Krista de Wit, born in Helsinki in 1986, trained as a violinist and went on to earn her doctorate in music education research in Vienna with a dissertation entitled Legacy: Participatory Music Practices with Elderly People as a Resource for the Well-Being of Healthcare Professionals, for which she received the Herta and Kurt Blaukopf Award for outstanding dissertations at the mdw. In this interview with mdw Magazine, she speaks about her experiences as a musician in healthcare and as a researcher studying the power of music to catalyse social change in hospitals and nursing homes for both patients and residents, but above all for the involved healthcare professionals, whom music helps to experience deeper humane connections in on-the-job interactions in the face of their everyday professional lives’ enormous demands.
How did you arrive at your research topic?
Krista de Wit (KW): As early as my studies in Helsinki, I’d had the opportunity to become familiar with community outreach projects—including ones involving seniors and individuals with dementia as target audiences. Later, as part of my master’s thesis in Stockholm, I specialised in participative music projects for older people with dementia. It was while studying in the Netherlands that I then became familiar with the concept of person-centred music. This is a dialogic approach to music-making in which music arises from the interpreted musical needs of patients or nursing home residents as they interact with specially trained musicians. I went on to lead interactive concerts and workshops for older people with dementia, a pursuit that I found very enriching. For instance, I witnessed in one such concert how a man with advanced dementia suddenly stood up and recited a poem. The music had catalysed something inside him; in that moment, he was experiencing a direct connection to his own biography through the music, and it was a very moving moment for everyone there. I then took part in developing a new practice in the context of Meaningful Music in Healthcare (MiMiC) both as a musician and as a researcher in Dutch hospitals. Seeing how music moves even complete strangers to support each other through musical interactions then motivated me at the beginning of my PhD-research, which focused on healthcare professionals’ experiences and learning in live music sessions.
What findings did this work end up producing?
KW: Initially, many care professionals were sceptical and uncertain regarding their roles in the music sessions—for example, as to whether it was actually appropriate for a nurse to sing along while on duty. But as the music sessions progressed, the care professionals realised that the musicians were pursuing the same goal as they were—namely to care for and pay individual attention to their patients in the best possible way. Person-centred music-making is a counterpart to person-centred care, representing care through music. It supports dialogue and exchange between musicians and care professionals, and one outcome is that the care professionals begin to view live music-making as an enrichment that supports them in their fundamental caregiving mission. In the communication between patients and care professionals, music opens the door to emotions and engenders a greater degree of humane connectivity in clinical routines. And creativity is likewise stimulated, since everyone can participate musically in their own ways—after all, everyone has some relationship with music.
How do the live music sessions and interprofessional learning transpire?
KW: In the sessions, musicians offer pieces from a broad catalogue of arranged repertoire and also create musical improvisations based on the patients’ or nursing home residents’ wishes and responses. This approach, which focuses on the respective individuals, is an expression of care—and it allows a sense of connection to develop between the musicians and the patients or residents as well as with the participating care professionals. And for interprofessional learning, it provides a valuable foundation. In workshops for people with dementia, for example, we might sing a simple melody together with the participants at the beginning and at the end of a session. This melody becomes familiar to them. The care professionals can then hum the melody while attending and providing care to the residents, which can help to calm them. Every session also includes a debriefing for the musicians and the care professionals. In such debriefings, the musicians and healthcare professionals can exchange valuable information regarding things like what they noticed about the patients or residents during the music sessions from their different professional perspectives, and they can also give each other recommendations as far as interacting with the patients or residents is concerned.
What kinds of things have you observed in the healthcare system, and what recommendations do you have?
KW: When hospital ward or nursing home managers are supportive of live music practices and communicate their goals and values to the care professionals in advance, the care professionals will often be more receptive to the live music projects at their workplace. The musicians depend on the care professionals’ collaboration in their efforts to offer the patients or residents person-centred music in an optimal manner. The musicians can only succeed in that if the care professionals open up to the music project despite any initial hesitatency. For attitudes to change, you also need time and continuity in terms of the individuals who are present in the context of music-making. The caregiving professions, however, are battling high turnover rates—and it can initially be difficult to convince people in management functions to invest in live music projects. Even so, it’s clear to see that musical projects contribute positively to care professionals’ workplace satisfaction: through the music and through creative involvement, they can briefly feel like they’re not on autopilot but rather just being in the moment—and that they’re perceived and valued as human beings in the musical interactions, as well. What’s more, musical offerings can help to briefly soften the strict hierarchies that exist in hospitals between physicians and nurses: experiencing music together helps to balance existing social structures.
In order to further promote music in the healthcare sector, we need to strengthen the professional identity of musicians who carry out projects in hospitals and care facilities. We need a common professional language, more training opportunities for musicians in this area, and more conferences and networking to develop the professional field of music in healthcare. Communicating actively about such developments would also attract the kind of public attention that could make it easier to get such projects funded. So in general, the cultural sector needs to continue working toward showing its relevance to and importance for supporting well-being through arts offerings in the healthcare sector.
What motivates you in your artistic work and your research?
KW: Music-related projects in the healthcare sector bring out all those things that unite us human beings: we come together around a piece of music, and the piece of music reflects its meaning to the participants. Music can reveal deeply human aspects to us—and from my point of view as a researcher, there are still a great many areas that we can study further where music in settings outside of or beyond musicians’ conventional occupational profile is of significance in rapidly changing societies. Music is something made by people, for people. And seeing how this humanity can be shared and how emotional connections with vulnerable groups such as hospital patients or people with dementia can be fostered is something that I find extremely motivating.