Dementia Care the Musical Way
Scientific studies and several recent popular books for general audiences examined the neurological underpinnings of music. It's pretty fascinating—and knowing more about how music works doesn't diminish one bit the pleasure we derive from it.
One thing these studies confirm is that music offers powerful health benefits. Listening to and performing music promotes emotional, intellectual and physical wellness. It decreases the perception of pain, improves sleep, and enhances both exercise and relaxation. And music is a powerful socialization tool, bringing people together in a way almost nothing else can do. For older adults, music provides a sense of meaning and fulfillment—a soundtrack for who we are and who we've been, bringing up vivid memories that are part of life review, an important task in our later years.
For people who have Alzheimer's disease or other dementia, music offers powerful cognitive and emotional benefits. It helps them connect not only with their memories, but also with other people and the world around them. Music is stored differently in the brain than is speech, giving it the capacity to bring forth recollections that mere words cannot. A study published in the Journal of Alzheimer's Disease even reported that singing decreased and slowed the impact of Alzheimer's disease on working memory, executive function and orientation.
Today, people with dementia and their caregivers can attend dementia-friendly concerts, dances and other musical events. Supportive living communities and home care agencies that provide memory care are using music therapy to great effect. One form of music therapy that's growing in popularity is to furnish patients with personal listening devices, such as an iPod, preloaded with music. You may have seen some of the heartwarming videos that went viral, such as those associated with the 2014 "Alive Inside" film, showing the powerful transformation when patients were provided with personal listening devices loaded with music selected just for them.
What's your playlist?
Music therapy for dementia isn't a one-size-fits-all activity. Researchers from the Georgia Institute of Technology reported that seniors who are engaged in an activity may be distracted by background music, so they are less able to concentrate and remember things. And of course, musical taste is very personal, not only generational but also individual.
Put yourself in a patient's place. What music genre sets your teeth on edge? Heavy metal? Opera? "Elevator music"? Now imagine someone plopping a set of headphones on you delivering a playlist of that very music! And what if the music were too loud—or, not quite loud enough? And imagine if it were hard for you to express your displeasure easily.
Researchers from the University of Toronto's Baycrest Health Sciences took all those variables into account and more, as they created an educational resource to help both families and care professionals use these devices in an appropriate way. Here are six tips taken from their "Creating Effective Music Listening Opportunities" information sheet:
- It's important that individuals with dementia be monitored while they are listening to music delivered through a personal listening device, such as headphones. They should not be left alone.
- Headphones should be used with caution, as they create a barrier between the individual using them and their caregiver. Ideally, if you are listening to the music together and able to talk to the individual, it is much easier to share in the moment and to know what music the person is or is not reacting to.
- Small ear buds are not recommended. Use either over-ear headphones or stetoclip-style headphones. Behind-the-ear type hearing aids should be removed before headphones are used. Deep-fitting hearing aids should not give feedback and are appropriate to leave in.
- Regarding volume, loud and soft are different for each person. If an individual cannot tell you when the music is too loud or too soft, look for signs on their face.
- Even favorite music can sometimes evoke difficult emotional responses, such as sadness, and caregivers need to be mindful of this.
- If music listening is overused, individuals may become immune to the positive effect.
If you're programming a playlist for a person with memory loss, how do you select music that will be meaningful? How long should a playlist be? What else can you do to enhance the experience for the listener? Baycrest has graciously offered the entire "Creating Effective Music Listening Opportunities" manual for free download. Says Adrienne Pringle, president of the Canadian Association for Music Therapy, "This excellent resource provides a useful tool for both loved ones and health professionals in understanding the benefits, risk and powerful potential of music listening" and for "safely using music listening with vulnerable people."