More threads by Daniel E.

Daniel E.

daniel@psychlinks.ca
Administrator
Music and the mind: Using an iPod to treat Alzheimer's
McKnight's Long Term Care News
by Dr. Concetta M. Tomaino
December 23, 2009

The prospect of Alzheimer's disease is one of the most frightening that people encounter as they and their loved ones age. It is after all, the loss of one's memories, one's sense of self and, ultimately, one's ability to function on any self-sufficient level.

If we are watching the disease take its toll on a parent or spouse, particularly if we take on the role of even part-time caregiver, our immediate concerns are to keep them safe and stave off the inevitable for as long as possible. As the daily reality unfolds, it is often compounded by the fear that a similar fate may be in store for us.

Indeed, forecasters tell us that the number of people afflicted with Alzheimer's disease will increase exponentially in the coming years, with some estimates topping ten million among the aging U.S. baby boomer population alone.

Those of us who wear an additional hat as professional long-term caregivers—whether on the front lines or in a management and administrative capacity—are faced with the reality of this burgeoning population, the people who love them and who look to us for answers, for treatment and for hope. The reality is that treatment and care for people with Alzheimer's disease is destined to be a long-term care challenge for the coming decades.

At the Institute for Music and Neurologic Function (IMNF), technology is playing a key part in helping people with Alzheimer's disease reconnect to their memories and their loved ones—if only for immediate periods of time. We call it our “Well-Tuned” program and its impact has been extraordinary.

The technology I mentioned is the iPod, which can be loaded with music that is emotionally significant to the individual with Alzheimer's disease. The music may spur memories thought long gone or stimulate recognition of a loved one that moments earlier was no more than a blank face. It may also help a person with Alzheimer's disease function and transition throughout the day, from energizing them during their waking hours to helping them wind down as bedtime approaches.

The iPod music play list is customized, changing from person to person based on their experiences, cultural backgrounds and frame of reference. As with lovers who grow sentimental when “their song” is played on the radio, the right music stimulates the personal associations that it is connected with, sparking memory and renewed “presence.”

When the person afflicted with Alzheimer's disease is non-verbal or can no longer communicate which music comprises the soundtrack of their life, family members and friends are engaged in the Well-Tuned process and help to assemble the autobiographical play list.

The clinical reasons that this type of therapeutic music works have to do with the emotional connection to music made throughout our life. It also has to do with areas of the brain that are involved in emotion, association and long-term memory processes that are stimulated by personally important music.

These areas include the limbic system (the amygdala and hypothalamus) and the medial prefrontal cortex. These areas and the neural networks that link them can still be stimulated through the auditory pathways in people with Alzheimer's disease and dementia. For this reason, key musical selections that are linked to emotional and personal memories can unlock memories and associations that had seemed lost forever.

The Well-Tuned musical selections also enhance the therapeutic value of other treatments. One musical menu might create stimuli to make it easier to participate in an exercise program, while another more “transitional” selection of songs is designed to keep the patient mobile over the course of the day. Still another program works to relax patients whose medications might make them hyperactive or agitated.

The presence of a Well-Tuned program, whether at long-term residential facilities, adult day care centers, in-home care programs or in assisted living environments, may well be a motivating factor when families are deciding whom to entrust with their loved one's care and future. The IMNF works with rehabilitation centers the world over, training caregivers in state-of-the-art, effective music therapy techniques.

Is Alzheimer's disease caused by environmental factors, genetic predispositions, some combination thereof, or simply because as people live longer lives, there are greater opportunities for it to present itself? Those questions and why Alzheimer's disease is on the upswing will no doubt be sorted out by science and scientists in the years to come. But when a loved one turns to us as healthcare professionals and long-term caregivers and we are able to give them one more opportunity to connect with a parent, a spouse, a sibling or a friend, that is truly, music to our ears.

We recommend that long-term care facilities find a trained music therapist who can not only provide therapy, but also consultation to the staff about how to use music therapeutically in other aspects of care, such as pain management or relaxation methods.

We welcome the opportunity to share the methods, mechanics and aspects of building Well-Tuned programs at other facilities. The costs involved are modest and can be customized to meet most budgets. Professional training can take place at IMNF headquarters in New York, or on-site at your local facility.

Dr. Concetta M. Tomaino, D.A., MT-BC, LCAT, is a pioneer in the field of music therapy for individuals suffering the effects of stroke and other brain trauma or are afflicted with such degenerative neurological diseases as Parkinson's or Alzheimer's. Tomaino is the executive director and co-founder of the Institute for Music and Neurologic Function and senior vice president for music therapy at Beth Abraham Family of Health Services.
 

Daniel E.

daniel@psychlinks.ca
Administrator
Caregivers Take Note – Music as Therapy
by Sherri Snelling, ALZ.org
February 2012

When Glen Campbell took the stage at the Grammy Awards and accepted his Lifetime Achievement Award, he did so as one of the more than 5 million Americans diagnosed with Alzheimer’s disease. What is inspiring about the 75-year-old Campbell’s Grammy night appearance is that he has not retired from his love of making music despite his recent diagnosis. In fact, he is starting his Farewell Tour and is cutting a new album.

Is music one of the keys to a longer, happier life – despite your health issues?

The news about Campbell got me thinking about studies and articles I have read about music therapy. Although music has been with us since the dawn of time, in the last few decades studies have found that music as a therapeutic tool can increase cognitive function in Alzheimer’s patients, help premature infants gain weight, encourage autistic children to communicate, lead stroke patients to regain speech and mobility, control pain for dental, surgical and orthopedic patients, and manage anxiety and depression for psychiatric patients.

Dr. Oliver Sacks, a renowned neurologist and psychologist at Columbia University Medical Center best known for his 1973 book Awakenings, which became an Academy Award-nominated film starring Robin Williams and Robert De Niro, and who also wrote Musicophilia: Tales of Music and the Brain, testified at the Hearing before the Senate Special Committee on Aging entitled, “Forever Young: Music and Aging,” and issued this statement:

“The power of music is very remarkable… One sees Parkinsonian patients unable to walk, but able to dance perfectly well or patients almost unable to talk, who are able to sing perfectly well… I think that music therapy and music therapists are crucial and indispensable in institutions for elderly people and among neurologically disabled patients.”

The Magic Brain Workout Is Music

Since music is associated with one of the five senses — hearing — which is controlled by the brain it makes sense that we should exercise our brains with music listening to spur cognitive function in the same way we use physical therapy to exercise our limbs, muscles and joints to regain mobility and physical function.

When it comes to Alzheimer’s patients, studies have shown that music reduces agitation or improves behavioral issues such as violent outbursts. In one pilot program, 45 patients with mid- to late-stage dementia had one hour of personalized music therapy, three times a week, for 10 months, and improved their scores on a cognitive-function test by 50 percent on average. One patient in the study recognized his wife for the first time in months. Another music therapy study showed that stroke victims can learn to walk and use their hands again.

And, music therapy is not just used with older patients. When it comes to those children diagnosed on the autism spectrum, music therapy allows these children to develop identification and appropriate expression of their emotions — music becomes the universal language. Many people with diagnoses on the autism spectrum have innate musical talents so music therapy can give these kids a sense of accomplishment and success.

When I spoke to Holly Robinson Peete, the successful actress, talk show host and singer, about her son R.J. who was diagnosed at age 4 with autism, she said he loves music and he has even recorded a song. In fact, Holly finds music a great way for her entire family to connect with R.J. and to enter his world.

She told me, “I think music makes him more comfortable — it is a way for R.J. to communicate without being judged.”

Music — Cure for Caregiver Complaints, Too

Music as therapy is not just for your loved one. We know that caregivers encounter increased stress over caring for a loved one. Since studies show that listening to music can lead to increased secretion levels of melatonin, a hormone associated with mood regulation, lower aggression, reduced depression and enhanced sleep. Using music to cope with these common caregiver complaints can be a welcome relief to caregiver burn-out.

How to Use Music in Your Caregiving Plan

Although the 2008 documentary Young @ Heart, showcased a chorus of 80-year-olds singing Beatles, Rolling Stones and Sonic Youth cover songs, most experts agree that with an older loved one it is best to choose music that reminds them of an earlier, happier time in their lives.

Discover the “happy times tunes”: Talking to your loved one about happy times in their life and understanding the music associations with that time are essential. Whether it is big band, gospel, rock ‘n’ roll, country, opera or blues, find out what made your loved one happiest. Most older loved ones, especially Alzheimer’s patients who retain long-term memory as opposed to short-term memory, find tunes from their youth the most joyful but be careful. Music can also evoke sad memories. One Holocaust survivor in a pilot program reportedly became very upset upon hearing a Wagner opera which reminded him of that era of his life.

Engage younger generations: You can help create emotional intimacy when spouses and families share creative music experiences. Whether it is downloading songs from iTunes, creating a Pandora play list or using the latest technical creation for digital music files, engage your kids in interacting with their grandparent or sibling with special needs to choose their favorite music.

Pick the right setting: It may not be as simple as turning on a radio. The radio can be distracting with constant advertising that breaks the peace of music. Instead, try internet radio like Pandora channels, or use an iPod or CD player. And, be careful with headphones — some may take comfort in the privacy of headphones while others will become irritated or uncomfortable. Also, consider live music situations carefully. For author Gail Sheehy, being able to take her husband, who was suffering from cancer, to a last jazz night out on the town was a gift she will always treasure. But, for special needs children and some older adults — the unsettling activity of a live concert or band can be frightening.

Let your music play: As a caregiver music is your therapy as well. Whether it is creating your own playlist to lift your mood when you have a “down day” or just taking pleasure in watching your loved one become engaged, music can make your heart soar. Celia Pomerantz, author of A Mother’s Daughter’s Journey, found that her mother, who grew up in Puerto Rico, loved a certain era of salsa music such as Tito Puente. She created song lists of her mom’s favorite tunes while her mother was in the nursing home. Celia became enchanted as her mother blossomed into the woman residents called “the dancing queen.” The joy of music and watching her mother dance lifted Celia’s spirits about her mother’s Alzheimer’s diagnosis.

Find a professional music therapist: The American Music Therapy Association (AMTA), a non-profit organization that represents over 5,000 music therapists, corporate members and related associations worldwide offers information about music therapy studies and a listing of credentialed music therapists that offer services in institutional, residential and private home settings.

Music can both evoke and create memories that last forever. I close with this heartwarming story from the AMTA website:

When a couple danced together for the first time after five years of the husband’s deterioration from probable Alzheimer’s disease, the wife said: “Thank you for helping us dance. It’s the first time in three years that my husband held me in his arms.” Tearfully, she said that she had missed him just holding her and that music therapy had made that possible.

This is an excerpt from Sherri Snelling’s book, A Cast of Caregivers – Celebrity Stories to Help You Prepare to Care.
 
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