Music in Hospitals – Artistic Reflections on Practice

Music created as part of the process of reflection on the ACE funded programme Music in Hospitals, Elderly and Dementia Care



Response: Sarah Matthews

(Click on play button to hear music)

      1. Response

Conversations began as to how to go about composing musical pieces to reflect and represent the practice of working with older people in hospital. We began discussing musical moods, motifs and characteristics that we felt were particularly related to older patients we had met in the healthcare setting, and music that we felt was particularly relevant, useful and effective when working with these patients, their families and the care staff around them. We discussed longer notes, and a sense of held moments without any feeling of pressure, a chance to breathe or sigh within musical phrases, taking time within the music as people needed to within their days. We also recognised the need for richness of harmony and the creation of a musical offer with a rounded sound with opportunities for sonorous layers to create a feeling of pleasant ease.

It seemed overwhelmingly that the right feel of pace and tempo was a slow waltz style with a pleasing shape and growing complexity, making reference to a particular piece that we all felt had been very useful and effective for patients in this environment (“The Swan” by Catriona McKay). We also wished to include a feeling of laziness and gentle lilt to reflect the general pace of movement around the wards and lack of a need to rush anything in this setting. A major key was chosen as a positive start to the piece, but it became obvious (upon discussion of other pieces that had, what we perceived as, the required feel) that the relative minor would lead at the start of the second half of the piece.

This piece has now been used many times in hospital settings, both with older patients and indeed in areas of the hospitals with much younger patients, and always seems to have had a profoundly relaxing, comforting and engaging effect on people.

The final recording was done around two opposing ribbon microphones with five musicians (Fiddle with four strings, Fiddle with five strings, Guitar, Clarinet in Bb and Clarinet in A) playing live with each other in the most sensitive and responsive way, taking turns, moving around the melody, creating subtle harmony lines, soaring high when needed, moving in unison to draw the music together and create simplicity as required and most definitely not played to a click track at exactly the same pace all the way through. The final result is a living, responsive representation of this very elegant and intuitive work that we do in an incredibly delicate environment which we will always feel honoured and privileged to be part of.

Sarah Matthews, 2018

Quirky Norm: Oli Matthews

      2. QuirkyNorm

Before writing this piece, I thought through the wide variety of musical offers delivered in hospitals to patients, families and staff and considered how different each interaction is. No two interactions are alike, even if the same piece of repertoire is chosen, the emotion, mood and character of each patient can be very unpredictable, in a good way. I started to make the correlation between musical improvisation and the patient’s character, and how ready we need to be responsive to the particular feelings in that moment of interaction. Improvisation can lead in many different ways and some very unexpected and surprising outcomes can occur. I feel this reflects the patient’s character.

So within musical improvisation, I started to think about unexpected musical phrases and techniques. Because of the nature of musicians needing to always be on their toes in a healthcare environment, I first thought about the pace in which we travel through hospital, sometimes slow, sometimes quickly to get out of the way of staff and beds coming though, for example. Having experienced many different responses to music I thought this would be best reflected in a piece with varying time signatures to reflect the quirky nature of patients. Within the older people’s wards the nature of normality is sometimes lost, as all patients are within the hospital day to day routine and not living their lives as if they were at home. Hence the title ‘Quirky Norm’.

A chromatic introduction to the piece in a major key I thought would add to the lilting nature and reflect well the responses observed from the patients. For the B part of the piece I decided to create a more introverted minor feel in B minor with an unexpected G# minor chord as the second chord to reflect the case that sometimes patients don’t want music at that time and that we as musicians respect that and move away in a calm musical manner.

In recording Quirky Norm, a stripped back arrangement of just melodeon playing the tune and fiddle accompanying on chords began the piece with a gradual introduction of clarinet. This is followed by a second fiddle and guitar adding to the complex nature and exploring more avenues and opportunities for improvisation with harmony to create a rich tapestry of sound. This all culminates with a dramatic accented B minor chord to end the piece.

Oli Matthews, 2018

Take me as you find me: Richard Kensington / OPUS Music CIC

      3. TakeMeAsYouFindMe

A reflection of older people we meet through our hospital practice, and the importance of playing for and with the person we meet, in that particular moment in time.

Life has changed for me
my world no longer as before
But I feel strangely free
dancing across the floor

Times long gone are back again
and things I knew have slipped away
My yesterdays become today
so take me as you find me
please take me as you find me

A tune once shared with me
memory of melody
The music sets me free
the words I sang come back to me

Times long gone are back again
and things I knew have slipped away
My yesterdays become today
so take me as you find me
please take me as you find me

A hand to hold
A love once wed
A smile is gold
My feelings led to

Other times and other days
I travelled very different ways
My yesterdays become today
so take me as you find me
please take me as you find me

Times long gone are back again
and things I knew have slipped away
My yesterdays become today
so take me as you find me
please take me as you find me

OPUS Musicians:

Nick Cutts: Guitar
Richard Kensington: Ukulele, Bodhran, Voice
Oli Matthews: Clarinet, Melodeon, Whistle
Sarah Matthew: Violin, Voice

OPUS Associate Musicians:

Becky Eden-Green: Clarinet, Voice
Aisling Holmes: Violin, Voice

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