Music Therapy in Dementia Treatment — Recollection Through Sound
By Juliann Schaeffer
People of all ages relate to and enjoy music, making it a universal language, of sorts. However, its value can go far beyond simple listening.
Most people enjoy music, but can it actually make the mind “move”? Absolutely, according to Kimmo Lehtonen, PhD, professor of education at the University of Turku (Finland) and a clinical music therapist for more than 25 years. In fact, therapists have been using music therapy to promote memory and a sense of self in the treatment of older adults with dementia.
Music and Emotion
John Carpente, founder and executive director of the Rebecca Center for Music Therapy in New York and a licensed, board-certified music therapist, describes the center’s music therapy program for older adults: “Meeting individually and within a group, elder clients express themselves and recall the memories that music sparks and stimulates. By listening to live music and being involved in live music-making experiences, a greater quality of life is possible.” This, he believes, empowers clients to emerge from the isolation imposed by Alzheimer's disease and dementia. He notes that program therapists use music therapy to improve the overall physical and mental wellbeing of dementia patients, including the following:
Basically, Carpente says, music is used with older adults to maintain or increase their levels of physical, mental, social, and emotional functioning. Music used as a sensory and intellectual stimulation can help maintain a person's quality of life or even improve it.
Memory in Sound
Since dementia is a degenerative condition, expressing basic needs and being understood can become problematic and lead to a complicated feeling of isolation for sufferers, says David Aldridge, chair of qualitative research in medicine at the University Witten Herdecke (Germany) and editor of Music Therapy in Dementia Care. “Using songs in a therapy setting promotes communication,” he says. “Singing has many functions; it offers a communicative structure, stimulates and regulates, and enables dialogue.”
Alicia Ann Clair, PhD, MT-BC, director of music education and therapy at the University of Kansas/Lawrence, says that making music and listening to it provide ways to employ cognitive skills to avoid losing them. “When older persons are interested in learning to make music or are looking for ways to rejuvenate skills learned in the past, many programs are available,” she says. “Opportunities for learning music that were once accessible only during childhood are now available throughout the life span, either through group lessons or private instruction.” Resources include local music stores, professional music education venues, and private teachers.
Music therapy can promote communication between therapists and patients in individual settings or among patients in group settings. “Undoubtedly, it’s one of the most engaging and emotionally powerful stimuli,” says Carpente. “Listening to music can have strong effects on people's moods, thinking, and even their physiology, which constitutes a probable reason certain songs remind us so vividly of a specific memory. That being said, memory is a mental system that receives, stores, organizes, alters, and recovers information from sensory input. Emotions and memory are very much linked, and because music is charged emotionally, it can trigger past memories, good and bad.”
This same triggering of memories via music can also promote communication within the older patient, essentially giving him or her a renewed sense of identity. “I have one particular experience, which was very strong and beautiful,” Lehtonen recalls. “I used to work as a supervisor of music therapy research. The therapist had a video camera set up in every session and afterward, we would analyze the tapes. In this case, the therapist sang old Finnish folk songs to an over 80-year-old man with dementia. After every song, the man sang his own song in a broken voice. He sang old Italian romantic songs, which were quite difficult. He exactly remembered melodies and words, and he sang many songs during these sessions. His voice and expression were so strong and authentic they put a shiver down my spine. I checked his personal history. This old man, who hardly remembered his name, had spent his best years in Florence, where he worked as an interior architect.”
Lehtonen believes music therapy can be used not only to treat elders with dementia but also to prevent the disease. “In Finland, the after-war generation is getting old, and there are more and more elderly people who are in a relatively good condition both physically and psychically. I think this kind of remembering through music is a good way of keeping people happy and active.”
Rather, she explains, it needs to be carefully selected music or specifically designed to support each particular exercise by cuing the pace, force, direction, and number of repetitions. In addition, because music makes exercise seem shorter and more pleasant, people—older or younger—tend to stick with exercise programs where music is included. However, she notes, it’s important to obtain a physician’s approval before starting any exercise program.
A Little History Plus
Their physical and emotional response to music led doctors and nurses to request the hiring of musicians by the hospitals. It was soon evident that the musicians needed some prior training before playing in hospitals, and so the demand grew for a college curriculum.”
The world’s first music therapy degree program was established in 1944 at Michigan State University. The American Music Therapy Association (AMTA) was founded in 1998 as a result of a merger between the National Association for Music Therapy and the American Association for Music Therapy. According to the AMTA, there are currently 75 institutions nationwide offering bachelor’s or master’s degrees in music therapy and approximately 100 internationally.
With the continuing increase in the United States’ older adult population, professionals may want to tune their clients and patients in to a therapy that fosters an enhanced recall of their forgotten histories. “The future of music therapy is promising,” says Carpente, “because state-of-the-art music therapy research in physical rehabilitation, Alzheimer's disease, and psychoneuroimmunology is documenting the effectiveness of music therapy in terms that are important in the context of a biological medical model.”
—Juliann Schaeffer is an editorial assistant at Aging Well.