How music helps with dementia
Why can dementia patients remember music?
The part of the brain which stores music remains intact no matter how advanced the dementia. Music is embedded in so many different networks in our brain, for example, movement, speech and emotions. The area of the brain which processes emotions, the amygdala, is unaffected by dementia, so although someone may not be able to speak or open their eyes, they can feel emotions and hear music. A patient with advanced dementia can process music even though they may not be able to tell you about it or show signs that they can hear.
What type of music is best for dementia?
Each person will have several songs from their past which make up the soundtrack to their life-story. If words are not possible, then you will need to be a detective! A good place to start are songs from a patient’s ‘reminiscence bump’ . If you are a carer and you wish to change a dementia patient’s mood, for example, to soothe someone who is very upset, or angry, you could start by matching their mood with a fast song, for example Charlie is my darlin’, so they feel heard and understood. When they see you are ‘listening’ to them, you can gradually turn down the emotion by choosing a song which is slower and calming for example a lullaby like My bonnie lies over the ocean. Music is highly potent and deeply affects the emotional state of the person with dementia, so choose your songs with care.
Why do dementia patients sing?
We all have a voice and singing is a natural extension of the speaking voice. The majority of older people will have grown up singing more than we do now, for example in church, in local choirs and in pubs at local singalongs with their families and neighbours. The music they would have known growing up (the ‘reminiscence bump’ between ages 15 and 30) was tuneful with memorable and meaningful words, calling to deep human and social experiences. They may have sung and danced to favourite songs which were very important to them, such as at their wedding or lullabies that their parents sung them as children. Some types of dementia affect the frontal lobe which is responsible for controlling our social behaviour which is why people with dementia may act without inhibition or sense of embarrassment, enabling them to express themselves freely. Dementia patients can remember music and even though they may be forgetful and muddle words, the ability to recognise and respond to melody and rhythm remains intact. Often people can sing the words of a song even though they can’t speak a sentence and this brings a great sense of surprise and recognition of identity, at least for a moment. Patients love to recall happier times and beloved songs from important events in their lives can reawaken memories and positive feelings from the past.
How do you plan music activities for dementia in care settings?
If you are a carer of someone with dementia, it would help you to have a variety of well-known songs by heart that can be reeled off at any time, around 20 songs, with a mixture of upbeat and gentle songs to suit different situations. Use your own voice! It doesn’t matter to anyone at all if your voice is not ‘professional’ quality. Your voice is the most immediate, comforting and honest way of communicating and people will respond to you with joy, so don’t be shy! You could use a backing track for another type of musical activity such as dancing to rock and roll, or shaking percussion. Singing groups for dementia will help build a group identity and the beauty is you don’t have to have many tools, achieve a goal, or rely on language. Let go of your embarrassment and have a wonderful time! Dementia patients will not be at all embarrassed, they were used to singing and dancing in their youth and early adulthood, much more than we do now.
How does music therapy affect the brain?
Music therapy is a general term that covers all kinds of musical activities which have a therapeutic benefit. It could take place in a one-to-one between a music therapist and a child with autism, for example, or a community musician working with a singing group of dementia patients. Music is embedded into multiple networks in the brain, co-ordination, physical activity, communication, speech, memory, emotion and many more. Athletes and politicians use music to train, or manipulate a crowd and the film industry has long known this: every film you’ve ever seen uses music to exploit our primitive emotional response, to make us feel happy, sad or excited. Music therapy works in this way too, influencing positive mood change by creating instant emotional connections using melody, intervals, rhythm and patterns. Music therapy activities are a way of connecting, using a primitive common language which doesn’t rely on speech, and this helps the patient feel understood.
What kind of music calms dementia patients?
When a dementia patient is upset, or angry or aggressive it may be because they cannot communicate how they are feeling. Using music and favourite songs that are meaningful to a person with dementia is way a to reach across the gulf and show that you are connecting with them. Any favourite song which a dementia patient has already shown they like shows you are communicating with them. Try to find out what songs makes that person tick to use in an emergency. Music and dementia research has shown that music not only has an effect on wellbeing but also that meditation music has a very calming effect too. Music can also cause negative responses, for example, if the music has a negative memory attached, is too loud, or goes on too long, or is just a noise in the background. Think of music like a balanced meal: not too much of one thing and just enough to feel satisfied. Do any music activity attentively, with lots of variety and in short bursts of 20 - 45 minutes, then stop.
Does music therapy work?
Yes, music is a unique and powerful tool for people with dementia. It is important to mention we are talking about music listened to attentively and not in the background. The right song and music for a person with dementia can act as a way of communicating instead of using words. For example, a marching song such as The Grand Old Duke of York can help walking form one room to another, while a calming song such as Kumbaya can help soothe an angry dementia patient. A lively song such Twist and Shout by the Beatles can bring a smile to a depressed dementia patient and they may start to join in. Music is much more than just entertainment. A professional musician, either a community musician or a music therapist, will know how to unlock responses from individuals by using specific and carefully chosen songs, and know how to engage with them. This is not to say that entertainers do not have their place, but music therapeutic activities have a totally different function.
What they said
After a 3 months of regular music with Eleanor...
100% care staff said they strongly agree that musical activity improves their relationship with their residents.
80% said they strongly agree that musical activity helped them gain an insight into the person living with dementia and allowed them to know them better and
80 % strongly agree that taking part in a musical activity helped improve their mood and enjoy their work.
100% said they had a good understanding of music’s impact on those with dementia.