97 year old Carina was slumped over the arms of her wheelchair. Her eyes were closed. Her mouth was open, small bubbles of saliva, forming on her lips, were rolling down her chin. I came into the room with Katie, the music therapist. We sat down and she said, ” Carina, I am going to play my guitar for you. Do you mind?” There was no answer; the only sound in the room was the stark tick-tick of the antique clock.
Katie started to play. At first Carina did not respond. But after a minute, her ear turned towards the music. A tiny smile turned up her lips, and ever so slightly, her foot started to tap.
This month Elder Voice looks at Music Therapy
Music has been used as far back as the time of our pre-historic ancestors.Whereas language appears to be a relatively new function of the brain in human history, music is a pre-verbal and sometimes non-verbal brain function, predating the ability for language.
Ancient healers used music to drive away illness and restore health. Music was used to relax and comfort people when they were challenged or incapable of dealing with the rigors of everyday life. Music therapy became a recognized profession in the 1950’s through the Veteran’s Hospital system. Doctors and nurses provided pianos and musical activities as a diversion for all of the men returning from war.They noticed that the soldiers spirit and attitudes improved during their recovery process. Medical and educational leaders began formally studying the beneficial effects of music and implementing programs in their clinics and schools.
Music therapy, simply put, is the therapeutic use of music by a trained professional to achieve a desired effect or accomplish a personal goal or objective. A treatment plan may include singing, improvising, song writing, movement, marching, playing percussion instruments or listening to their preferred style of music.
Music is processed by many different parts of the brain rather than just one center, as in language. The elements of music such as rhythm, pitch, and melody and are all processed differently. The emotions are also tied in with music, thus activating the limbic system. The arousal is in the brain stem and the dynamic registers in the basal ganglia. With music being received and processed at the brain stem level, it shows how basic and primeval sound is to humans.
This is why, as Sacks says, deeply demented people respond to music (Frohnmayer, p. 27). Music therapist and author Alicia Ann Clair identifies four main benefits for those with late stage dementia:
- changes in facial expression and tension
- increased eye contact
- vocal activity
- physical movement (Clair, pp. 81-82)
Music memory is a separate pathway in the brain and singing is often easier for clients that may have started to lose speech ability.Thus, music can serve a means of communication for those where the function of language has become very challenging or lost due, for instance, to Alzheimer’s Disease or Stroke. It is also effective for people with Alzheimer’s and other dementias because the music can be directly associated with memories of specific times and places and images, helping the individual to remember their life history.
Singing also encourages deep breathing to help the client increase oxygen flow to the body. When combined with playing instruments, singing increases physical movement and dexterity and the musical rhythm assists with regulating breathing.It is said that the human mind can only focus on one issue at once, so music is effective in reducing pain levels through positive association with familiar music and singing those familiar songs reduces boredom and feelings of loneliness.
Music therapy also addresses issues of isolation. It reduces anxiety during transitions into a new home and creates positive social interaction to build relationships with their peers.
(For more information click here to read ” Music Therapy in Alzheimer and Dementia Care” by Kevin Kirkland, PhD, MTA” from the Music Therapy Association of BC website. We thank them for for allowing us to print this excerpt.)
A good nursing home should have music therapy as a central part of it’s programming. If it does not, families should advocate for one. Although many music therapist are hired by facilities and work in groups, many also do one to one sessions.It is also possible to hire a music therapist for private sessions. The extra attention and stimulation can be remarkably healing,calming, restorative, and centring for people with dementia, who are depressed, or who are palliative.
Creating music in a social group of peers in a nursing home or other setting brings about shared positive experiences with new memories, and develops social community in a new and unfamiliar setting. Music therapy doesn’t just offer music to sing along to, it engages with each client in a unique way that draws out that person’s skills and personality to create a successful music space for them. It is an opportunity to share their voice and their gifts among their peers, encourage each other and share in a common experience that creates and restores positive memories.
A few weeks ago Carina was sent to hospital. They were not able to stop her health from failing and she was moved to the hospital’s palliative care unit. From there we brought her back to the care home for her last bit of time and to be with the caregivers she knows.The little dog who lives there comes to her room every day; when he curls up on her bed, her arm reaches out and goes around him. The music therapist comes to see her twice a week.
Diamond Geriatrics would like to thank Sandy Pelley of Creative Music Therapy Solutions, www.cmts.ca , Lori O’Leary, of Musicworks, musicworkswonders.org, and the Music Therapy Association of British Columbia for permission to use content and/or their input on this article.