Making a Playlist for Loved Ones: Music Therapy for people with Dementia

It’s almost impossible to find someone who doesn’t feel a strong connection to music. Even if you can’t carry a tune or play an instrument, you can probably reel off a list of songs that evoke happy memories and raise your spirits. Surgeons have long played their favourite music to relieve stress in the operating room, and extending music to patients has been linked to improved surgical outcomes. In the past few decades, music therapy has played an increasing role in all facets of healing.

Dementia is a neurological condition characterized by deterioration in cognitive, behavioural, social, and emotional functions. Pharmacological interventions are available but have limited effect in treating many of the disease’s features. Several studies have proposed therapy with music as a possible strategy to slow down cognitive decline and behavioural changes associated with aging in combination with the pharmacological therapy.

People with dementia gradually develop difficulties with memory, thinking, language and daily activities. Dementia is often associated with emotional and behavioural problems and may decrease a person’s quality of life. In the later stages of dementia, it may be difficult for people to communicate with words, but even when they can no longer speak, they may still be able to hum or play along with music. Therapy involving music may therefore be especially suitable for people with dementia. Music therapists are specially qualified to work with individuals or groups of people, using music to try to help meet their physical, psychological and social needs. Other professionals may also be trained to provide similar treatments.

What is music therapy?

Music therapy is a burgeoning field. People who become certified music therapists are usually accomplished musicians who have deep knowledge of how music can evoke emotional responses to relax or stimulate people or help them heal. They combine this knowledge with their familiarity with a wide variety of musical styles to find the specific kind that can get you through a challenging physical rehab session or guide you into meditation. And they can find that music in your favourite genre, be it Hindustani Classical or Jazz.

Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. After assessing the strengths and needs of each client, the qualified music therapist provides the indicated treatment including creating, singing, moving to, and/or listening to music. Through musical involvement in the therapeutic context, clients’ abilities are strengthened and transferred to other areas of their lives. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words. Research in music therapy supports its effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people’s motivation to become engaged in their treatment, providing emotional support for clients and their families, and providing an outlet for expression of feelings. People of all ages relate to and enjoy music, making it a universal language, of sorts. However, its value can go far beyond simple listening.

Music and Emotion

Music therapy is a target-oriented and purposeful activity in which therapists work with individuals or groups, using musical expression and the memories, feelings, and sensations it evokes. It has been found to be particularly beneficial for older adults with various types of dementia. “Music therapy has many faces,” says Lehtonen. “With older adults, I mainly use old wartime songs, which seem to bring many lively memories to their minds. Music has a close relationship with unconscious emotions, which are activated by musical movement. To me, music represents a microcosmos which has a close relationship to our inner feelings. These feelings are so strong, they’re meaningful even if patients cannot remember who they are.”

In 1588, English composer, William Byrd said, ‘Since Singing is so good a thing, I wish all men would learn to sing’ – today, that still holds true. The feel-good cognitive, physical, social and emotional benefits of singing have been widely researched and proven. Now, the many fine and enthusiastic singers living with dementia just need more chances to carry on doing what they love, and to sing the socks off the rest of us.

Singing exercises can exercise the brain

But these are far more than just singalongs. Scattered amid songs are warm-ups and cognitive tricks to tease the brain into action. It feels simply fun, but there is an underlying therapeutic agenda. Coming to the groups builds strong networks of friendship and support, and the joyful anarchy and release of singing makes everyone feel better.

Sound taps into parts of the brain that survive even in late dementia

Experiencing sound involves not just hearing, but also sight, touch and movement. The parts of the brain processing these, survive relatively undamaged late into dementia, so hearing familiar sounds can often bring feelings and memories to life as vividly as ever.

Familiar words and turns of phrase can help someone to connect to their own identity and build bridges of understanding with those around them. Even the information on paper, without live music, is useful. Music mirrors cost nothing and need no personalised equipment. In this way they are quite distinct from playlists of favourite music for entertainment or solitary listening.

A recent study conducted at the University of Miami School of Medicine revealed that music therapy helped produce more of the brain’s “feel-good chemicals” including melatonin, serotonin, and prolactin in Alzheimer’s patients. This means that after listening for a certain amount of time, the patients’ moods began improving and even facilitated some cognition. Even as cognitive functions decline, the brain still responds naturally to music, thus giving patients many benefits.

Music can be used to evoke memories from a patient’s pasts. Choose your loved one’s favorite songs or musical styles and try to sing together. If your loved one is mobile, perhaps you could even try dancing to it! Not only could it bring back memories of his/her childhood, but it also may help you to connect with one another.

Even if your loved one is in the later stages of the disease, music can still make a positive impact. Patients who are frustrated by the inability to communicate or environmental stimuli can react positively to soft music.

 

Memory in Sound

Although music therapy is used for people of all ages, it is especially beneficial for older persons with dementia who may be unable to communicate in another way. “Music can function, for instance, as an interpreter of the patient’s world picture without the problem essentially connected with verbal interaction.”

Since dementia is a degenerative condition, expressing basic needs and being understood can become problematic and lead to a complicated feeling of isolation for sufferers. Using songs in a therapy setting promotes communication. “Singing has many functions; it offers a communicative structure, stimulates and regulates, and enables dialogue.” 

Make them happy

What songs will help your loved one most? Familiarity can be important, because one of music’s most important powers for people with dementia is evoking memories of happier times. For this reason, ask other family members and friends for insights into making a playlist. Someone who’s religious, for instance, may be engaged by songs of worship. Of course, tastes can vary, so a little investigation is warranted; playing rock for a lifetime fan of classical opera might have the opposite of your intended effect. Also consider the mood you’re going for, and save certain kinds of songs for certain activities. Calmer, more soothing tunes can help during routine activities like eating and cleaning. More upbeat music is helpful for moving around (like while walking for exercise) and boosting mood. If your loved one is up to it, encourage clapping, tapping feet, and maybe even dancing. Music that was popular when your loved one was between the ages of 18 and 25 may be the best choice. Experts say this period of life is when we typically develop our musical tastes. Monitor your loved one’s reactions to songs, being ready to turn off music that elicits an upset response and return to pieces that make them happy.

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