This article will focus on the role of music therapy for people with advanced dementia and their families as well as considering the resource that the family can be for the Music Therapist in informing their work. Information on meaningful themes in the life of the person with dementia can be provided by the constellation of significant people around them. The importance of personal history and identity will be explored. Family members can influence music therapy in numerous ways, both outside and within sessions. This article will explore ways in which a reciprocal relationship, or therapeutic alliance, can be developed with family members and their loved one, with an emphasis on finding a unique approach that fits the family concerned. Much pain is encountered in this work, requiring the Music Therapist to proceed with caution and sensitivity. Ways in which music therapy enables expression of intimacy, particularly between couples, will also be addressed. Clinical illustrations underpin themes of this article, demonstrating the value of alliances being made between the Music Therapist and family members.