Life - The Art of 'Making It Up'

In my experience, care homes can be joyous, vibrant places. And re-injecting spontaneity back into the home can rapidly have a positive effect on the wellbeing of both individuals and the whole community.

I was talking to someone at the weekend about how much improvisation is involved in my job as a music therapist. "Are you naturally a spontaneous person then?" they asked. I had to think about that. Did they mean 'spontaneous' in the sense that has been appropriated by dating websites, implying an approach to life where at any second I might suddenly burst into song in the middle of the restaurant or impulsively whisk my date off for a weekend in a yurt? If so then no, I'm not.

To be honest, as an adult with a regular job my day is pretty structured; dress, breakfast, commute, work, lunch, work, commute, kids to bed, dinner, sleep. So I began to consider the last time I did something outside of work that could be described as spontaneous. Try it yourself... an hour ago? Yesterday? Last month?

What about when you clicked on the link to this blog, was that a spur-of-the-moment 'spontaneous' decision, or was it pre-meditated?

Chances are it was the former. Because within the parameters of our daily routine, the lives of most healthy, independent adults are largely ad-libbed. Making a cuppa, stopping to chat to a colleague in the corridor, updating a Facebook status. Generally these things aren't planned, we do them on impulse.

Kids are the masters of spontaneity. Mine, like most children of their age (under seven years old) have only a hazy concept of 'the future' and improvise their lives from moment to moment, leaving us adults to provide the structure. Lucky them.

But for some, such as many children with an autistic spectrum disorder (ASD), this spontaneous way of interacting with the world can be overwhelming. Often they seek solace in repetitive behaviours to avoid constantly having to deal with the unfamiliar, the new, the surprising.

Being spontaneous, making split-second decisions, however mundane is fundamental to our existence as creative, social beings. It gives our life variety and vitality. It propels us forward. And perhaps unsurprisingly we take it for granted - until something impairs our wellbeing, such as when we become ill.

Physical, cognitive or communicative impairment means acting on impulse becomes harder than it once was. We might no longer be able to make that cuppa, pop into a shop, have a chat with a friend or colleague, or go to the toilet on our own. Things that were once spontaneous and instinctive become planned, laborious or just plain impossible.

In her book 'Illness', philosopher Dr. Havi Carel describes how the ill person must adapt to 'a new world... a world without spontaneity, a world of limitation and fear'. Within a care home environment, where there are many people all facing this 'world without spontaneity' in close proximity, this can be palpable. Residents are constantly confronted with what they can no longer do. Left unaddressed, this jarring new reality can result in inertia and isolation and may spread like a virus as the drudgery of routine sucks the life from the institution as well as the individuals within it.

Yet in my experience, care homes can be joyous, vibrant places. And re-injecting spontaneity back into the home can rapidly have a positive effect on the wellbeing of both individuals and the whole community.

The nature of music makes it an incredibly powerful tool within residential care for creating these spontaneous meaningful moments. Its flexibility (it can be made in residents' bedrooms, communal areas, corridors, kitchens etc), its universal understanding (for those residents unable to communicate verbally it becomes often the only language able to be accessed and shared), its potential to be experienced or created by one or many people simultaneously and of course its ability to be improvised. As a result I'm often told by staff and relatives that our music-making brings residents 'back to life'.

Whilst music used in the right way is a particularly effective form of interaction within this environment, there are of course others. A joke, a dance, in fact any impulsive act that shows compassion and understanding can be profoundly beneficial. But however we do it, the more we get to know the person behind the impairment, the person who before their illness improvised their life just as we do now, the more resources we will have as carers and professionals to create authentic, spontaneous moments of connection that are so fundamental to effective person-centred care, and to life.


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