By Carol A. Cates, MSN, MBA, RN
Odessa Regional Medical Center
Music has always played a huge role in my family. I can’t remember a family reunion where we didn’t huddle around a piano or sit at a campfire where someone had a guitar and sang for hours. Everything from hymns to folk music to silly songs.
I didn’t really think it was anything other than our family culture when my mother-in-law, in the worst of her dementia-related anxiety, would calm down and start “leading the choir” when we sang hymns to her. I’ve seen the same with other family members with dementia, where music would bring them such peace, especially if it was live music – not necessarily professional, but just someone singing or play an instrument.
I just thought it was the music and its calming effect. I think we all know the old adage “music soothes the wild beast”. But with dementia, it’s more than music, it’s how music taps into memory and communication.
Researchers from Northwestern University have proven that musical memories stay with people even when they have lost their language ability. This musical memory can allow people with dementia, particularly Alzheimer’s disease, and their loved ones to maintain many of the emotional connections and communication that are otherwise lost as dementia progresses.
In the study, two groups of memory care unit patients and their families were examined. The first group, the control group, had no intervention. The families were recorded conversing with their loved ones during 10-minute interactions, then they went through their normal routines for 45 minutes, and then had another 10-minute interaction with their loved ones. The researchers looked for patients’ social engagement by monitoring eye contact and distraction.
They also assessed agitation levels and mood changes between the first and second interactions. In the study group, rather than continuing with their normal routines, after the first interaction with family members, the researchers asked a group of chamber musicians and a singer to play music from the youth of the patients.
Music therapists gave patients simple instruments like tambourines or shakers, more verbal patients were encouraged to hum or sing, and patients with good mobility were even encouraged to dance. In the 10-minute interactions that followed, the patients showed significant changes compared to the control group in each criterion studied. Social engagement and mood were greatly improved and restlessness was greatly decreased. While this was great on its own, they also found that with repeated sessions of musical intervention, the positive effects lasted longer and longer.
The other part of this study that I found good is that it also asked families how they thought music affected their loved ones. Rarely do dementia studies examine family outcomes as well as patient outcomes. To one person, families involved in the study group said that the music allowed them to relate to their loved one with dementia where they could not before the music intervention. Researchers have seen caregivers invite multiple family members to participate in ongoing research sessions. One researcher said, “It became a normalizing experience for the whole family.”
I have often thought that dementia, especially Alzheimer’s disease, is one of the most cruel diseases that exist, because it affects not only the person, but the family. My dad still talks about how hard it was to see the terror my stepmom went through at the end because in her mind she was a little girl and she wasn’t home and she couldn’t find her parents, and the only way they could relieve that terror was to keep her sedated. I’ll never forget the look on my daughter’s face the first time my mother-in-law didn’t recognize her. That music can make a difference to both patient and family is truly exciting and this research may continue to find a way beyond medication to help reduce the anxiety and outright terror that so many patients people with dementia feel when they lose their memories and cognition.
Of course, this is just one study, and to better develop the programs, researchers will look at larger groups of patients and try to isolate the exact parts of music therapy that make a difference. But in the meantime, if you have a loved one with dementia, add music to your interactions with them. Be careful with the dance so they don’t fall over, but otherwise they’re unlikely to cause any damage and it could really help.