“Music is a part of being, and there is no human culture in which it is not highly developed and esteemed. Its very ubiquity may cause it to be trivialized in old songs going through our minds for hours on end, and think nothing of it. But to those who are lost [in some cognitive or neurological issues, such as Alzheimer’s] dementia, the situation is different. Music is no luxury to them, but a necessity, and can have a power beyond anything else to restore them to themselves… at least for a while”.
Oliver Sacks, Musicophilia
From the moment life begins until our last breath, the human being responds to music. We hear music when in the womb via our mother’s heartbeat and despite how withdrawn from the world someone with Alzheimer’s can be, you will see them come alive with music.
Although it’s not clear how music and rhythm interact with the brain, the therapeutic benefits of music has been well documented and researched. Music allows them to express pent-up emotions they don’t have a release for such as anxiety, joy, sadness, anger; it provide them with an avenue to express those emotions in a therapeutic way.
In this video excerpt from segment of The Doctors TV that featured Music & Memory, host Dr. Travis Stork explains how the brain processes music and Dr. Laura Mosqueda, Director of Geriatrics at the University of California, Irvine School of Medicine, explains what happens to the brain when affected by dementia and why musical memories are preserved.
Can personalized playlists be an alternative care managers can implement to reduce reliance on antipsychotics to manage behavioral and psychological symptoms of dementia? Research is ongoing in Wisconsin to answer that very question. The results so far has seen a 25% dosage reduction in just a four week period.
ALIVE INSIDE is a joyous cinematic exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity. This stirring documentary follows social worker Dan Cohen, founder of the nonprofit organization Music & Memory, as he fights against a broken healthcare system to demonstrate music’s ability to combat memory loss and restore a deep sense of self to those suffering from it.
At our practice in Pittsburgh, PA (Holistic Aging-Options For Elder Care), we have had excellent success in prevention and managing the behavioral and psychological symptoms associated with varying cognitive disorders without the need for medication. Our Aging Life Care Managers (Geriatric Care Managers) seek family permission to implement this program with all our clients, personalizing the playlist.
One of the methods we utilize is an individualized IPod Music Program. When we are managing the client in the home, we educate the caregiver on preventing escalation of these behavioral symptoms by trying music therapy. When the caregiver is intuitive to the client’s needs, this highly successful. When a client is in an institutional environment (Assisted Living or Skilled Nursing) or the caregiver is not able to adapt to the perspective and needs of the person, we include music therapy as part of our care plan.
Our plan of care will either be based upon a PRN (as needed) of symptoms (agitation, restlessness, walking about, verbally or physically inappropriate) or a time of day or event (bathing) we know the person typically experiences these symptoms. We ask this be part of their MAR (medical record)and be applied like any other treatment. Depending on the facility, we may need a physician order.
- If the client has the funds, we ask the family to purchase (or we do for them) an IPod shuffle. We have also utilized used varying MP3 players: iPod shuffles, IPod Nanos and even old IPhone (plus charger) that were donated to us by conducting a local donation campaign through a school district or Girl Scout troop.(you will need to purchase a SIMS card)
- Make sure to restore the device to the factory settings.
- You can also ask for donations of I-Tune gift cards or we have shared CDs downloaded into ITunes with our clients with similar music taste.
- Utilize a teenage volunteer to help compile play lists and download it to the device. Girl Scout and Boy Scout troops are eager for a project, the local high school band/music department and/or most high schools now have a requirement for volunteer hours. We compiled our list into categories we can select per each individual client (meditation, musicals from the 40’s and 50’s, classical, jazz, etc.)
- Download their customized list to the MP3 player
- We have found that older adults prefer headphones to the earbuds. I have had success with an inexpensive pair ($4.00) we purchase on Amazon; if it is broken or lost, as many items are in facilities, our loss is minimal.
- Assure the caregiver knows how to turn on the music, select the play list, adjust the volume and charge the device.
- Since many items get misplaced by our client with cognitive disorders, we have the use and storage of the IPod be the caregiver or facility responsibility.
- Yes – our devices, headphones, and/or chargers have disappeared in facilities. We do our best to prevent this by placing the clients name and our phone number on each device and have brightly colored storage packs; but it happens. Since the music is stored on ITunes under the individuals account, we can quickly make another one.
If you have interest in helping us with our campaign – we are in need of volunteers to download CD’s into Itunes and individualized playlists (perfect for a boy or girl scout troop project! ) We also continue to collect gently used Ipods.
Bobbi Kolonay RN BSN MS CCM and Certified Holistic Nurse – President of Holistic Aging – Options For Elder Care in Pittsburgh PA; is also on the Board of Directors of the Aging Life Care Association (ALCA)