Burton 1

Sadie Burton

Rice

ENGL 101: 02

27 November 2017

The Power of Music in Alzheimer’s and Dementia Patients

For a person suffering from a form of dementia, life can be quite a challenge. Memory

can no longer be relied on for remembering people, places, or even how to accomplish a

seemingly simple task previously completed every day for an entire lifetime. Someone with

dementia often lives within his or her own reality, disengaged from those around him or her,

including familiar family members and caregivers. One of the challenges for those who care for a

person with dementia is to provide moments that encourage movement, communication, and

engagement. My experience with both my grandfather, who battled dementia, and my

grandmother, who was diagnosed with Alzheimer’s disease has given me insight into the nature

of this challenge and an understanding about how important it is to stimulate these people in a

way that allows me to connect with them and them to connect with me. According to Dan

Cohen, the founder of Music and Memory, “even though Alzheimer’s and various forms of

dementia will ravage many parts of the brain, long-term memory of music from when one was

young remains very often. So if you tap into that, you really get that kind of awakening response.

It’s pretty exciting to see” (NPR Staff). My visits with my grandmother and my work

documenting the CCES Middle School service project “Alive Inside” have reinforced the idea

that using music to engage with a person with dementia is a powerful tool that can reap

significant benefits.
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My grandmother, who died this past October, was one of the most important people in

my life. Because we lived on the same farm together, we were able to create a bond that was

extra special. When my brother and I would visit her, and when I wasn’t “putting my nose in the

corner” for misbehaving, we would birdwatch, do art, watch our favorite television shows, listen

to the radio, and cook food. About seven years ago, my family and I began to notice changes in

my grandmother. She would wander around the house, misplace objects, leave ice cream out on

the counter until it melted, forget how to dress and undress herself, and tell the same stories

repeatedly. These odd behaviors became more frequent as time went on. Eventually, she was

diagnosed with Alzheimer’s disease. For a long time, my family and I were able to look after her.

However, as the disease progressed, it became apparent that she would need 24-hour supervision.

We were able to find a caregiver that would come during the day, and either my mom or dad

would stay with her overnight. About two years after her diagnosis, she got a serious sore on her

hip and had to be hospitalized. Because of this, my parents and aunts and uncles realized that my

grandmother needed special nursing care, and that she would be able to get this from

Shannondell, an assisted living facility in Pennsylvania where my uncle works. Shannondell has

a special unit for Alzheimer’s and dementia patients. In a way, I believe that the disease was

much harder on my family than it was on my grandmother. Visiting her was always enjoyable,

but it was very difficult to see and accept the changes she was going through and realize that she

could not remember parts of her past. She was not able to complete simple daily tasks that she

once was able to do. It was devastating that she was not able to remember that she ran a summer

camp for 25 years, was very active with her church, or had five children, eight grandchildren,

and one great grandchild. However, my grandmother’s attitude and the way she approached life
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never faltered. She was the same bright, enthusiastic, sassy woman she always was. Many times

when we visited her, the Alzheimer’s unit at Shannondell had musicians come and sing, and

exercise therapists dance. The music that was played was always upbeat music that my

grandmother grew up listening to. Her eyes always lit up, and she would immediately start

tapping her feet, clapping her hands, and reaching out to dance. If the song was really familiar,

she was even able to sing along, which was remarkable. Many of the other residents were able to

sing and dance in their wheelchairs as well, and the music created such a fun environment for

everyone.

After witnessing the power that music had on my grandmother, I became curious about

why music had such a positive effect on those living with Alzheimer’s and dementia. During my

senior year in high school, I was approached by Elizabeth Jarrett, the service learning

coordinator at my school, to see if I would be interested in documenting, through film and

photographs, some middle schoolers as they created music playlists for patients in Shepherd’s

Care, an assisted living facility in Greenville. I jumped at the opportunity because it combined

my love of photography and music with something that was very near to my heart. It also gave

me the chance to see if music had the same effect on other people that it had had on my

grandmother. For 10 weeks in the spring of my senior year, I went with a group of middle school

students to visit residents with dementia at a local nursing facility. The students were working to

create music playlists that included favorite and familiar music tailored to each individual that

could be played through a special set of headphones. My job was to document the experience

that the students and the elders were having, and I did that through video and through still

photography. What I saw happen time and time again convinced me that music was an incredibly
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powerful way to engage the same population that otherwise tends to be sedentary and quiet. In

interviews that I conducted with the adults who lead the service program and the students

themselves, it became clear that we were all witnessing the same thing; elders responding

positively to music. We watched elders sing along, tap their hands and feet, smile often, and

enjoy every session we had with music. This project made me even more certain that music

should be used with all persons who suffer from dementia and Alzheimer’s because it truly

engages them in a way that most attempts to engage do not (Burton).

Getting older and noticing some memory loss is typical for most Americans. However,

those people that are suffering with dementia have a loss of cognitive function so significant that

the routines involved with everyday living become impossible to complete. There are several

symptoms often present for individuals afflicted with dementia, such as difficulty recalling

words and paying attention or remembering names, dates, and places, but these memory lapses

may seem slight in the early stage of dementia. Over time, more drastic memory loss becomes

noticeable, and individuals lose the ability to complete tasks that previously were automatic, like

finding their way to the store and back home again or remembering where to keep certain

household items. According to the Alzheimer’s Association, “Dementia is caused by damage to

brain cells. This damage interferes with the ability of brain cells to communicate with each

other” (“What is Dementia?”). It makes sense, then, that if the brain cannot send, receive, and

process information correctly, then a person with dementia would likely have trouble making the

decisions and judgements required for everyday life. The two most common forms of dementia

are Alzheimer’s disease and vascular dementia. Unlike Alzheimer’s, vascular dementia happens

as a result of a stroke. In a person with Alzheimer’s, however, the brain is unhealthy due to the
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large amount of specific proteins that cause difficulty within the hippocampus. This region of the

brain, coincidentally, is the area most concerned with memory and learning, two functions that

are often noticed as impaired in individuals with this type of dementia. (National Institute on

Aging). The National Institute on Aging states that, “Alzheimer’s disease is an irreversible,

progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the

ability to carry out the simplest tasks.” When dementia has reached its most severe stage,

unfortunately, individuals can no longer adequately care for themselves and must rely on

caregivers. Alzheimer’s statistics are quite alarming. In the United States today, almost five and

a half million people are living with Alzheimer’s. That number is expected to triple by 2050.

Alzheimer’s is now recognized as the sixth leading cause of death in the United States overall,

and the fifth leading cause of death in those over age 65. Out of the top ten causes of death in

America, Alzheimer’s stands out as the only disease that cannot be prevented or cured

(Alzheimer’s Association). Patients with Alzheimer’s generally move through three stages: mild,

moderate, and severe. According to the Alzheimer’s Association, some symptoms of the mild

stage are being unable to remember correct names for people, places, and things, being unable to

retain new information or make new plans, and becoming unorganized and misplacing objects.

During the mild stage, the patient is still able to complete tasks like driving, working, and

socializing on their own. The second stage, the moderate stage, lasts the longest. During this

time, the person affected with dementia will start to mix up their words, forget special events in

their life and history, wander and become lost, become irritable, and be confused about their

environment. Patients that have reached the moderate stage will not be able to express their

thoughts, complete daily tasks, pick out their outfits, control their bladder or bowels, or
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remember things such as their address, phone number, high school or college. The severe stage is

the last of the three stages. At this point, patients require 24-hour care and help with daily tasks.

They are unable to hold conversations, respond to their environment, control their body

movements, remember short-term things, or do physical tasks like walking, sitting, and

eventually swallowing. During this stage of Alzheimer’s, people are more vulnerable to illnesses

and infections like pneumonia.

Helping individuals with dementia and Alzheimer’s live full and enjoyable lives can be a

challenge for caregivers and family members. People afflicted with these diseases often struggle

to connect with individuals they have known for many years or those they see every day. Music

has become a valuable tool in helping these individuals tap into memories from long ago and

make connections with those people present.

Using music as a form of therapy was first considered after World War II when nurses

noticed that listening to music seemed to improve soldiers’ moods (“Music Therapy for

Dementia”). Music therapy, as defined by the American Music Therapy Association, is, “The

clinical and evidence-based use of music interventions to accomplish individualized goals within

a therapeutic relationship” (“Music Therapy and Alzheimer’s Disease.”). Today, using music

with persons who have dementia or Alzheimer’s is growing in popularity because the benefits

can be significant, “Undoubtedly, it’s one of the most engaging and emotionally powerful

stimuli. 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
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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” (Schaeffer).

Generally, the effect music has on these patients is explained by knowing that music

often brings forth emotions and memories in all of us. Music that has been learned, referred to as

music memory, is stored as procedural learning that comes from repetitive activity. Though

dementia destroys some portions of the brain’s function, the area focused on procedural memory

remains intact. There is variability in reactions to music among patients, but the goals are to help

people recall memories, lift moods, reduce stress, promote a sense of calmness, help with focus

and attention, improve pain tolerance, encourage more movement, speech, and communication

with others (Alzheimer’s Association). Music can help someone with Alzheimer’s be entertained

and can trigger memories that seemed to be forgotten.

Dr. Oliver Sacks, author of ​Musicophilia: Music and Identity​ and noted neurologist,

argued that, “It is astonishing to see mute, isolated, confused individuals warm to music,

recognize it as familiar, and start to sing and bond with a therapist” (380). In his work with

patients, many of whom had dementia and Alzheimer’s, Sacks reported that memories were most

often triggered when the music used was familiar. Weeping, singing, and faces full of expression

were familiar sights when patients were stimulated with music. In today’s world, we often take

music in our lives for granted; we change stations on the radio, choose our favorite Spotify

playlist, and hardly notice background tunes in commercials. But, Sacks suggested that for a

person with memory loss, music plays a much more significant role, “To those who are lost in

dementia, the situation is different. Music is no luxury to them, but a necessity, and can have a
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power beyond anything else to restore them to themselves, and to others, at least for a while”

(385).

Music therapists have suggestions for how best to use music when working with people

with dementia and Alzheimer’s. It is important to target music that would have been popular

during the patient’s late teen to early adult years. Patients with late stage dementia may connect

more strongly, though, with early childhood songs. Choosing music that has an upbeat, rhythmic

tune like patriotic songs or favorite hymns, is more likely to engage a patient in singing, foot

tapping, clapping, or dancing. Songs that are particularly soft and slow, like lullabies, can

sometimes quiet a restless person. Asking family members to identify music that was familiar to

the patient can also provide clues to the types of music that will evoke the most response

(“Singing and Music Have Benefits for Alzheimer’s”).

One organization that has made bringing music to elderly people in nursing homes its

mission is Music and Memory. Music and Memory is a nonprofit organization founded by Dan

Cohen, a social worker committed to providing personalized music playlists for elders. Cohen’s

work has been documented in the film ​Alive Inside,​ which followed his experience sharing music

with persons with Alzheimer's. According to Cohen, “You see, people often lose their sense of

self and identity in a nursing home or assisted living facility. Nursing home staff know who

someone is as far as his or her medication or daily routine, but actually knowing who people

are—and their past—is a different story. Through music, senior housing staff and their residents

are able to connect as a resident’s reaction to music can bring up fascinating questions, stories,

and conversations of the resident’s past” (Anderson). Cohen has witnessed the transformation of

numerous elders, some who appeared to be totally unresponsive until just the right musical
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selection was shared. Music that relates to the elders’ former lives triggers memories and causes

personal stories to be shared. The music provided then becomes a bridge to sharing parts of lives

and revealing true selves.

Using music as a tool for helping people with dementia and Alzheimer’s is now

well-documented in research. Oliver Sacks’s book ​Musicophilia​, has valuable information about

this subject, and the original ​Alive Inside​ documentary by Dan Cohen is inspirational. Music can

bring joy and energy to those suffering with dementia, and every caregiver who works tirelessly

to comfort and support these elders should put music to work and witness the effect for

themselves.
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