Music is present in every stage of a person’s life. Think of when you listen to the radio and a song from your childhood comes on. Often times these “throw back” songs are the ones that we recall the best. Music stimulates our brains in a way that allows long-term memory to be accessed. When we hear a familiar song or tune we are quickly and accurately accessing parts of the long-term memory. Long-term memory is located in various parts of the brain, the hippocampus being the catalyst. When we are able to make music with others through singing, and enjoy knowing the words of a song we haven’t heard in years, we also experience positive feelings. There is enjoyment and comfort in this kind of music listening. Individuals living with dementia do not get to experience the easiness of knowing or even awareness in everyday life. Due to the nature of their diagnosis, they can often feel confused, anxious, and agitated. Dementia affects orientation and overall awareness. Even in early stages of dementia, individuals may experience the uneasiness that feeling overly forgetful can bring. As a Music therapist I have had the opportunity to be involved with memory care groups and observe various settings where memory-care patients receive music therapy services. Music therapy can make a difference in all of these areas listed above. We use music to aid in mood management, physical and mental engagement, and so much more.
Dementia is defined in general as a neurodegenerative disease that is characterized by the progressive loss in memory as well as other mental functions including language and judgment. Because of the nature of these types of diseases, therapeutic techniques that involve multiple parts of the brain are important. Studies show that Alzheimer’s disease is the leading type of dementia that affects people in the United States. It has been reported that 60 percent of all cases are of the Alzheimer’s disease (Solé, Mercadal-Brotons, Galati, & De Castro, 2014). This study further supports the importance of research in these areas where music therapy is involved. Individuals with dementia that are receiving services deserve the most effective interventions. Music therapy provides just that! The article referenced here also highlights how an individual’s quality of life is affected by music therapy in a group setting.
Although this study had a small sample size of 16 individuals, three groups according to stage of dementia were formed. Each group met for 12 weeks and received 45 minutes of music therapy once a week (Solé, Mercadal-Brotons, Galati, & De Castro, 2014). Documentation was done through the help of registered nurses before, during, and after each group session. Quality of life was measured using the Government of Catalonia (GENCAT) questionnaire. This questionnaire consisted of questions revolving around emotional well-being, interpersonal well-being, material well-being, personal development, physical well-being, self-determination, social inclusion, and equal rights. The higher individual’s scored on this indicated higher qualities of life. Participation was measured through data collection as well as through video analysis. But enough of the data details, lets dive into the music therapy specifics!
For each group the music therapy interventions used centered around stimulating cognitive functions, social interactions, and motor skills. Motor skills were addressed through instrument playing. Other musical activities during each group included singing, listening to music, movement to music, and improvisation (Solé, Mercadal-Brotons, Galati, & De Castro, 2014). The music used for the groups was selected based off of personal preferences of the group members. This is a common technique in music therapy and in my experience using familiar music is especially important with this population. Familiar music brings about quicker responses and has proven to be most useful when trying to evoke active participation. Sessions for this population commonly include opening activities, like a hello song, one main activity, and a closing activity.
Sometimes less is more when we are trying to connect with patients that have memory loss or confusion. Starting with 3-5 songs and adding in techniques specific to the individual’s needs is one of the best ways to structure a session. The brain and body often need priming before going straight into movement or instrument playing. Too much stimulation can be overwhelming, and too little can leave patients disengaged and sometimes even sleeping. As a music therapist my goal is to help every patient GROW and that looks different for everyone. Goals for this population are often emotional and social, since dementia is a degenerative disease it can be difficult to measure other goal areas, as most caregivers are concerned about the day-to-day quality of life. That is what music therapy provides- quality care and life enrichment opportunities in the moment!
This study example made it obvious which areas of the patient’s lives were most influenced during the analysis. The categories being measured were verbalization, physical contact, visual contact, active participation, and emotions (facial affect and body expressions). Some of the areas that showed the largest changes were emotional well-being and personal development. However, emotional well-being was the only domain to show a statistically significant increase, recorded as Mdn=21 pretest toMdn=23 posttest (Solé, Mercadal-Brotons, Galati, & De Castro, 2014). Although the personal development domain did not reap significant results, the data still presented interesting outcomes. It is worth noting that the medians for all groups in personal development either stayed the same or increased. What a wonderful foundation for future research!
Since personal development and emotional well-being had such positive outcomes in this study, I will close by briefly discussing those in the memory care setting. I especially loved that this study used primarily patient preferred music and the comfort that music can bring was reflected in the patient’s emotional responses. When patients have decreased levels of anxiety or have the opportunity to increase their overall mood, this benefits the entire body (blood pressure, breathing, sleep, etc.) Music therapists experience firsthand the benefits of group music making with dementia patients. Although personal development is hard to measure with this population, there are still many promising examples. It is always a special moment when an individual comes out of their shell to sing several verses of a song from memory, or passionately plays an instrument with peers. After a moment like this, many times that individual sustains attention and participation for the rest of that session.
This article screams, Music therapy works- pass it on! I look forward to passing on more research and continually retaining knowledge through my clinical experiences moving forward. Three-Chord Music Therapy Services, LLC is built on the belief that ALL clients deserve a chance to seek growth no matter what age or ability level they are in life. If you have a loved one experiencing the negative effects of dementia, reach out today for a free music therapy consultation. We would love to help you find a therapeutic routine that helps your loved one work through symptoms in a risk-free way.
Carme Solé, Melissa Mercadal-Brotons, Adrián Galati, Mónica De Castro; Effects of Group Music Therapy on Quality of Life, Affect, and Participation in People with Varying Levels of Dementia, Journal of Music Therapy, Volume 51, Issue 1, 1 March 2014, Pages 103- 125, https://doi.org/10.1093/jmt/thu003