Music therapy for dementia and individuals with Alzheimer's is so
very beneficial. It can spark compelling outcomes even in the very
late stages of Alzheimer's disease. When music therapy with
individuals with dementia is used appropriately, it can shift mood,
manage stress-induced agitation, stimulate positive interactions,
facilitate cognitive function, and coordinate motor movements.
This happens because rhythmic and other well-rehearsed responses
require little to no cognitive or mental processing. They are
influenced by the motor center of the brain that responds directly
to auditory rhythmic cues. A person with dementia has the ability to
engage in music through the use of music therapy particularly rhythm
playing and singing, remains intact late into the disease process
because again, these activities do not mandate cognitive functioning
for success.
Dementia Therapy
and Music
Most people associate music with important events and a wide
array of emotions. The connection can be so strong that hearing a
tune long after the occurrence evokes a memory of it. Prior
experience with the piece is the greatest indicator of an
individual's likely response. A melody that is soothing for one
person may remind another of the loss of a loved one and be
tragically sad.
If the links with the music are unknown, it is difficult to predict
an individual's response. Therefore, observe a person's reaction to
a particular arrangement and discontinue it if it evokes distress,
such as agitation, facial grimaces or increasing muscular tension.
Top Ten Music Picks
Selections from the individual's young adult years, ages 18 to 25,
are most likely to have the strongest responses and the most
potential for engagement. Unfamiliar music can also be beneficial
because it carries no memories or emotions. This may be the best
choice when developing new responses, such as physical relaxation
designed to manage stress or enhance sleep.
As individuals progress into late-stage dementia, music from their
childhood, such as folk songs, work well. Singing these songs in the
language in which they were learned sparks the greatest involvement.
Sound of Music
Typically, "simulative music" activates, while "sedative music"
quiets. Stimulative music, with percussive sounds and fairly quick
tempos, tends to naturally promote movement, such as toe taps.
For music therapy ideas for individuals with dementia, lLook to
dance tunes of any era for examples. Slightly simulative music can
assist with activities of daily living: for example, at mealtime to
rouse individuals who tend to fall asleep at the table or during
bathing to facilitate movement from one room to another.
On the other hand, the characteristics of sedative music, ballads
and lullabies, include unaccented beats, no syncopation, slow
tempos, and little percussive sound. This is the best choice when
preparing for bed or any change in routine that might cause
agitation. Responses that are opposite of those expected can occur
and are likely due to a person's specific associations with the
piece or style of music.
Agitation Management
Non-verbal individuals in late dementia often become agitated out of
frustration and sensory overload from the inability to process
environmental stimuli. Engaging them in singing, rhythm playing,
dancing, physical exercise, and other structured music activities
can diffuse this behavior and redirect their attention.
For best outcomes, carefully observe an individual's patterns in
order to use music therapies just prior to the time of day when
disruptive behaviors usually occur. Emotional Closeness. As dementia
progresses, individuals typically lose the ability to share thoughts
and gestures of affection with their loved ones. However, they
retain their ability to move with the beat until very late in the
disease process.
Ambulatory individuals can be easily directed to couple dance, which
may evoke hugs, kisses or caresses; those who are no longer walking
can follow cues to rhythmically swing their arms. They often allow
gentle rocking or patting in beat to the music and may reciprocate
with affection.
An alternative to moving or touching is singing, which is associated
with safety and security from early life. Any reciprocal engagement
provides an opportunity for caregivers and care receivers to connect
with one another, even when the disease has deprived them of
traditional forms of closeness.
Music
Therapy Stages
Early stage
Middle stage
Late stage
Contributed by Alicia Ann Clair,
Ph.D., MT-BC, professor and director of the Division of Music
Education and Music at the University of Kansas in Lawrence.
"How-to" section contributed by Concetta M. Tomaino, DA, MT-BC,
vice president for music therapy and director of the Institute for
Music and Neurologic Function at Beth Abraham Family of Health
Services, Bronx, NY.
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