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I have recently read a number of short reports and studies of music and its effects on dementia. None are methodologically sophisticated and all of them have flaws. But taken together, they offer a compelling picture of a simple step to make the lives of the millions of people living among us with dementia more pleasant and the lives of their caregivers easier. And, happily, it is an intervention that is simple, inexpensive, and, should it not work, probably harmless.
Music.
Anecdotal accounts and clinical case studies document that when those with dementia are fitted with headphones and listen to music they remember their youth and become animated. Sometimes they sing, especially if it is church music or music they have sung to in the past. Often it seems to activate memories from their youth. As many people know, earlier memories tend to cling most tenaciously in the minds of people with Alzheimers and other forms of dementia. Listening to music from their younger days, many people with less profound forms of dementia will be able to talk about people and places from their past. Paired with photographs, music can activate areas of the brain that seem otherwise inaccessible.
Sitting and talking with an elderly parent or relative or friend, old music and photos can provide the basis for a conversation that goes beyond what they had for lunch.
A more systematic study by Ziv et. al (2007) found that music also made dementia patients calmer and seemed to evoke more positive affect. In this study, Alzheimer patients in a nursing home were observed under two conditions: with or without music. When listening to music, patients were less agitated, seemed less uncomfortable (engaging in repetitive behaviors indicating nervousness), less vocal, and seemed more positive and calm. In this case, all patients listened to the same music. Even with no special associations with the music other than that it was familiar music they had heard when they were younger (Beatles), positive effects were found.
Will it work for your loved one? Give it a try.
- Pick music that the person likes.
- Most people react most strongly and positively to the music that was popular during their teen years. Whether this is because music tastes are formed at that time or that is when we listen to music most is unclear.
Watch how the person reacts and respect that reaction.
- My nephew has profound cerebral palsy, is unable to speak, and has severe difficulty communicating his needs. But he knows what music he likes. Put the wrong music on his iPod and he will let you know. But you need to watch and listen. The same is true of people with dementia. Maybe they never liked the Beatles. Maybe they were Tommy Dorsey fans. Maybe they like Country Western. Try classical. Maybe it's opera. If they can respond, ask. If they have loved ones who know, ask. If you can't ask, try, watch, and listen.
Pay attention to volume.
- Music needs to be loud enough for people to hear, but not so loud that it is uncomfortable. Hearing in the higher ranges often goes first as we age. Pick music that is lower and has a stronger beat. Go for clarity. Decent speakers or headphones help. People with hearing loss or using hearing aids often have uneven hearing - they can't hear quiet noises, but sounds above a threshhold are loud and startling. Pick music without sharp peaks and valleys.
Use music to make connections.
- For many people, music can be more than just a tool for keeping people quiet and happy (although that is reason enough to use it). Sometimes music can help make a connection. Listening to music can trigger memories, feelings, and emotions that aren't expressed at any other time. Take out pictures and spread them out while the music is playing. Two triggers together can help bring back memories of times and people in the past and allow you to share memories you might otherwise lose forever.
I was at a formal banquet a few months ago where an a capella group wandered through the hall singing a song that almost the whole audience knew from our youth - Feeling Groovy. It is a silly and sweet song, but has easy words and a limited range. Spontaneously, the entire audience broke into song. The moment was magical and had awoken something in all of us. After the song, the strangers at my table starting talking about their past and things that the song had brought back to them. Sometimes music can have the same effect on people who are much harder to reach.
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A final note . . .
My father died two weeks ago. The very last thing he responded to was music as his pastor and my mother sang hymns for him and I accompanied them on recorder. His eyes opened and he reached out and squeezed the pastor's hand. That was a gift indeed.
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Other posts on caregiving aging parents and loved ones . . .
