Music as a Therapeutic Tool
by Sheryl Karas M.A.
"When I was encouraged by a music therapist to sing to my husband who had been lost in the fog of Alzheimer's disease for so many years, he looked at me and seemed to recognize me. On the last day of his life, he opened his eyes and looked into mine when I sang his favorite hymn. I'll always treasure that last moment we shared together. Music therapy gave me that memory, the gift I will never forget."
"When a couple danced together for the first time after five years of the husband's deterioration from probable Alzheimer's disease, the wife said: 'Thank you for helping us dance. It's the first time in three years that my husband held me in his arms.' Tearfully, she said that she had missed him just holding her and that music therapy had made that possible."
"The power of music is very remarkable. . . One sees Parkinsonian patients unable to walk but able to dance perfectly well or patients almost unable to talk who are able to sing perfectly well. . . I think that music therapy and music therapists are crucial and indispensable in institutions for elderly people and among neurologically disabled patients." —Dr. Oliver Sacks, at a Hearing before a Senate Special Committee on Aging
These quotes from the American Music Therapy Association's website illustrate the powerful healing effects of music in working with dementia and dementia caregiving. Research results and clinical experiences show that music therapy has therapeutic effects even in those who are resistive to other treatment approaches.
What is Music Therapy?
Music therapy is much more than simply playing records in nursing homes. Therapists who are trained in psychology, group interaction, and the special needs of those with brain impairment can design programs that fit a variety of needs and situations.
Singing is the most accessible form of music therapy and one where the results have been the most well-documented. Popular songs from the past can help Alzheimer patients recover memories of significant times in their lives and express feelings they are unable to express in any other way. The use of songs with particular lyrics can help them sequence a task. Singing old songs can become a way to communicate even for those who have seemingly lost the ability to speak. In fact, a particular kind of music therapy called Melodic Intonation Therapy has been used to help stroke victims with aphasia (a particularly severe language disorder) recover their ability to speak.
Rhythm and rhythmic movement is another commonly used therapeutic technique. It has been used with Parkinson's patients to improve range of motion, joint mobility, agility, strength, balance, co-ordination, gait consistency, respiration patterns, and muscular relaxation. There is also research being conducted on the use of drum circles in nursing homes to increase social interaction and raise self-esteem. Preliminary results show that the success of drumming with dementia patients hinges significantly on the abilities of the facilitator. Using a stick or mallet to beat the drums rather than hand-drumming has also been noted as more effective.
Learning to play a musical instrument can help victims of traumatic brain injury improve their motor coordination. Learning to play in a music ensemble is even more helpful because working within a group structure helps them learn to control the disruptive impulses that are typical with certain forms of brain impairment.
Listening to music is used to facilitate relaxation and reduce pain. Dominican Hospital in Santa Cruz, CA has been participating in a study which seems to show that providing live music in the hallways and in patient's rooms on request has emotional and sometimes spiritual benefits. Patients and staff were so enthusiastic about their experience as research participants that music by various local musicians is now a regularly scheduled event.
Other forms of musical therapy include expressive movement, song composition and various forms of improvisation.
Music therapy has a special purpose for redirecting anxious or agitated patients. It can be particularly effective for "Sundowner's Syndrome" behavior, becoming agitated in the late afternoon and early evening. It is thought that the structure of familiar music -- a consistent rhythm and familiar melodic and harmonic structure -- calms the confused mind by providing a predictable, organized structure with which to orient one's thoughts.
Ways to Use Music Therapy at Home
The easiest way to add music to your life is to sing or listen to favorite songs together. Put on an old record or tape and just sing along. If your patient is mobile you might also try singing in a choir together or attending music or dance-oriented events. Old popular songs and hymns can often be remembered and sung by those in the very late stages of Alzheimer's disease. Don't let your loved one's deterioration hold you back. Invite the grandchildren to join in. This is a great way for young ones who feel uncomfortable about interacting with someone with dementia to have a way to relate with their relative.
The Alzheimer's Association makes the following recommendations:
* Identify music that's familiar and enjoyable to your patient.
* Use live music, tapes, or CDs. Radio programs, interrupted by too many commercials, can cause confusion.
* Use music to create the mood you want.
* Link music with other reminiscence activities such as asking questions or flipping through old photographs to help stir memories.
* Encourage movement (clapping, dancing) to add to the enjoyment.
* Avoid sensory overload by eliminating competing noises. Shut windows and doors and turn off the television.
Caregiving Articles
© Copyright 2007 Sheryl Karas & Paul Hood
This article can be found in Sheryl’s latest book The Spiritual Journey of Family Caregiving.
Caregiving Articles