And the beat goes on.

Since the earliest times of humanity, the steady percussion of a beating drum has held a prominent place in the religious and social structures of many cultures. Whether it was used for communication, rituals, celebrations, healing, or entertainment, the drum has embodied the rhythms of life. Rita Lopienski, MA, RMT, CAC, director of leisure services, has introduced drumming to the residents at Beacon Hill Retirement Center, a CCRC in Lombard, Illinois.

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As an undergraduate, Lopienski taught music in Haiti in its government's only official music program. "That experience opened my eyes to new music forums and different kinds of instruments," she says. Since her Haitian experience, Lopienski has traveled extensively and has participated in music programs of various cultures and the instruments indigenous to them. "I've been to Africa, South America, the Caribbean, and much of Europe," she says. "I've led drum circles for ladies' clubs, church groups, hospital units, and children, as well as for the residents of Beacon Hill and its Healthcare Center's residents. And I've discovered that drums are universal instruments that cross cultures, ethnic groups, and religions."

A drum circle is simply a group that gathers to create music through the use of percussion instruments. It enables people of any age, ethnicity, health status, or social standing to use rhythm as a tool for healing and health, building a sense of community, embracing cultural and religious diversity, and relieving stress. In other words, drumming reaches a person's core.

"A drum circle facilitator [leader] does not need to be a drummer," claims Lopienski, a violinist. But, she adds, a facilitator does need to be a leader, understand how different drums and percussion instruments are played, and have a sense of rhythm. "I don't look for perfect technique because the idea is to have the experience of playing, creating, self-expression, and the fun of being together," she says.

Lopienski recommends that a facilitator use some icebreaker techniques and games to start things going if the group is not spontaneous. "For example," she says, "I'll play a rhythm and have the group echo the sounds or do rhythm exercises. Working with them in this preliminary way stimulates creativity." Icebreaker games that she uses include saying a name and beating it on the drum. Another fun approach is to have the group think about a particular food, such as spaghetti, and then ask those who like it to beat their drums loudly and then ask those who don't to beat softly or not at all.

A circle starts with the facilitator providing a steady beat and having some group members join in on their drums or shake their rhythm instruments. More creative or experienced members can blend in with an opposing rhythm. "It gets exciting when there are multiple beats and patterns interweaving. I encourage the group to experiment," says Lopienski.

There is no one accepted formula for conducting a drum circle. "My circles tend to be joyous and upbeat; other circles play slower and in unison for relaxation and meditation," explains Lopienski. Drumming can reduce blood pressure when incorporating deep breathing with rhythm, which lets a person get in touch with his or her chakras (spiritual or physical energy). No other music accompanies a drum circle because the group would tend to listen to the music, and that would interfere with the circle's purpose. "Although no music is played, when I meet with the residents of our Lilac [Alzheimer's/dementia] unit, we might sing a familiar song and drum along with it at times. But the circle is about self-expression, creating personal songs and rhythms," she explains.

Lopienski's travels have allowed her to a mass an exotic collection of drums and rhythm instruments. "I've purchased some," she says, "and others have been acquired through various grants, donations, and fund-raising efforts. The Beacon Hill collection has drums from Africa, India, South America, and the Caribbean. It also includes Native-American drums, which are called buffalo drums."

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Different drums have various ways of producing sound, such as the therapeutic ocean drum from India. "Remo, an American drum company, has a very large ocean drum that is very visual. You can see pebbles and an aquatic seascape complete with colorful fishes painted inside of it," says Lopienski. The ocean drum is beaten with a mallet. It can be played in other ways, too. By holding the drum in your hand and slowly moving it around, the pebbles inside roll around and mimic the sound of the sea. The drum can be shaken to make the pebbles jump up and down to produce an entirely different sound, or a resident can rub his or her fingers around the drumhead. Experimentation is encouraged.

Along with the usual jingle sticks, maracas, and tambourines, Lopienski has acquired an exotic variety of rhythm instruments, too. "From Vietnam, we have a wooden frog that makes a croaking sound when it is rubbed with a stick. 'Toenails,' which are actually donkey hooves strung together, are Peruvian. They are played by shaking them," she explains. Gourds are also part of the drum circle. They may be covered in glass beads, shells, pods, or seeds and produce a variety of sounds when rubbed or shaken.

"Of course, some residents have physical limitations," says Lopienski, "and we have been able to adapt the use of the instruments to meet some of those challenges." To help someone with physical limitations from a stroke, a partner might help that person with drumming. To overcome the inflexibility of hands crippled by arthritis, a jingle stick can be fitted over the wrist with a strap, or a drum can be placed in the lap for the resident to tap on. "If you are aware of the disability, adaptation is very doable so the resident can be successful," she says. The program received a 2004 Shining Star for Outstanding Program Award from Life Services Network of Illinois, a statewide LTC association.

Lopienski has seen some heartwarming results. "It's wonderful to see the change in someone with Alzheimer's at either behavioral extreme--from lethargy to agitation--as a result of drumming. I've seen the withdrawn person's eyes light up and become more alert. I like to give an agitated or restless resident a big drum to play. It releases energy without pacing," she explains. "In fact, one resident bought a drum for her personal use. She hates television commercials and drums during commercial breaks in her favorite programs."

Drum circles, according to Lopienski, are a growing movement, and Web sites offer instruction and information. Two sites that she recommends are www.drummingcircle.com and www.wisespirit.com. Activities and music catalogs are other excellent resources to discover drums and rhythm instruments. Not only do the resident musicians enjoy drumming but, at Beacon Hill, some residents enjoy just watching and tapping a toe. During summer vacation, grandchildren like to visit on drum circle days. Not only do they enjoy playing the instruments, but they get to see their grandparents in a new light. Some residents even form a conga line to add to the fun.

As long-term care populations become more ethnically diverse, drum circles are unifying, all-inclusive, intergenerational, and educational.

For more information, contact Rita Lopienski, MA, RMT, CAC, Director of Leisure Services at Beacon Hill Retirement Center, at [phone]. To send your comments to the author and editors, e-mail [e-mail].

BY SANDRA HOBAN, MANAGING EDITOR

A collaboration of the American Association of Homes and Services for the Aging and Nursing Homes/Long Term Care Management Not-for-Profit Report, appearing in every issue of Nursing Homes magazine, addresses issues of particular interest to long-term care's not-for-profit sector. It provides nonprofit aging service providers with an additional information resource. Topics have been identified in collaboration with the American Association of Homes and Services for the Aging. Nursing Homes welcomes comments and suggestions for future coverage.