If Music Be The Food of Life, Play On

by Women's Brain Health Initiative:The Power of Music:Dr. Michael Gordon, Medical Program Director of Palliative Care at Baycrest Health Sciences in Toronto, explains, “The range of potential alternative therapies for coping with dementia is quite wide and different approaches work for different patients, depending on what activities have past positive associations for them. It might be pet therapy or gardening therapy or a therapy using any of the creative arts.”When used appropriately, music can help boost cognitive function and memory, bolster mood, stimulate positive social interactions, encourage movement, and reduce stress, agitation and aggression. The effects of music therapy sometimes last long after the session has ended. What is especially notable is music’s ability to spark heart- warming outcomes even among patients who are in the very late stages of dementia.It is thought that music often gets through to late stage dementia patients, even when often nothing else does, because earlier memories remain intact, and music can evoke emotion that helps aid in recalling them. Rhythmic and other well-rehearsed activities like singing are possible in late stage dementia because they do not depend on cognitive functioning for success. This could explain why musical appreciation and aptitude are two of the last abilities to remain in dementia patients as the disease progresses.Music Therapy – How It WorksThere are a variety of ways that music can be used to help people with dementia, ranging from listening to music, to singing in a choir, to formal music therapy sessions.Personalized Music “Recipes”Formal programs like the one offered by Music & Memory, a non-profit organization which gives iPods to dementia patients in nursing homes, each one programmed with music customized for the recipient, are reaching many patients. The program has been implemented at hundreds of care facilities throughout Canada and the US and its reach continues to expand.Dr. Gordon points out that caregivers can provide similar musical stimulation on their own, either in a long-term care facility or in the home. This involves more than turning on the radio. Rather, Dr. Gordon advises caregivers to compile a music “recipe” for the dementia patient; a personalized playlist of music which that person associates with pleasure. If you don’t know the person’s favourite songs or preferred style of music, experiment with different songs and watch for their effect.Once you’ve finalized the music playlist, put that music on a CD or iPod and ensure it is listened to regularly. “Occasional play is not enough,“ Dr. Gordon explains. “You need to do it as a program.” Schedule it into each day at the same time, for an hour if possible. It’s well worth the effort to establish a routine, since the positive effects often last for hours afterward.Baycrest is currently developing guidelines for caregivers on how to prepare playlists as well as a tip sheet on what to do if there is an unexpected emotional reaction to music shared.Singing in a ChoirA more interactive musical experience that works well for dementia patients, particularly in the early to mid stages of the disease, is participating in a singing group. One such group, Buddy’s Glee Club, was founded for a three-phase research project at Baycrest. In each phase, patients participated in choral sessions once a week for 16 weeks, led by a music therapist.The first phase (Glee 1) involved 28 participants from the adult day centre who were cognitively intact and/or diagnosed with mild Alzheimer’s disease or other forms of dementia. Glee 2 involved 22 people living in the nursing home, primarily with mild to moderate cognitive impairment including Alzheimer’s disease. Glee 3 tested an innovative variation by including caregivers in the choir; 14 nursing home residents with moderate cognitive impairment participated in the choir with a caregiver, the same person each week.Dr. Amy Clements-Cortes, Senior Music Therapist at Baycrest, who led all three phases of the study, explained, that “a variety of test measures wereincluded in each phase of the study, looking at the potential benefits of the experience on the physical, social and emotional dimensions of health.”Overall, the results indicated that singing has benefits for dementia patients, and in the case of Glee 3, for caregivers as well. Participants demonstrated improved mood and happiness, along with reduced pain and increased energy.The benefits are obvious when observing the choir in action. Dr. Clements-Cortes explains, “It’s quite amazing working with people that have dementia. Many of them might sit in a fog or be unconnected to their environment, and as soon as you start singing a song that’s in their long-term memory, they can sing along, often with the words intact.When the level of dementia increases, they are still able to respond rhythmically and even sing the melody with ‘la’ or a syllable. So we know that it’s reaching them. It’s a way to stay connected and provides an avenue for communication and expression, whereas other therapies might not do so at that stage.”Live MusicYet another way music has been shown to benefit dementia patients is through listening to live music, either one-on-one with a caregiver or as part of a larger audience listening to a performance.Dr. Clements-Cortes says that many nursing homes bring in musicians to play for residents and there are benefits to that. She also explains that there is a lot of evidence to support caregiver singing. This means that it’s a great idea to have nurses and other caregivers use singing as part of their daily caregiving. It helps to bring back memories, minimize agitation and reduce any resistance to necessary tasks such as bathing, eating and taking medication.Formal Music Therapy SessionsMusic therapy can be provided bothindividually or in small groups. Participants work with a professional music therapist and experience a range of interventions such as playing instruments, improvising, moving to music, reminiscing to music, singing and writing songs. A variety of goals can be reached through music therapy such as: reducing pain perception, stimulating cognitive function, decreasing depressive symptoms and enhancing communication.Music as PreventionThe benefits of music extend well beyond treatment for dementia. Research is showing that musical activities are an engaging form of cognitive training that improves brain plasticity in young brains and old. Investing time in musical pursuits not only provides young brains with a cognitive boost, it has the potential to prevent or delay cognitive decline in later years.Numerous studies show that participating in musical training early in life can aid in healthy brain aging years later. For example, a 2014 study in Neuropsychology followed thousands of older adults, some of whom eventually got Alzheimer’s and some of whom didn’t. The study found that participants who had music lessons in childhood were less likely to experience cognitive decline later in life.Another example is a study published in the July 2012 issue of Frontiers in Human Neuroscience. It also showed that musical instrument training may reduce mental decline associated with aging. The research found that older adults who learned to play an instrument in childhood and continued to play for at least 10 years outperformed their non-musician peers on tests of mental acuity, visual-spatial judgment, verbal memory and recall, and motor dexterity.Yet another example can be found in a Canadian study led by the Rotman Research Institute (RRI) at Baycrest, which found that musical training in younger years appears to enhance key areas in the brain that are used for speech recognition, and that those enhancements seem to be maintained as you get older. The results, published in The Journal of Neuroscience in January 2015, showed that brain response related to speech in older musicians was two to three times better than in non-musician peers.When an enjoyable pastime like music offers so many potential benefits for the brain, it makes “treatment” a pleasure.