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In the first two blogs of this Key Change series, we looked at why music is considered a care solution. Undoubtedly, there is still a lot of work to do in educating the public and the care sector with a clear rationale for musical care. The bigger question, though, isn’t why music, it is how music can become integrated into the daily practice of caregivers and caring communities in a way that is meaningful, sustainable, and measurable. Many caring communities struggle to operationalize approaches like music care in a way that’s both intentional and measurable. While the research supports music’s therapeutic benefits, there’s often a disconnect between evidence and practice. The real question is how do we move from theory to everyday application? Room 217’s Integrated Model of Music Care (IMMC) is a proven framework designed to embed music into the daily practices of caregivers and care organizations. This model not only addresses cultural and contextual differences but also optimizes music in any health or social care setting. The IMMC ensures that music is not simply an add-on or an afterthought but an integral part of a care delivery system. By considering the specific needs and operational realities of an organization, this framework encourages implementation of purposeful music and sound based interventions—such as personalized playlists, music therapy, soundscapes, or community performances—tailored to improve the physical, emotional, and social well-being of everyone in the circle of care. The IMMC framework is grounded in four key components, beginning with education. Informed music use begins by training a team at the care site to champion the music care approach. With this knowledge, the team identifies a clear intention for using music to make an impact, such as reducing isolation for residents by introducing music initiatives and interventions. These can include initiatives (like a bell choir or personalized playlist) or interventions (evidence-based practices, such as those provided by a neurologic music therapist.) These initiatives are implemented through measurable programs, care tasks, or therapeutic relationships, with changes tracked through both process and outcome evaluations. Music care integration is achieved when music becomes an essential, recognized component of the care process, with all caregivers using it intentionally to address challenges in the care environment. 

Health and social care leaders are tasked with making critical decisions that impact the wellbeing of both care recipients and staff. Since the COVID pandemic, we have all come to appreciate the complex challenges of providing quality care in long-term care (LTC) environments—challenges that often seem insurmountable, despite efforts to allocate resources effectively. A few years ago, I had a conversation with a newly appointed administrator in a long-term care home who asked me, "What’s so special about music?" It was a fair question. She was new to the sector, and with so many competing demands on her time and budget, she was understandably cautious about where to invest. That day, I gave her several compelling reasons why music should be a priority: it’s cost-effective, non-pharmacological, easily accessible, and most importantly, it’s part of the human experience. If I were to meet with that administrator again today, I’d focus on one key issue that’s at the heart of many care challenges: poor quality of life (QoL) for residents in long-term care, and how music care is a solution that can turn this around and quickly. Here’s why music care integration to address QoL is the investment every care leader needs to prioritize: Tangible Person-Centred Care Funding models often prioritize medical solutions over quality of life interventions, leading to institutionalized care recipients being treated as pathologies instead of people. Music, however, is an affordable, non-invasive, and customizable tool that can enrich the QoL for individuals at any stage of life. By purposefully designed music care programming, the focus can be shifted from just managing illness to fostering meaningful, person-centered care that enhances well-being. 2. Staffing and Retention The stress and burnout that care staff face is undeniable. Overworked and under-resourced teams struggle to meet the needs of care recipients, leading to high turnover and poor morale. Music care programs, which include self-care strategies for staff, create a calmer, more peaceful environment that can help reduce stress, improve job satisfaction, and bolster retention. Supporting staff resilience is essential in ensuring quality care for both residents and the workforce. Safety Safety concerns—whether physical, psychological, or environmental—are at the core of every caring community. Music care can enhance safety by reducing falls, especially during high-risk times like shift changes. Music also promotes cooperation and calm during caregiving tasks, helping care recipients feel more at ease. By incorporating mindful sound management into the environment, music helps create a safer, more comfortable space for all. Complex Care Needs Particularly in LTC, care recipients often face complex, multifaceted challenges—loneliness, pain, depression, anxiety, and behavioral issues. Music care offers a non-pharmacological, therapeutic intervention that addresses these needs without relying on medications or emergency room visits. By integrating music care into daily routines, the need for antipsychotics is reduced creating a more holistic approach to care. Operational Framework One of the biggest obstacles to music care integration is the lack of a structured framework. Without clear guidelines, standards, or expectations, music care often remains an afterthought. That’s why an evidence-based model, such as Room 217’s MUSIC CARE CERTIFY program, is critical. It promotes measurable outcomes, establishes the role of professional music care practitioners, and ensures that music care is sustainable and scalable across LTC organizations. Awareness and Advocacy While some care providers are beginning to recognize the benefits of music as a therapeutic modality, widespread public awareness and funding remain limited. Advocacy is needed by supporting music care education and public awareness campaigns. In this way, the evidence of music’s efficacy and especially for QoL, is brought to the forefront, making a compelling case for change that resonates with the LTC community and its decision-makers. Training for Healthcare Practitioners There’s currently no mandatory music care training for health and social care practitioners. While many professionals, including nurses, social workers, and recreation therapists, intuitively use music in their practice, they may not always have the tools or training to do so effectively. Providing music care skills training equips LTC staff with the confidence and knowledge to integrate music strategies responsibly and with purpose and to use it to boost their own self-care. In every meeting I have today with LTC administrators—whether they’re in suits or sweaters—I make it clear that musical care is a viable solution for ensuring good quality of life for everyone. With the right framework, education, and investment, music can be a transformative, scalable solution that impacts everyone in the circle of care.

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.

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

Room 217’s MUSIC CARE CONFERENCE brings together healthcare professionals, music therapists, musicians, educators, students and caregivers to explore the profound impact and power of music in care. This year, Wilfrid Laurier Faculty of Music was the lead and host partner of our 16 th conference with Concerts in Care , Metalworks , SoundsUnite and Research Institute for Aging involved as secondary partners. From the main stage, delegates experienced a mix of touching music care cameos by professional and community musicians and ensembles, keynote presentations by leading industry experts in the field of music and health and two engaging workshops aimed at building caregiver confidence using music. The theme - music across the lifespan – was brought to life by a riveting concluding performance by Canadian gospel and blues icon, Jackie Richardson. MUSIC CARE CERTIFY stories from organizations, individuals and schools were featured in Lunch and Learn session. The conference is a rich opportunity to meet people who are passionate about using music in their daily practice and to expand our music care community. This year, there was a significant increase in the number of caregivers at the conference. The work of frontline workers does not go unnoticed, and this day apart offers an opportunity for caregivers to refuel their tanks, share meaningful stories and gain new ideas and strategies for the use of music in care. This sentiment is reflected in the words of some of the delegates. Conferences are a great opportunity to refresh, reinspire and reconnect. There’s also great research and innovation happening in the world of music and wellness! I wanted to share what an amazing experience the conference was! I found every session to be either full of knowledge, skills building and/ or incredibly inspirational! I left with a brain full of knowledge and ideas and a heart full of inspiration. A beautiful conference that hit exactly the right balance of learning, connecting, and, well, loving. So important in these days and times. I just wanted to tell you how much everyone of our team members loved the conference. It was so inspirational! We were able to learn, network and be joyful. Thank you for hosting such a wonderful event. It was truly the best conference of the year for me....and I attend a lot. Key highlights included our inspiring keynotes from Brian Harris , CEO of US-based MedRhythms , focusing on music and neurologic rehabilitation, and Emily Foulkes , from the UK, a practitioner and researcher in singing for wellbeing. Workshop were deeply appreciated and topics ranged from songwriting for dementia, using ukuleles in care, from spirituals to gospel music, using songs to express hope in care, using music as direct service workers, making connections through community music and live music as a universal language of memory. The research track was popular with emerging research from music therapy, community music and Room 217 presented. For me, our conference brings opportunities to network. Professionals from diverse backgrounds connect, share experiences, and collaborate on future projects. This networking aspect is crucial for fostering a community of practice that advocates for the integration of music in healthcare. Room 217 continues to play a vital role in leading and developing partnerships towards this end.  For more information on the Music Care Conference and to stay updated on future events, visit www.musiccare.org/conference .

A key takeaway for me at Canada’s first Social Prescribing Conference is that we’ve only just begun. Every great movement must begin. By beginning, we become. Admittedly, my colleagues and I attended the conference to see where we might contribute as an arts-based community organization. While we didn’t receive pat answers or direct pathways, we met people, engaged in conversation and began to think about how we can be involved. In retrospect, I think that was the point of the conference. Beginning, exploring, connecting, conversing, becoming. We heard about several compelling examples of social prescription in Canada. Dr. Grace Park and her team in the Fraser Health Care Authority in BC have developed a systemically integrated SP approach for older adults. The partnership between Fraser Health, the provincial government, United Way BC, BC Divisions of Family Practices, Fraser Health Teams, Fraser Health Patient and Family Advisory Council and other nonprofit community organizations began in 2019 and is a leading model. Community Connectors play a critical role in the success of implementation and hold the community knowledge and put the legs on referrals by linking individuals to programs. Healthy Aging Alberta has developed a tool for SP assessment and case management used by a variety of professional and volunteers. Based on social determinants of health, this tool looks at seven domains based on Alberta’s health aging framework: physical health, safety and security, social engagement, physical environment, personal wellbeing, mental health and social supports. This tool is being used in Edmonton to support older adults in living in community. There is a SP student movement in Canada. In 2022, the Canadian Social Prescribing Student Collective was establishing joining a global network of students champions in six other countries. The objective of this group is to call for action by students, staff in health care and community organizations and faculty/administration at postsecondary institutions. The Collective believes their efforts will shape the social prescribing movement and the future of our health system. We also learned that SP is extended to family caregivers. Various provincial family caregiving organizations are developing SP pathways to build resilience, social connectedness, decreased reliance on healthcare services to support family caregivers with their overwhelming responsibilities, financial strain and system navigation. Family Caregivers of British Columbia have caregiver support specialists provide wellness planning, healthcare navigation and community connections for family caregivers. The elephant in the room for most of the conference is how SP is funded in Canada. It appears as though the CISP is strategically encouraging multiple expressions of SP to bubble up locally, having the communities themselves figure out implementation pathways and funding models. And perhaps this is the way of influence, bottom up, upstream programming that creates a demand and groundswell with compelling results that governments will not be able to deny. The recent CISP report claims that for every $1 spent on SP in Canada, the ROI is $4.30. And so we think about the arts in this movement. Our colleagues from the Mississauga Arts Council were also there, and along with us, were learning and exploring and becoming. They have launched a 2-year pilot with their ArtsCare SP program to benefit mental health of individuals living in Mississauga. While historically our work at Room 217 has been and will continue to be supporting caregivers with music care tools, training and standards to improve care outcomes, we have been developing a music wellness model. Salutogenic or preventative in approach, we define music wellness as interacting with music in a way that contributes to holistic health and flourishing. Our research shows this happens in specific ways. So we may very well have several contributions to make as we consider our intersection with the social prescription movement. In my mind, music as social prescription is a pure bullseye. Music by its very nature is connective. Music contributes positively to an individual’s state of being and can catalyzes improved mood. Doing music contributes to health and wellbeing such as increased oxygenation, cross-lateral brain activity. Musical engagement improves quality of life in every human domain.  So we continue to explore the application of music care and music wellness within the arena of SP. Stay tuned.