Music therapists have a lot to consider throughout the day- aside from the medical issues, ethics, and infection control, we also have to make musical decisions that will meet the needs of our patients. Under the 'musical decisions' umbrella, we make in-the-moment adjustments to tempo, lyrics, harmonies, rhythms, repeats, and extramusical considerations. And these have to be made with the tools we have at hand. It didn't occur to me until last month, when I was presenting at a conference for healthcare professionals, that facilities often make instrument choices with very nonmusical reasoning: mainly, budgets and exposure. So, I thought I'd share some ideas of budget-friendly and client-friendly instruments for use in different settings. If you're a music therapist, music teacher, activities director, or anyone who would like to incorporate instruments in your healthcare setting, this list is for you (if you're a performing percussionist, you might like the list but it's really not written with performing in mind):
1. The Ocean Drum.
Ah, the ocean drum. Originally developed for infants in the NICU, this has become a fan favorite of adults and children alike. These come in all sizes, at various price points. When I worked in a NICU, we used the ones covered in leather which were quieter. They're soothing to hear if played correctly, and mesmerizing to watch. I recommend these for individual sessions only- and know that every once in awhile, a client will just absolutely hate this instrument. That's ok. Don't give it out in groups because you won't be able to hear over it. And while it's a simple design, don't bother trying to make your own.
2. In that same family, the Rain Stick.
I don't have much to say about this, the Rain Stick is not in my daily-use bag. If you're a teacher giving a lesson on weather, could be cool to use this and the Thunder Tube, but again it'll be the loudest thing and there's only one way to play it.
3. Speaking of shakers!
Let's get into the world of shakers. Egg shakers vs. fruit shakers vs. real shakers- how does one decide?! Considering price point, the egg shaker wins. Pro egg shakers are actually kind of pricey considering, but you can buy a bag of rice and some plastic easter eggs at a dollar store and make them equally well. Eggs are also great for tiny hands to grip. I've seen some shakers with a little handle to grip, too, even better. The downside of fitting in tiny hands is that they also fit in little mouths- so be careful. For larger hands, the fruit shakers are a nice compromise. You can also keep them in a basket on your kitchen table for much less than the Williams Sonoma fake fruit. These sound good- I prefer the pear/apple shakers to the banana- because, how does one shake a banana? but I never take these out at a memory care facility. They look too real but don't taste it. The next option up, as far as I know, is to go for actual percussive shakers, made by companies like LP. These are more expensive, but they sound great and no one will try to eat them.
4. The Shekere.
This is a favorite for percussionists, but I don't recommend this for any non-musicians. It'll just be loud and grating and/or someone will try to pull the beads off and it'll be a mess.
5. The Cabasa.
No, not the meat. The cabasa is a fun sensory experience, and can be played in a few different ways- shaken, stirred, rolled, tapped. Make sure your cabasa is screwed together tightly or again, you're in for a day of vacuuming beads off the floor.
Getting into drums!
6. Sound Shapes:
These are super fun. They're basically drum heads without the bodies (like the headless horseman, but less scary)- and they sound surprisingly great. I have the circles, but you could order squares or triangles or whatever shape floats your boat. I wish Remo didn't paint these with sparkly edges, because they're pretty but after wiping them down every day with clinic-grade disinfectant, the paint doesn't hold up. My favorite thing about the Sound Shapes is that they're portable- they fit right into one another and slip in a carrying case. And each size has a different pitch, so it's a great way to start talking about that aspect of music.
7. Frame Drums / Buffalo Drums / Paddle Drums:
These are all variations of a small lap-sized drum that has an attached handle, either on the back (buffalo drum) or the edge (paddle drum). Kids love the paddle drums that look like lollipops, but they have sort of a dead sound compared to the frame drums. Buffalo drums have a nice deep resonant sound, so they're great for working with older clients or anyone who is hard of hearing.
8. Djembes / Hand Drums:
I have a gorgeous djembe that my cousin brought from Senegal, and it's got carvings of trees and elephants and a goat skin head. That's what I play for myself, but I couldn't bring it to work. Even if you trust your clients not to break something like that (and I do, most of them..), there's no good way to disinfect an actual goat skin or a porous tree stump drum. So unless you want to get sued for transporting c-diff around the hospital, I recommend some other options. Namely, anything in Remo's HealthRhythms collection (no, I don't work for them.. but Remo if you're reading, here I am!). They have a huge variety of sizes, sounds, angles (i.e. drums that have feet and sit on the floor vs. drums you hold with your knees) and colorful designs. These drums can be played with hands or mallets, sound very good (even the pre-tuned drums) and are ... drumroll please... pun intended... WASHABLE! The only downside to these is they're not as easy to lug around. I only recommend getting a whole set of hand drums if you're planning to make drum circles a frequent part of your facility. And if you're traveling to multiple facilities, well.. I'll leave it up to you. I have a whole set of these, but I love facilitating drum circles so the work is worth it.
9. Gathering Drums / Table Drums:
These are gigantic (but not very heavy) and I think are meant for small children or a few adults to play together. There are some cool activities you can do with table drums (probably a book out there full of them), but I've never made use of these only because most of my clients are adults and/or individuals.
10. NSL covers fit right over a drum head in order to deaden the sound a bit. Great for large groups, boomy spaces, or clients with sound sensitivities. "Not so loud!"
11. I'd be remiss to leave out the ukulele.
An instrument I ignored for many years, until partnering with the Ukulele Kids' Club turned me into a believer. The ukulele is portable, easy to learn, fun and upbeat, and can be strummed without any chord shape and still sounds good! Pure magic. My big complaint about the ukulele is similar to my big complaint about a lot of pop music- it's just too cute. It's harder to express any emotion beyond "happy!" with a ukulele. Even if you can finagle a half-diminished chord without cramping up your hand, something about the timbre just still sounds adorable and then it might seem like you're not taking therapy seriously. So I reserve ukulele for when it's requested, or when it's appropriate- which, thankfully, is fairly often. It's awesome for kids, too. There are size options and colors- again, if you have to disinfect things i recommend the plastic-y ones rather than the wood ones, even though you'll compromise on size a bit. And these are delicate, so if you have people who like to throw things or tend to drop things I recommend wrapping them with some kind of tape or... even bubble wrap. No joke.
Play any guitar you want, but for clients (especially clients who have never played guitar) I recommend a smaller size. I'm not a guitarist so I don't have many specific recommendations- just make sure the action is set so they're not too tense to play, and then tune the E strings (at least) down to D. Play with some other tunings, see what works for you- but for someone who may not have the physical or intellectual capability to learn a bunch of guitar chords, the chance to participate in a guitar jam just by strumming an open guitar and having it sound good is powerful, positive stuff. You can then play around that chord, with progressions that give it what it needs. OH and put a sock over the headstock, because everyone just wants to 'turn knobs': nope.
13. Q chord or Autoharp:
Here are some nice options for someone with use of just one hand or who need the instrument on a table/desk rather than held up. The autoharp still has that acoustic instrument feel, and the Q chord is a more modern (relatively speaking) deal. By now, it's probably obvious what my preference is, but I'll leave it up to you!
These seem to be popular these days. A few suggestions: 1. Set some ground rules, or you'll be breaking up sword fights instead of leading a group in song. 2. Don't hand out all 7 colors of these at once. Buy a few sets and then work to set up 'chord teams' or only hand out a few at once. If you've got 30 people playing every note of the scale at once, it's just a cacophony of sound- and that isn't usually what anyone is going for.
15. I am LOVING the 'desk bells'.
They're kind of like hand bells that are rung, but you can leave them on a flat surface and just tap the top of these instead. Perfect for people who can't grip the handle of the bell.
16. Speaking of clients with atypical bodies, check out some alternative mallet shapes (like the T-bar drumstick) or items like the egg shaker guitar pick. These can make it easier to participate. And ask a music therapist or a luthier/builder about creating adaptive instruments! Anything can work with some creativity.
17. I recommend pricing out pieces separately- sometimes you can find a good 'music group package', but they're often overpriced and include some pretty useless instruments you may never use (unless you're filming a monty python skit). Check out craigslist for used items, apply for instrument grants, or just buy buckets from the hardware store and drumsticks from the drum shop and go at it.
18. iPads have free apps that simulate instruments, and some of them are not bad. I've used the piano one a few times, and the garage band drumset- definitely not even close to the real thing, but for recording projects etc., it's workable. Use the 'guided access' so that if someone rocks out too hard they won't accidentally navigate out of the app.
19. I didn't include keyboards here because we'd be here all month. All I can say is, if you want it to feel like a piano, get the weighted keys. If you want to form a Jimmy Fallon "I wish it was christmas today" cover band, grab any small keyboard from Goodwill and you'll be fine!
20. Many people ask me about the Wing, an instrument I bring to some groups.
I want to recommend it! It's beautiful! It sounds beautiful! Alas, I cannot give this instrument 5 stars. These are made by a company called Freenotes, with a beautiful idea in mind: "When we redesign instruments, everyone becomes a musician." Each wing is in a different key, in a mode that allows 'no wrong notes'- so they sound lovely. But for upwards of $350 a piece, the design is awful. The bars fall off all the time, they can't be held safely in a lap, the mallets get ripped up easily... and they're beautiful if you have good hearing, but older adults simply can't hear these. Which is such a bummer. I see these things in art galleries all the time, and that seems to be where they belong. I'd check out Orff instruments if you want to get into mallets.. and email me! Because I am a mallet player. :)
Whatever you add to your music collection, be sure you're thinking about the needs of your clients FIRST. Don't hand a child's toy maraca to a mature adult, and don't offer a regular guitar to someone who has never played and isn't feeling confident. DO make sure everything sounds good, and DO have fun.
If you have any suggestions, please email me! I'll add them to this list.