View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Illinois Digital Environment for Access to Learning and Scholarship Repository TRANSCENDING THE LIMITATIONS OF INSTITUTIONALIZATION THROUGH MUSIC: ETHNOMUSICOLOGY IN A NURSING HOME BY THERESA ALLISON DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Musicology in the Graduate College of the University of Illinois at Urbana-ChampaiGn, 2010 Urbana, Illinois Doctoral Committee: Professor Emeritus Bruno Nettl, Chair Professor Emeritus Clark E. CunninGham Associate Professor Gabriel Solis Professor Thomas R. Turino ABSTRACT This is an ethnoGraphic study of the music life of the EnGlish speakers in a 430-bed not-for-profit nursinG home. Research took place between AuGust 2006 and June 2008, and included participation in both musical and non-musical activities at the home, formal and informal interviews, volunteerinG with the activities staff, and large-Group observations. In this monoGraph, I treat the nursinG home as an artificially constructed community in order to examine the role of music in daily life for the people to who live in, work at, and visit the Home. Particular attention is paid to the role of songwriting in an institution, the role of the sing-along for its participants, and the role of music and memory in the context of end-stage dementia. The study was desiGned to elucidate the followinG humanities research question: how do institutionaliZed elders use music to cope with increasinG physical, cognitive and social limitations? What I learned was that they do no such thinG. The elders at the Home use music to transcend the limitations of illness and the institution that cares for them. ii To my parents, Eva and Brian Allison, who taught me to love, to listen, and to write iii ACKNOWLEDGMENTS Every ethnoGraphic project results from the support of many people. I was fortunate to have the support of a broad network of teachers, friends, family and research participants. It is not everyone who is able to say that their research participants pushed them to continue the research project, but the elders, volunteers, administrators and staff members at the Home provided me with encouraGement, feedback and advice throuGhout this research project. AlthouGh I am unable to thank most of them by name, they deserve the first mention as my teachers, my Guides, and my friends. Of those who I can mention by name, I am grateful to Judith-Kate Friedman and Rabbi Sheldon Marder for welcominG me into their sonGwritinG Groups, for teachinG me about sonGwritinG and about Psalm study, and for reading drafts throughout this process. Janice Schwartz, director of research at the Home, mentored me throuGh the challenGinG task of desiGninG and implementinG a project in a regulation-laden facility with participants who were considered to be a special population requirinG additional safety measures. Jay LuxenberG, the medical director of the Home and a former director of the UCSF Geriatrics fellowship, has guided me throuGh this project since the first year of my residency traininG, introducinG me to the music of the Home, listeninG to my ideas, openinG doors at each step of my traininG and ultimately shapinG my career path into one that inspires me daily. At the University of Illinois at Urbana-ChampaiGn, I am indebted to Donna Buchanan, Clark CunninGham, Charles Capwell, Charlotte Frisbie (althouGh iv technically she belongs to SIUE, we grad students like to think of her as ours), Lawrence Gushee, Thomas Turino and Isabel WonG for teachinG me how to think critically and to write. I would like to thank Nora Few, Diane Gottheil and Tony Waldrop from the Medical Scholars ProGram for supportinG my desire to complete an MD/PhD in Musicology. Over the years these researchers have formed a network of support that both challenGed and inviGorated my thinkinG. After I disappeared into the world of medicine, Donna and Charlotte sat me down each time they saw me at meetinGs to listen to my GrowinG ideas about music and nursinG homes, GivinG me new sources of material to read and new ideas to brinG home with me to California. Without Diane’s endless cheerleadinG, I miGht have lost faith lonG aGo. Larry first pointed out what the medical researchers had all missed, that people with dementia remember best the sonGs of their parents’ Generation. His comments, coupled with Tom’s insistence that I learn semiotics properly, led directly to the ideas that underscore the chapter on dementia and the remembered song. Many thanks to my committee, Clark CunninGham, Bruno Nettl, Gabriel Solis and Tom Turino, for cominG toGether and supportinG a dissertation that had transformed between prelims and defense. Their critical readinGs have improved the work significantly, and all resulting errors and omissions are mine alone. This project has taken place under the steady support and mentorinG of my advisor, Bruno Nettl. Bruno has walked with me since the day in 1992 when he first showed me how to Get to the MusicoloGy Division at the University of Illinois. Over coffee, lunch and office meetinGs, throuGh medical traininG and Graduate study Bruno has cared for me and challenGed me to brinG toGether ethnomusicoloGy and medicine in v a way that draws upon the strenGths of each and brinGs something new to the table. I am lucky to have such a teacher and friend. At the University of California, San Francisco, I was fortunate to encounter another network of support in the form of a completely new Group of researchers. ToGether, they have furthered my foundations in medical anthropoloGy and supported one of the most unusual research fellowship topics at UCSF. In the Department of Family and Community Medicine, I am Grateful to Thomas Bodenheimer and William Shore, both of whom are parents of ethnomusicoloGists, for understandinG what I was tryinG to accomplish and for urGinG me on. Many conversations with Tom, sandwiched between patient visits in our clinic, led to the eventual change of research topic from Navajo sonG transmission to the music ethnography of a nursing home. The support of my department chair, Kevin Grumbach and my residency director, Teresa Villela, made it possible to audit Graduate courses while still in residency, and to Get to Tucson for the 2005 SEM meetinG in order to probe the idea of a topic chanGe with my committee. My clinical mentors, Tom Bodenheimer , Kirsten Day, Jessica FoGler, Kevin Grumbach, Shieva Khayam-Bashi, Ina Lee, Todd May, Daniel Pound, Jonathan Rapp, GeorGe Saba, Teresa Villela and Norma Jo Waxman and helped me to uncover my love of Geriatrics while retaininG the perspective of a family doctor. AmonG the Family Medicine research and teachinG faculty, Norman Hearst, Laura Hill-Sakurai, Jessica Muller, Peter Sommers and David Thom provided exceptional Guidance and support. vi In the UCSF Department of AnthropoloGy, History and Social Medicine, I was welcomed into the Graduate series on fieldwork, and was fortunate to have the support of Sharon Kaufman, Vincanne Adams and the late Gay Becker as professors and mentors. In the Division of Geriatrics, I have to thank the entire division, all of whom have at some point read my drafts, listened to my papers, and taken seriously the concept of the medical humanities. They have been Generous with their time and ideas. Seth Landefeld, our division chief, and Michael Harper, my former fellowship director, made possible a Health Resources and Services Administration Grant that funded both my clinical traininG and a year of fieldwork. Kenneth Covinsky, my Geriatrics mentor and a quantitative health sciences researcher, Gave me the Gift of takinG me seriously, learninG about qualitative research and offerinG excellent advice on writing, ideas, publications and career choices. Ken and Seth, in particular, have provided me with invaluable feedback and ideas, and have trained me in the art of communicatinG with health sciences researchers. Ken has been my teacher, my mentor, and my friend, showinG me how to naviGate a path that includes the humanities and health sciences literature. AlonG with my primary teachers in Geriatrics, Deborah Barnes, Helen Chen, Anna ChanG, Rebecca Conant, Mary Ann Johnson, Bree Johnston, Kahla Mehta, Sandra Moody, Jacqueline Richter, Michael Steinman and Louise Walters, they have provided the network of support and inspiration that I feared I had lost when I left the shelter of the University of Illinois. ThrouGhout this journey of music and medicine, a core Group of fellow students (from Graduate school, medical school and post-graduate traininG) have helped me vii through conversations, close readings, laughter, lots of food and drink, and even the occasional dance lesson. They include Joanna Bosse, Carla Brunet, Rebecca Bryant, Judah Cohen, Heather Cousins, Vikas Gulani, Chris Hess, Sarah Janssen, Sei Lee, David McDonald, Rozalia Mendoza, Vas and Shauna Naidu, Tony Perman, Chris Scales, Adam Spira, Lisa Vargish, Elyse Carter Vosen, Ron Walent, Eric Widera and Brie Williams. Your ideas have shaped my own, and your lauGhter has warmed my heart. Many thanks to David Lewis, who Gently reminded me, late in the Game, that Frances Densmore deserves mention for her pioneerinG research into healinG sonGs. The final push to finish took place under the support and encouraGement of Carla Brunet, Pattie Hsu, and Francesca Rivera from UC Berkeley and the University of San Francisco. I would particularly like to thank my parents, Eva and Brian Allison, and my sister, Sarah Allison, for readinG multiple drafts of everythinG that led to this thesis. Without the comments, love and encouraGement of these three writers from EnGlish literature, this thesis would not exist. Finally, I would like to thank my best friend, my husband Christopher Hess, and our children, Madeline and William, for the endless hours that they have spent takinG care of each other and of me as this project was carried out and brouGht to closure.