8.29.16 Mary Yamim-Garone, DeMystifying Alzheimer’s: The Power of Music
Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “The Power of Music and Alzheimer’s.”
The man had not spoken in three or four years. An older man in the late stages of Alzheimer’s, he could no longer care for himself and required a high level of assistance with his activities of daily living.
But on one particular day, Concetta Tomaino, DA, a certified music therapist, offered a different kind of dementia therapy. She sang an old Yiddish song to him and some of her other patients. “You could tell by his face that he was watching,” she recalls. From a man in his condition, attention was a lot to ask for. “Whenever I got a chance I played this song to him and sang to him. Within a month of doing this, he was making an attempt to speak, and he eventually started singing the song himself. He also started talking again and he continued talking and lived for many years after that.”
Music has power—especially for those suffering from Alzheimer’s. Research suggests that listening to music or singing can provide emotional and behavioral benefits for those with AD. Musical memories are often preserved because important brain areas linked to musical memory are relatively undamaged by the disease.
For example, music can:
- Alleviate stress
- Decrease anxiety and depression and
- Lessen agitation
Music can also benefit caregivers by lowering their anxiety and distress, lightening the mood and offering a means to connect with loved ones who have Alzheimer’s, especially those who have difficulty communicating.
In a small 1986 study, only music elicited a physical response from those with late-stage Alzheimer’s as measured in heart rate, breathing, eye blinking and mouth movement. A later study that used music in palliative care found the combination of language, which is processed by one part of the brain, and music, processed by many parts of the brain, increases the chance of activating neurological pathways that language alone cannot.
“There are certain areas of the brain that are still relatively intact even as a progressive disease like Alzheimer’s takes effect,” says Suzanne Hanser, PhD, department chair of music therapy at Berklee College of Music in Boston and former program director of San Francisco’s Alzheimer’s Association. “In particular, the limbic system. And specifically, the hippocampus, which retains long-term memory and has retained emotional impact. Music triggers these long-term memories. So we see people who have not spoken in years begin to sing songs that they knew in their early teens and early adulthood.”
Most of us associate music with important events in our lives and a wide range of emotions. The connection can be so strong that hearing a song long after the circumstance arouses a memory of it.
Song selections from your loved one’s young adult years—18 to 25—will more than likely have the strongest responses and the greatest likelihood for engagement. On the other hand, unfamiliar music can be advantageous because it doesn’t hold any memories or emotions.
As your loved one moves into the late-stage of Alzheimer’s, music from their childhood works well. Singing songs in their native language sparks the greatest involvement.
In the early stages, your loved one will most likely enjoy playing music and singing. Encourage them to get involved by:
- Going dancing or dancing in the house
- Listening to music they liked in the past. It’s important to recognize that perceptual changes can alter the way someone with Alzheimer’s hears music. If they say it sounds horrible, it may to them.
- Taking them to concerts
- Encouraging your loved one who used to play an instrument to try it again
- Compiling recordings of their favorite songs, which often date back to their younger and middle years
Some people in the middle stages of Alzheimer’s can continue to play whatever instrument they may have played well and benefit from it. Others may become frustrated when they forget a chord or can’t read the music.
In the middle stages, when behaviors can sometimes be challenging, music is an often-effective way to distract your loved one. For example, a nurse aide almost always sings a song with the person she’s helping while they walk together. The person walks farther because they’re singing along and has a more enjoyable time getting their daily exercise.
In this stage:
- Use song sheets or a karaoke machine so your loved one can sing along with old-time favorites.
- Play music or sing while they’re walking to improve their balance or gait.
- Use background music to improve their mood.
- Choose relaxing music—a familiar, non-rhythmic song—to diminish sundowning or behavior problems at night.
Music is often used in the later stages of Alzheimer’s to connect and evoke a response from your loved one. It also can calm someone who’s restless or uncomfortable in the end stages of life. Some severe AD sufferers will mouth the words of a familiar song when they hear it and visibly relax and rest while they listen to the music.
In this stage:
- Use the collection of old favorites you recorded.
- Do sing-alongs with “When the Saints Go Marching In” or other tunes from their generation.
- Play soothing music to provide a sense of comfort.
- Exercise to music.
- Drum or perform other rhythm-based activities.
- Use facial expressions to communicate feelings
Here are more tips for using music to help your loved one.
- Think about their preferences. What kind of music do they enjoy? What music evokes happy memories? Have family and friends suggest songs or make playlists.
- Establish the mood. Play music or sing a soothing song to calm your loved one. If you want to give their mood a boost, try upbeat or faster-paced
- Avoid overstimulation. Eliminate competing noises. Adjust the volume based on your loved one’s hearing ability.
- Encourage movement. Help your loved one clap along or tap their feet. If possible, dance with them.
- Sing along. Singing with your loved one can boost their mood and enhance your relationship. Some early studies also suggest musical memory functions differently than other types of memory and singing can help stimulate unique memories.
- Focus on your loved one’s response. If they seem to enjoy particular songs, play them often.
My mother loved music. She was an accomplished pianist with a beautiful voice. Playing the piano and singing was an important part of her kindergarten classes. Even now, music is always playing in her room. While my mother no longer speaks, she still responds to the sound of the music.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me next time for more Demystifying Alzheimer’s.