By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
Music has always played a huge role in my family. I cannot remember a family get together where we haven’t stood around a piano or sit at a campfire where someone had a guitar and sing for hours on end. Everything from hymns to folk music to silly songs.
I didn’t really think about it being something other than our family culture when my step-mom, in the worst of her dementia driven anxiety, would calm down and start “conducting the choir” when we would sing hymns to her. I saw the same with other family members with dementia, where music would give them such peace, especially if it was live music—not necessarily professional, but just someone singing or playing an instrument.
I just thought it was the music and its calming affect. I think we all know the old saying “music soothes the savage beast.” But with dementia, it’s more than the music, it’s how music taps into memory and communication.
Researchers at Northwestern University have proven that music memories stay with people even when they have lost their language ability. That music 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 patients from memory care units and their families were looked at. The first group, the control group, had no intervention. Families were recorded conversing with their loved ones in 10-minute interactions, then they went about their normal routines for 45 minutes, and then had another 10-minute interaction with their loved ones. The researchers looked for social engagement in the patients by monitoring eye contact and distraction.
They also evaluated levels of agitation and mood changes between the first and second interactions. In the study group, rather than going about their normal routines, after the first interaction with family members, the researchers had a group of chamber musicians and a singer perform music from the patients’ youth.
Music therapists gave the patients simple instruments like tambourines or shakers, the more verbal patients were encouraged to hum or sing along, and patients with good mobility were even encouraged to dance. In the 10-minute interactions that followed, patients showed significant changes over the control group in every criterion studied. Social engagement and mood were greatly improved, and agitation was greatly decreased. While that is great by itself, they also found that with repeated sessions of music intervention, the positive effects lasted longer and longer.
The other part of this study that I thought was good is that it also asked the families how they felt the music affected their loved ones. It’s rare that studies about dementia look at family results as well as patient results. To a person, the families involved in the study group said the music allowed them to relate to their loved one with dementia where they couldn’t before the musical intervention. Researchers saw caregivers invite multiple family members to participate in ongoing research sessions. One researcher stated, “it became a normalizing experience for the whole family.”
I have often thought that dementia, especially Alzheimer’s, is one of the cruelest diseases out there, because of how much it affects not just the person, but the family. My dad still talks about how hard it was to watch the terror my step-mom experienced at the end because in her mind she was a little girl and she was not in her home and couldn’t find her parents, and the only way they could relieve that terror was to keep her sedated. I will never forget the look on my daughter’s face the first time my step-mom didn’t recognize her. That music can make a difference for both the patient and the family is really exciting and this research may go on to find a way beyond drugs to help reduce the anxiety and outright terror that so many dementia patients experience as they lose memories and cognition.
This of course, is just one study, and to better develop programs, the researchers are going to look at bigger groups of patients and try to isolate the exact parts of the music therapy that make the difference. But in the meantime, if you have a loved one who does have dementia, add music to your interactions with them. Be careful with the dancing so they don’t fall, but otherwise, its unlikely to cause harm, and it might really help.
