Music-Spitex. Music against loneliness and dementia.

Problem

1. The specific problem within the Challenge that we are solving is cultural isolation of elderly people

2. Loneliness of elderly people with and without dementia in home health care.

The aged population is currently at its highest level in human history due to increasing life expectancy and decreased fertility rate. It is a global observation in all countries of the world, but is highest in developed countries, where people above 65 years represent about 10% of the population (UN World Population Prospect, 2008). This aged population faces a number of challenges related to their decreased general health conditions, including their cultural isolation and loneliness. Indeed, with age, going to a concert is increasing challenging and, in cases of severe mobility issues or dementia, even impossible. Retirement homes offer some relief to this isolation, but it is often not the ideal solution and people prefer to stay in their own homes for as long as at all possible. Although staying at one’s own home has been shown to be fully beneficial, when at all possible, it increases the isolation and loneliness of the elderly people who choose this option. With our project, we propose to reduce the cultural isolation and loneliness of the elderly population by bringing live music directly at their home with Music-Spitex.

Music-Spitex has recently been tested in Basel, Switzerland, relying on the existing structure called Spitex.Spitex is an abbreviation for “spitalexterne Hilfe und Pflege”(external hospital help and care) and a general term used in the German-speaking part of Switzerland for home health care. In the year 2020, 2'546 Spitex services provided services for 420’793 people. Compared to 2019, this corresponds to an increase of 6.7%, (Source: For CH: Link, for US: Link, p.58). This increase can be explained by the increasing aging population and the preference of people to stay at home rather than enter retirement homes.

Despite all the advantages that staying at home offers, many people who are in home care systems such as Spitex are lonely and culturally isolated. They do not benefit from the programs offered by retirement homes. Home care systems sometimes also offer program initiated by diverse associations such as social gathering, playing cards together or visiting a public concerts. However, the elderly people are then in charge to book and attend these programs. This requires energy and skills that they might not have, especially if they suffer from reduced mobility or dementia. As Dr Bohn summarizes it in her dissertation, “comprehensive participation is hardly possible for all elderly people, as they can only take advantage of social cultural and structural offerings to a limited extent due to health or material restrictions.” (Source: Caroline Bohn, 2006, Dissertation: Link, p. 154). Often, the home health care service is then their only regular interaction, as it is the only one that comes regularly to their home. Since the outbreak of the corona pandemic, this situation has worsened, as the elderly are more vulnerable and therefore even more isolated. They take even less part in cultural events and cut themselves off culture and social life.

Music-Spitex is the first organization to offer cultural solution to a global problem like loneliness of elderly people.

In our model professional musicians come to the home of the persons cared for by a Spitex organization and play a concert for about 20 minutes. Thereby we respond to the musical wishes of the persons, e.g. to give people with dementia nice memories. In doing so, we break through the loneliness of the people and bring variety into the usually somewhat dull and monotonous everyday life. In addition, another problem is solved in a playful way: musicians, who have no income or little income since the outbreak of the corona pandemic, receive new performance opportunities and are not only culturally engaged but also socially. They receive new social skills and an additional income. 

Music-Spitex provides a replicate model as music can be used many different continents around the world by adaption of the local desires of the elderly and the available talents. Music speaks a language that everyone can understand. We cooperate with the local authorities, the Spitex organizations in Switzerland. With this solution, we want to cooperate with many other partners so that something can be achieved socially: Break loneliness, further research dementia and support dignified aging. We aim to cooperate with many more partners and association round the world.

©Daniel Bossart, Photographer

Our solution serves four categories of people:

• Elderly people with demetia 
  • The experiences we had so far, the music creates interaction and positive emotional reaction
• People who are culturally isolated and lonely
  • People in home health care are many times isolated from public events. We bring kind of a public event into a small setting and reduce loneliness and create more interaction
• Young musicians that see new performance opportunities
  • Due to corona freelance musicians are confronted with no income and much less activity. We give them a new oppornutity to earn money and use their skills not only for high educated listeners in concert but for private intimate concerts at home.   
• Relatives and close friends of elderly people with and without dementia
  • Music-Spitex is supporting the care givers and is giving them the needed emotional breaks to care efficient from their daily routine

The solution is intended for the people who are in home health care. In Switzerland, this home care is covered by Spitex organizations and/or relatives. In 2020, almost 421,000 people in Switzerland were cared for and looked after by Spitex. This corresponds to just under 5% of the total Swiss population.

(Source: Link)

In the graph of the Federal Statistical Office (FSO) (Cases managed by Spitex Services, 2020) one can clearly see that not only persons over 80 years of age are in home care, but also children, adolescents and adults under 80 years of age. Music-Spitex will have a positive impact on the lives of these people. With our solution, we will alleviate suffering and create beautiful moments that will be remembered by the persons. Therefore, we focus on participation and want the people who want to benefit from Music-Spitex to actively communicate to us what music or instrument we can use to make them happy.

People in home care are usually no longer able to attend cultural events and are therefore culturally underserved. Streaming, online offerings can never replace a live performance. Due to the corona pandemic, this vulnerable group of people has become even more cautious and cultural public events are no longer frequently attended because the group of people is afraid of becoming infected. Music-Spitex is always available with or without the pandemic. It could be that the music Spitex demands the person group emotionally at a first visit, since domestic concerts do not actually take place in such a setting. However, as soon as the first contact and the first visit have taken place, the solution will have a positive effect on daily life. When the Music-Spitex regularly visits these affected people at home, they have a goal to look forward to something, to get to know new music styles and musical instruments and if they wish they can also join in the music. This is especially intended for the still younger target group. Music-Spitex is also available for palliative therapy. We also try to realize extraordinary wishes and want to contribute to the fact that people can die in dignity.

For professional musicians, Music-Spitex wants to be a reliable partner. We pay wages according to the tariff and thus provide musicians with a new source of income. With professional musicians, even master's students who have to finance their second studies on their own and thus depend on external employers can get a chance. Musicians will gain other qualifications through this type of concerts, which are very intimate. In addition to social skills, besides new opportunities to perform, they will also gain social skills to actively interact with other groups of people. Musicians participating will get a diploma of being member of the Music-Spitex and if they want to we find a possibility that they can build up a second mainstay such as home care assistants.

We are currently working in Switzerland, but we want to expand the model to other countries in cooperation with different partners.

During my music studies, I played concerts in a retirement center and in a hospital in Oslo for a man who was about to die. I accompanied him with my music until the end of his life, for about a year. It was a very intense exchange, sometimes stressful but incredibly touching. I was able to alleviate pain with the music, to evoke good memories. This time had a very strong impact on me and gave me a lot of insight and understanding for the target group. When the Corona Pandemic broke out, touring and live performances were no longer possible; many musicians lost their income. As I was affected myself, Prof. Tania Barkat and I, Mirjam, founded the association cassiopeia, with the aim to engage in cultural participation and research on hearing. In December 2020, I played Christmas concerts for a Spitex organization at home during the harsh restrictions imposed by Corona. Since this experience was so incredibly rewarding and so many people were suffering from loneliness benefited from it, I decided to develop a pilot project out of it called Music-Spitex.

In January 2021-August 2021, the pilot project took place in collaboration with Spitex Allschwil Binningen Schönenbuch. We visited 45 people at home and played music despite the lockdown. Since then, there is a great demand on the part of the Spitex organizations and the people being in home health care. An idea became a (still very young) service, which is now open for booking to all Spitex organizations in Switzerland since December 2021.

Our small team is able to understand and cover the needs and wishes of the clients. Through my many years of work as a professional musician (viola), I have access to an intact and large network of musicians, which consists of freelance students, employees in the orchestra or at music schools. I select suitable musicians who deal empathetically with the people they care for and prepare the musicians psychologically for the sometimes very emotional concerts. I would now like to further develop Music-Spitex in order to serve our target group even better and make the offer available to as many people as possible, worldwide.

How do we involve our audience in Musik-Spitex?

We are trying to collaborate with institutions which can gain from our product and we adapt our product of their needs. Spitex is a good example how it worked so far.

Once a home health care service books Music-Spitex for their clients, we ask the clients what styles or pieces of music and instruments they would like to hear at home. If a client has its own instrument that he/she would like to hear, we clarify if it is ready to play and if it can be used for the performance. For people with dementia, we involve the relatives in the planning. This is essential so that the home concert is a success and the people are not caught off guard or overwhelmed. We create a basis of trust even before the actual assignment, which is very much appreciated, both by the hoe care service and by its clients.

We face a global problem which concerns many people: loneliness and cultural exclusion. We apply to get a voice which will be heard, we need stronger and more partners to construct a bigger network and work on different business models for different countries. We want to reduce loneliness and we want to give older and in general sick people in the last stage of life joy, comfort, hope and dignified aging. And we believe that Solve can provide us with the needed network.

1. Our model is an interdisciplinary social initiative connecting musicians with care institutions. It is adaptable, replicable and solves daily needs of elderly and their caregivers.
2. Our solution Music-Spitex will work as a catalysator. We are the appropriate intermediary between the home health care organizations and the target audience. Music is like medicine, except that it has no harmful side effects and can give energy, courage and confidence again and again.
3. Our solution can be used all over the world, with all styles of music. Because it’s important that the target group will listen to the music which will comfort them, not any new music defined by our organization. Music-Spitex is international because music is international.
4. We create new memories and cognitive stimulations for people who are lonely, who suffer from dementia, if wished until the end of the lifetime. Because all people deserve to live and to die in dignity. 
5. We encourage old people not to hide away, but to learn new things and try them out. Therefor we use more a younger generation to serve the older generation. As the two groups get in contact, we fuel generational exchange.

2021            Pilot project: finished (March-July 2021)

2022/2023   Currently we have three institutional partners. We are moving from the pilot project to the next phase. Music-Spitex becomes a service which is paid by Spitex organizations, Music-Spitex is also available to privately cared for persons

2023-2028   by 2028 we aim to have in Switzerland 10 more partners and 10 global partners. 

We are constantly in discussion with institutional partners in Switzerland and we try to tap into the network of funding partners, health insurances networks, local authorities, and other matching partners.

Music-Spitex actively lives cultural participation. People who are cared for at home and can no longer attend concerts look forward to the appointments with Music-Spitex. We create new memories, positive moments that will remain in the memory of the people concerned for a long time. In the first Pilotproject to start the Music-Spitex we visited in cooperation with one Spitex Organisations 45 homes during March 2020 and July 2021. In autumn 2021 we developed the service and made a payable service out of it. Since then, December 2021 until March 2022, we got requested 112 concerts. We also plan to do research on the impact of our work on the health status of our public in general but also especially for persons with dementia. For this purpose, we select biographical music of the persons to be visited and use it during the concerts. Through Music-Spitex, people in health home care receive a new caregiver who visits them regularly. People will feel better and will be empowered through our music.

Currently we are measuring the numbers of return visits we have and the sustainable business model. In the first Pilotproject to start the Music-Spitex we visited in cooperation with one Spitex Organizations 45 homes during March 2020 and July 2021. In autumn 2021 we developed the service and made a payable service out of it. Since then, December 2021 until March 2022, we got requested 112 concerts. We also plan to do research on the impact of our work on the health status of our public in general but also especially for persons with dementia.

We have two innovative ideas in our program. One is very old, but still working.

We use a very old and traditional form of technology. Music against sadness, loneliness and pain. King David got music played to lift up his heart. There are many studies that listening to music has a positive impact on your life (e.g. Link: https://www.scientificamerican.com/article/how-music-can-literally-heal-the-heart/ )

The other innovative idea is very new, but we are only about to start it testing.

As getting old goes mostly in one hand with hearing loss we want to implement a new technology “The SoundShirt”. By playing music the sound is transmitted through microphones via bluetooth to a Shirt which has 28 sensors to capture different sounds. By this we want to stimulate the non-hearing and not excellent hearing persons and give them an additional possibility to feel the music on the body.

Equity: We pay all musicians the same tariff and will include them in our work fair and welcoming. 

Gender Equality: Our concerts, services, research and working possibilities are open for all groups of persons.

Female 80%, Male 20% 

Our goal is to keep gender equality in balance. We follow the SDG 5 regarding gender equality.

Diversity: We have an inclusive approach. We focuse on the needs of the people in home health care and their caregivers. We are working and collaborating with people and organi from all backroudns, taking into account elements of human difference including: 

• Age 
• Differing abilities 
• Education 
• Ethnicity 
• Gender identity and expression 
• Geographic location 
• Marital and family status 
• National origin and immigration status 
• Race 
• Religion 
• Sexual orientation 
• Socio-economic status or/and economic background

Discrimination: We are against any kind of discrimination. We don’t accept unfair or unequal treatment of an individual (or group) in our association based on certain characteristics of identity. 

We sell our service to home health care institutions so far only in Switzerland, called Spitex Organizations. From the income that we get there, we can pay the musicians and all overhead costs. 

For longterm overhead costs we built up partnerships with so far one foundation (Sulger-Foundation) which gave us grants to continue our work after the pilot project. 

One of the main objectives of this application is that we need support with the business model of our solution.

We would grately appreciate to get your support on this!

So far, we use a mixed approach of our income and donations. Our aim is to develop strategic partnerships and focus more on generation revenue which will allow us to sustain our activities.

We have currently CHF 14’000 on our bank account. In the next following 3 months we count on a gross income of CHF 16’000 or with a net income of CHF 8’000 if our already booked concerts will take place as planned.