The magic of music
Music therapy is helping stroke survivor relearn lost speech, movement
By all indications, it’s time for a break. Angelina Gigone, 82-year-old Gigone family matriarch, sharply attired in a black cardigan and patterned dress, offers a few words in her native Italian and gestures toward a table in the middle of the living room.
On the table there is a plate of cookies and a small blue-and-white china cup.
In this moment, language barriers dissolve in a mutually understood message.
Eat. Drink.
She holds a cup in her left hand, takes sip of the rich, dark Caffe Gioia blend and smiles.
It meets her approval.
Then she addresses her son, Giancarlo Gigone, the only other Italian speaking person in the room.
He approaches her, listening carefully.
She pauses, furrows her brow, and carefully tries another few words. He is patient.
They exchange a few more words until he understands.
He promptly disappears into the kitchen and returns with a small, silver stove-top espresso maker.
“She wanted you to know that she doesn’t use a regular percolator. It was made in an espresso maker,” he says.
A simple message but one that has a deeper, more important meaning.
His mother had something important to say.
And he understood.
Three months ago, Angelina would not have been able to so easily explain her needs and wants, thoughts and feelings.
Last September, she had a stroke that affected the left side of her brain, which controls functions such as speech, and the right side of her body.
She lived alone and her grandson found her on the floor of her St. Catharines home.
She could not speak. Or walk. In the early days, two people were needed to help her out of a hospital bed into a wheelchair and she could not feed herself.
The fiercely independent woman was gone.
In time, with rehabilitation and speech therapy, parts of the Angelina they knew returned, including some of her language.
And while she was happy to return home, she had trouble communicating her needs and her voice was barely audible, so quiet that Giancarlo couldn’t hear her if they sat side by side.
In January, she started a new therapy.
Every Friday, music therapist Laura Cowal-Belet visits Angelina in her home for one hour. Together they sing traditional Italian songs as Laura strums on a guitar. Sometimes Angelina keeps a steady beat with a mallet and tambourine.
And while it might appear as pure entertainment, Laura is using the power of music to teach Angelina’s brain how to relearn what the stroke took from her life.
The science behind the brain-music connection is complicated, says Laura.
In simple terms, music stimulates all areas of the brain. The first rhythm we hear is the beat of a human heart and that might explain why people are naturally drawn to a steady, one-two rhythm, she says.
“It’s the cadence of people,” says Laura.
Simply put, our bodies are naturally programmed to move to the beat of music.
When Laura plays and sings the Italian ballad Volare — which translated means flying — its strong onetwo-one-two rhythm triggers something within Angelina, allowing her to hold a mallet with her right hand — the side impaired by the stroke — while banging it on a tambourine, reading the song’s lyrics on a table in front of her, and singing along.
Complicated tasks made easier with music.
She also sees people who live with other neurological impairments such as dementia or Parkinson’s Disease, at home and in long-term care facilities.
A person with Parkinson’s Disease often takes tentative steps interspersed with shuffles but with music, endurance and gait improves, she says.
As they walk, she first measures their average pace with a metronome. Then she plays a song on her guitar or keyboard, timed to the tempo of their steps and asks them to walk again. Instead of shuffling, they often take more deliberate steps better matched the beat of the music.
“It’s amazing what music can do,” she says.
Music can also help to form new pathways in the brain, she says. It can promote neuroplasticity, the brain’s ability to change and adapt, by rebuilding connections among neurons.
In simple terms, music can help the brain rewire parts of itself in order to have an undamaged area take over a function, like language, previously managed by the damaged area.
Singing helps Angelina’s brain relearn speech. Words, how to pronounce them, and the connections needed to put them in the right order and context.
In essence, a different, undamaged part of her brain is taking over the job of speech.
Every week, they practise the same repeat-after-me song.
At first, Angelina could barely repeat two words at a time. Now, she can sing full phrases.
“The melody is taking over to allow her to retrieve those words,” she says.
Giancarlo has peace of mind knowing his mother can communicate her needs. I’m hungry. I’m hurt. And with better language skills, she can voice more complex thoughts, although she still mixes up and mispronounces words.
“I don’t have to guess,” he says. Giancarlo demonstrates. “Would you like to go to Italy?” he asks his mother, in Italian.
She smiles. “I think it costs too much money,” she replies, another indication that his mother is recovering.
One of Laura’s clients gained more independence when she taught the person to sing, “I have to go to the washroom.”
Repetition, and lots of it, is required.
Angelina has a live-in caregiver, who engages her in rich conversation.
She can instruct her caregiver on the steps required to make homemade pasta sauce and the correct way to cook noodles. She’s returned to tending her garden, a passion that now involves sitting on a small stool. She plays bingo and can keep track of four cards.
Her voice is strong.
Near the end of the music session, first cup of espresso consumed, Angelina asks her son for another.
She takes a sip and makes a face. It’s too bitter.
Giancarlo returns with a container of sugar and she adds two spoonfuls.
He says something in Italian, she stops and they laugh.
Angelina takes another sip.
She nods. Smiles.
“Bene,” she says. “Bene.”
*****
To learn more about music therapist Laura Cowal-Belet visit her website at http://majorprogressions.ca/