Nov 4, 2011

Music and Alzheimer’s Disease, Using Music to Engage, Comfort and Bring Joy to Your Loved Ones

Can any of you out there share stories of your own experiences using music to connect and bring pleasure, comfort, or calm to your loved one?

By Marie Marley
Alzheimer's Reading Room

Music and Alzheimer’s Disease | Alzheimer's Reading Room
Family caregivers and others caring for those with Alzheimer’s have long known that music is special to these individuals. It won’t stop or slow the progression of their disease, but it can be of significant benefit to them in many ways.

Music has the power to reach Alzheimer’s patients on a deep level. Many can sing songs, including most or even all of the lyrics, long after their Alzheimer’s has progressed beyond the point of recognizing loved ones, dressing themselves, or even remembering what happened five minutes earlier.

Most importantly music can have positive effects on the health and social functioning of Alzheimer’s patients. After listening to music some are clearly more calm, in a better mood and more outgoing than before, which improves the quality of life for both the patient and the caregiver. Music has been found to help those with dementia retrieve some memories their caregivers had assumed were lost forever.

Here are a few very simple recommendations anyone can follow for using music therapeutically with loved ones with Alzheimer’s:
  1. Simply play music for the person, using selections from their favorite type of music or favorite musical artists
  2. Arrange for musical experiences in which the person can participate
  3. Use music appropriate for the person

Let’s look at each recommendation in more detail.

Play music for the person

Live music: Live music, often considered the most therapeutic musical activity for those with dementia, can be provided in several ways. Patients in the early stages of dementia may be taken out to concerts of the type of music they like. You could also have a musician or very small group of performers come to your home to play for your loved one. If you’re bringing in an artist to play for someone who is a former musician it can be quite effective to hire a person who plays the same instrument the patient used to play.

Nursing homes, of course, typically have an activity staff member who regularly performs for their residents. They can also arrange to have soloists or small ensembles come to the facility to put on concerts.

Further, whether at home or in a facility, caregivers can simply sing to groups of patients. They can also sing to individuals, who usually relish the individual attention.

Recorded music: Having the person listen to recorded music is somewhat less engaging than listening to live music because, unlike live music, it doesn’t provide any visual stimulation. It does have the advantage, however, of being a modality that allows the patient to listen to over and over and at any time of the day rather than just when performers are present.

Persons with Alzheimer’s can listen to recorded music either through earphones or speakers. The latter provide an opportunity for the loved on and caregiver to share the listening experience. Some caregivers these days are loading up iPods with the type of music their loved ones cherished the most before they became demented.

Background music: Even background music can bring comfort, calm and pleasure to people with Alzheimer’s. It should be played very softly, though, so as to not overstimulate the patient who may be carrying out some other task.

Arrange for musical experiences in which the person can participate

Getting your loved one to actually join in musical activities is more engaging than having them just listen. This, too, can be conducted in various ways.

Sing-alongs: In facilities the most common type of musical participation is in sing-alongs. Typically led by activities staff, these sessions often catch the attention of even the more demented residents. It’s surprising the number of lyrics they can remember given their state of cognitive decline. For those living at home sing-alongs with family and friends can be arranged, bringing enjoyment to all.

Individual Patient Performances: Patients in any setting can be given drums, tambourines or other simple percussion instruments to “play” in addition to, or instead of, singing. These require no musical talent or experience and can bring smiles to faces that were previously blank.

Another approach is to have loved ones who played instruments before they became demented try to play them again. Many will be unable and the experiment should be tactfully ended, but some, especially those with early dementia, may be capable of performing even if not at the same level of competence as before. If they can play they will probably get quite a bit of enjoyment from it.

Use music appropriate for the person

The cardinal rule when using music with someone with Alzheimer’s is to always observe how they are reacting to the music and stop it immediately if it seems to be having a negative effect.

What Types of Music to Use:  There are some guidelines for selecting the types of music you can employ. The first is to use whatever type of music the person liked most before he or she became demented. So you might play Ella Fitzgerald for one patient and Bach for another. An alternative strategy is to use “golden oldies.” A third consideration is that people with dementia will generally react most favorably to music that was popular when they were in their teenage years or early 20s. Again, this will mean using different music for different people..

What Types of Music to Avoid: To avoid over-stimulating or making the person agitated you should avoid music that is loud, dissonant, or frenetic-sounding. Also be careful to avoid sad music, such as sad love songs, or selections that individuals may connect to some specific sad experience in their past, such as music played at the funeral of a loved one or the “favorite song” they had with a deceased mate.

Experiment with the above approaches to see if any work with your loved one. Following these simple guidelines may give you and your family new ways to connect, interact and bring comfort and joy to your loved one. In fact with patients with advanced Alzheimer’s you may find it’s one of the very few things to which they’ll really respond.

I personally used to listen to music on a regular basis with my 92-year-old Romanian soul mate and he always enjoyed it. His face would light up and he would move in time with the music. Sometimes he would hum along.

Two instances in particular stand out. One was when I pretended to be conducting the music, emulating the type of “wild” conductor he had always enjoyed so much before he became demented.

The other was when I had a classical violinist show up in a tux to play a special concert just for him in his room in the nursing home.

See, Alzheimer’s and Music: How a Classical Violinist Brought Great Joy to My Demented Romanian Soul Mate.

Both events brought him great joy and consequently brought joy to me as well.

Can any of you out there share stories of your own experiences using music to connect and bring pleasure, comfort, or calm to your loved one?

Marie Marley, PhD, is a professional medical grant writer who, over the years, acquired a keen understanding of many geriatric topics, including dementia. . In Come Back Early Today: A Memoir of Love, Alzheimer's and Joy she describes her remarkable 30-year relationship with Edward Theodoru, PhD, a delightfully colorful yet wickedly eccentric Romanian gentleman - the love of her life. Learn more about their story at Come Back Early Today.

Original content the Alzheimer's Reading Room