bring to care settings—improving both the experience for clients and reducing the burden on staff. In this blog series, we’ll delve deeper into Room 217’s MUSIC CARE CERTIFY as a transformative program for health and social care organizations. We’ll explore how music is not a disruptive force, but a framework for meaningful, sustainable change. With case studies from a variety of care settings across Canada, we’ll showcase how embedding music in care culture improves quality of life for all involved. Imagine a care environment where music is always accessible, integrated, and sustained! This is the future we’re working toward. Music isn’t just an art form; it’s a catalyst for measurable change in health and wellbeing. Care leaders have the power to make that change a reality within their organization. Over the next few months, our Key Change blog series will explore how the transformative power of music can improve the care experience and create lasting impact across Canada’s health and social systems. Want to learn more about MUSIC CARE CERTIFY?  Come to our free, online, 45-minute Discovery session on Wednesday February 26 – 2 pm EDT. Contact Tanya for more information talbis@room217.ca

It was two years, two months and 16 days ago that my mother was told that she had vascular dementia. The brain scans indicated she had suffered some strokes that had resulted in permanent changes to her brain. Her geriatrician suggested to her that she should consider not driving any more and that she begin to make arrangements for increased support if she wanted to stay in her own home. I could hardly believe these words; they seemed impossible, a mistake, a joke, perhaps something that this doctor told all her patients. My mum continued to be the most intelligent person I knew. I depended on her opinions, her feedback and her perspective on almost every aspect of my life. I knew my brother felt the same; he would take her through the minutia of his decisions, his financial planning, house purchases, and the plans he and his wife had for their children during their long weekly phone calls from Vancouver. My mum had spent one year taking care of his daughter during a year abroad in Florida where she studied dance at a ballet academy, a crucial step towards her present career as a dancer with the Stuttgart Ballet in Germany. Similarly, she took care of my own daughter when she moved up to Collingwood, Ontario to train as an elite cross-country skier with the Ontario Nordic Ski Team, racing at a national level. My sister’s life was equally intertwined with mum’s. Her family bought a cottage in the village our mum retired to, a sleepy, enchanted summer paradise, perched on the cliffs above Lake Huron, world famous for its sunsets. We all enjoyed long summers together, taking turns hosting family dinners, entertaining, laughing, swimming and enjoying the beach. We were a family who benefitted from the commanding presence of a brilliant, captivating, beautiful and inspiring matriarch. My mother truly was the centre of our large, bustling, extremely vibrant family with her three children who adored her and nine grandchildren who considered her as their beloved “Gabby”. I read and reread the doctor’s scrawled notes that day, with her recommendations for everything from further testing to commentary on the accompanying brain scans. I had dozens of questions: would her dementia progress quickly? Would this mean her independence was coming to an end? Should she live with one of us? What happens next? How can we help her, preserve her dignity, save her? Exactly two days later, on a cold and dark November night at 11:00 pm, she fell on the steps to her porch after walking her little Pomeranian. This fall represented the onset of a rapid decline in just about every marker of her wellbeing. After 2 weeks in and out of the hospital she came out a very different person. She was consumed by the pain from her back injury, was extremely confused from hospital induced delirium, and on heavy pain medication. What now? My sister asked. Nursing care, the doctor responded. We had absolutely no road map for how to proceed, all of us anxious, bereft, and completely at a loss. I cared for my mum over the next five months at our home, loving her, physically rehabilitating her, until we secured a place for her at a beautiful independent living senior’s residence in Toronto, near the neighbourhood she grew up in Rosedale. She is in a small apartment and has made some wonderful friends and receives the most loving care from the caregivers and staff. Mum has had her ups and downs, her dementia continues to progress, notably more significantly after an illness. Despite this being her greatest fear prior to her diagnosis, mum still lives a life that she values and has gratitude for, each day. She loves our visits and the continued devotion and love of her grandchildren. She has regained her hearty laugh and love of conversation she shares with new friends in her new community and she adores the twice weekly music concerts at her seniors home. She promises us that she intends to be sticking around for some time, excited to see how the lives of her grandchildren she has been so invested in continue to unfold, their careers and their romances. Despite struggling with memory, especially short term, her vocabulary is still superior to mine as she artfully constructs her sentences for maximum impact. During my last visit with her, I had to remind her of today’s date and that she was approaching her 89 th birthday, but she sang an entire verse of a song from “Me and My Gal” and correctly remarked, “this is definitely Chopin” that we were listening to on her speaker.  Dementia is a cruel, cruel disease, but my advice to anyone whose loved one is suffering from it, is to remain there to witness, love and appreciate the essence that is there, within the confusion, to find that essence, be present with it, let it comfort you, and hold it dearly, with gratitude, every single day.

Memory, Dementia, music and dementia, music care, musical care, singing, singing for dementia, singing for the brain

A growing concern among both recreational and clinical staff in long-term care (LTC) is the health and wellness of men in care. Health professionals have long recognized that men, both in and out of care, tend to experience lower overall health profiles compared to women. RESEARCH widely acknowledges that sex and gender intersect with factors like race, ethnicity, socioeconomic status, disability, and age to shape individual health outcomes. Notably, men face unique challenges when it comes to health and wellness. Globally, men are outlived by women in all settings, a phenomenon known as the male– –female health-survival paradox The Male-Female Health-Mortality Paradox | SpringerLink . This disparity highlights the need for gender-specific approaches to healthcare, as men’s health is increasingly recognized as a public health concern. Researchers and policymakers are working to understand the roots of these inequalities, with many pointing to social norms and behaviors formed in adolescence. We are familiar with stereotypes about men engaging in higher-risk activities, from motorcycle riding to nicotine addiction. However, one of the most significant factors affecting men’s health and longevity is their tendency to have fewer and less robust social connections compared to women. Women generally participate in social forums where they express emotions more freely, while men, historically, have been less likely to depend on social groups or engage in regular emotional expression. This can lead to isolation, which negatively impacts both mental and physical health. One promising approach to addressing social isolation among men is through men’s musicking. Music has always provided a way for men to come together—whether through singing, playing instruments, or participating in music listening groups. From male choirs like the Maesteg Choir in Scotland, to garage bands playing for the sheer joy of it, music offers a safe, non-threatening environment for men to gather, share memories, and express emotions, even if only subtly. Our September webinar presenter and partner, Gertrude Letourneau, shared a powerful story from her work in a long-term care home. One resident, a veteran, asked for permission to sing in his home language, which happened to be German. Being deeply sensitive to the other veterans he lived with, he began to sing which prompted an incredible emotional release of grief, tears, regret, reflection and sorrow.  Menno Place, a recent graduate of our CERTIFY for ORGANIZATION program, discovered through their own research that hosting a vinyl record listening hour provided a powerful way to engage self-isolating men. This nostalgic activity brought men out of their rooms and into a safe, non-judgmental space where they could share memories, relive the joy of past entertainers, and reflect on times gone by. The program bridged generational gaps, allowing them to swap stories with the younger caregivers. Linda Weatherly, Manager of Therapeutic Recreation and Volunteer Services at Menno Place in Abbotsford, British Columbia, recalled that some conversations became quite lively, even veering into “racy” territory at times. However, this openness was precisely what was needed—creating a space where the men felt comfortable being themselves and expressing what they needed to. The program, known as Men’s Musicking, became much more than a listening hour. It was a catalyst for cognitive stimulation, sparking memories and conversations that promoted social interaction and emotional expression. The long-term effects of this initiative remain to be seen, but for now, we can applaud the creative and innovative leadership of people like Linda, who are using music to address some of the most pressing concerns in healthcare today.