When J.L. Gallese’s father entered the later stages of dementia, music became a regular element of his care. There were a few LPs of old TV show theme songs that he loved, and they played on repeat until it became tiresome to hear them in the same order over and over.
That’s when Gallese had the idea to burn a CD with those tunes and put it on shuffle play.
“We made a game out of it,” he says.
Gallese’s family played the CD in the mornings to start the day, or while Gallese was cooking his dad breakfast.
“Dad definitely enjoyed it, and he usually knew every song. This was a great confidence builder, inevitably bringing a smile to his face,” Gallese recalls.
This is a common sentiment from families of people with dementia, as music has an uncanny ability to tap into parts of the brain that haven’t been ravaged by cognitive decline.
“Most people have deep connections with music — some more than others,” explains Dr. Alvaro Pascual-Leone, Boston-based chief medical officer and co-founder of Linus Health, which offers science-driven digital solutions for brain health.
“Just hearing a certain musical piece or singing a song with others that is particularly meaningful to an individual can create strong positive feelings, evoke memories and generate joy,” notes Pascual-Leone, who is also a professor of neurology at Harvard Medical School, a senior scientist at the Hinda and Arthur Marcus Institute for Aging Research and the medical director of the Deanna and Sidney Wolk Center for Memory Health.
Leveraging those positive emotions and the specific brain connections that music can activate is the aim of music therapy and the reason this alternative therapy for dementia has become more popular in recent years.
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What Is Music Therapy?
Music therapy is a clinical and evidence-based practice that uses music to help enhance the quality of life for individuals living with dementia. It can also help people with dementia accomplish their individual goals and objectives.
“Those goals and objectives usually center around the individual’s social, emotional, physical, cognitive, communication, musical and spiritual needs,” explains Lakelyn Eichenberger, gerontologist and caregiver advocate for Home Instead Inc., a network of independently owned and operated senior home care agencies headquartered in Omaha, Nebraska.
As a specific type of expressive art therapy, music therapy can be especially helpful for people with dementia because it’s highly accessible. It requires no special skills and virtually no equipment — simply singing a song can make a difference for a loved one with dementia.
Formal music therapy encompasses a range of activities, from listening to soothing background music to doing attention-demanding exercises, Pascual-Leone says. And it works because music connects disparate areas of the brain.
“Rhythm entrainment can trigger specific action in the brain that can improve certain motor activities, like walking, and can help people talk better and think quicker,” Pascual-Leone explains.
What’s more, social interaction during music therapy enhances communication, enjoyment and connection with others.
Types of music therapy
There are two main types of music therapy:
— Active. Also called expressive music therapy, this involves creating music, playing an instrument, singing a song, improvising to make musical sounds, or clapping or tapping out a rhythm in time with music. This highly interactive approach actively engages the individual in making music in some way.
— Receptive. This more passive approach, also called receptive music therapy, can include listening to music — recorded or live. A therapist may engage the patient in a discussion of thoughts and feelings the music conjures.
How music therapy is administered
According to the American Music Therapy Association, music therapy works best when it’s delivered by a trained therapist, and this care is commonly delivered in conjunction with other interventions and treatments as part of a multidisciplinary care team.
A music therapist will start with an assessment of the patient and their needs, which typically includes conversations with family members, caregivers and the person’s medical team to determine how best to proceed.
According to the AMTA, music therapy serves a number of purposes. It can be soothing, but it can also promote self-expression and smooth transitions from place to place, such as a walk to the dining hall for a meal.
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How Music Therapy Helps Dementia
Music is a part of our lives from early on, Eichenberger explains, so even with a dementia diagnosis, older adults can and should still experience music that brings them joy.
And, because of how music is processed in the brain, it can be particularly helpful for people with dementia.
“In dementia, the part of the brain that stores music is often one of the last to be impacted by the disease,” she says. “Therefore, music can help activate the brain, especially the areas connected to our memory and emotions.”
Key benefits
While music therapy cannot reverse dementia or stop it in its tracks, it can provide a host of benefits that make for a better quality of life for people living with dementia.
According to the Alzheimer’s Association, key benefits of music therapy for dementia include:
— Improved mood
— Reduced agitation and fewer behavioral issues
— Enhanced memory recall
— Better communication and social interaction
— Reduced anxiety and depression
— Decreased reliance on medication in some cases
— Enhanced quality of life
“Each person’s response to music therapy is unique,” says Yelena Sokolsky, CEO at Galaxy Home Care in Brooklyn, New York.
And for those who still have the physical ability, dancing or moving in time with the music can be a wonderfully expressive outlet.
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How Music Therapy Is Used In Dementia Care
There are different ways to approach music therapy in dementia care, but it works best when it’s tailored to the individual and their stage of dementia, Sokolsky says. This makes it adaptable to their changing needs and abilities.
— Early stages. “In the early stages, individuals may still actively participate in music-related activities, such as attending concerts, singing in a choir or playing an instrument,” Sokolosky explains.
— Middle stages. As the disease progresses, group sessions that involve active music therapy can encourage social interaction and stimulate cognitive function.
— Later stages. When mobility and verbal skills are limited, listening to personalized playlists, soothing lullabies or calming instrumental music can offer comfort and a sense of familiarity, Sokolsky says. “Caregivers should adapt these activities to the individual’s abilities and preferences,” she adds.
Currently, many assisted living communities, memory care facilities and nursing homes employ music therapists to work with their residents and guide them through music therapy.
Several large hospital systems also offer music therapy resources and some have presented cogent case studies and success stories of how music helps dementia patients.
For example, researchers at Brown University recently conducted one of the largest studies to date on the effects of personalized music in dementia care. That study followed more than 3,500 nursing home residents and tracked how music programs improved mood, social engagement and cognitive awareness while reducing agitation, distress and reliance on medications.
A three-year study at the Betty Irene Moore School of Nursing at UC Davis in California followed more than 4,100 nursing home residents across 265 nursing home and found a 13% decline in the use of antipsychotic drugs and a 17% decline in the use of anti-anxiety medications for residents with dementia who were in the music program.
How to Implement Music Therapy at Home
If your loved one is living at home or if their senior living facility doesn’t offer music therapy, use these tips to replicate some of the benefits on your own.
— Curate a playlist of old favorites. Focus on tunes they would have enjoyed in their teens or early 20s; music from that era will recall long-term memories that tend to be more locked in than recent ones.
— Observe how your loved one responds. When you play a new list of music for your loved one, are they moving to the beat? Are they smiling? Or do they seem upset or anxious? Not all music has positive associations, so watch for songs that might stir up unwelcome memories.
— Tie a song to an activity. For example, every time your loved one needs to wash their hands, sing a simple song, such as “Twinkle, Twinkle Little Star,” to help them associate that music with that specific activity.
— Establish a routine. Many people with dementia will get more out of their sessions if they happen at the same time of day and follow a similar progression each time. Short sessions a few times a week can be especially helpful.
— Take it outside. When the weather is nice, head outdoors with your loved one to experience music while surrounded by nature. Note how birds chirping complement the music and how the breeze feels as familiar tunes drift along.
— Set the right environment. Music has a particular capacity to soothe agitation and alleviate anxiety, research suggests. Enhance those effects by making the room comfortable and quiet and eliminating distractions (such as commercial interruptions) so you can both focus on the music. Matching the music with smells, colors or other sounds that coincide with the era the music is from can further activate memories, Pascual-Leone notes.
— Make it intergenerational. “Music can strengthen interactions with family members, including caregivers, even in advanced stages of dementia,” Pascual-Leone notes. And bringing the grandchildren in for a singalong can be a wonderful way of brightening your loved one’s day.
— Use it to as a redirection tool. Music can also be used to refocus a person’s attention on something positive and provide assurance that they’re safe.
— Get professional help. A few sessions with a certified music therapist can help you kick off music therapy at home. Sokolsky recommends seeking referrals for local certified music therapists from health care professionals, such as doctors, nurses or social workers. Your local senior center or national dementia association can also likely suggest therapists near you. Search the Certification Board for Music Therapists website, look for Music & Memory-certified music therapy organizations or reach out to AMTA for additional listings.
Apps and resources
These tools and apps can help you get the most out of an at-home music therapy program:
— SingFit STUDIO Caregiver is a therapeutic music platform that helps connect caregivers and older adults with dementia via music and singing.
— Spotify is an online streaming music platform that makes it easy to build your own playlist.
— YouTube is a video platform with many vintage music clips that can help recall earlier times.
— M4D Radio is a range of free, curated radio stations geared toward adults born between 1935 and 1945.
— Musical Memory Care is an on-demand workshop program available online for seniors living with dementia.
While music therapy can’t cure dementia, Pascual-Leone notes that it can play a role in helping prevent it.
“Learning to play a musical instrument is one of the best ways you can train your brain. Picking up an instrument you played in the past can be useful, but it’s even better to learn a new one,” he says.
Similarly, moving to music can help because it stimulates powerful brain connections.
“In Spain, where I’m from, flamenco dancing is popular,” Pascual-Leone says. “Part of the art of this dance is focusing on what your partner is doing and making adjustments. In that way, it’s similar to jazz improvisation, where you keep track of what you are doing while listening to what others are doing to incorporate your efforts. That type of interaction is extremely valuable because it trains the brain to switch focus rapidly.”
And that could pay dividends for brain health later in life.
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Music Therapy and Dementia originally appeared on usnews.com
