With dementia, music can be soothing or stressful
I recently visited my aunt who has dementia and noticed that when my kids played music on their iPad she started to hum and clap. Yet, at another point, she covered her ears. Is music a good thing with dementia?
You have discovered how music can bring happiness, inspiration, relaxation and comfort to someone with dementia. There is a growing body of research acknowledging and supporting the use of music with people who are living with dementia.
But music can also have the opposite effect — evoking negative emotions such as sadness and agitation, so it’s important to know how to use it safely and effectively with a frail, vulnerable adult.
When cognitive abilities start to decline, an individual may no longer be able to articulate their musiclistening preferences. It is up to you when visiting your aunt to make an informed decision about what kind of music your aunt enjoys, the best time of day to introduce it and how it should be delivered (i.e. through headphones, the radio, CD player or iPod speakers).
Even when language fails with advancing dementia, music offers an opportunity for a person to use their other senses and enjoy another form of communication.
If the individual can still articulate what their likes and dislikes are, the task is a lot easier for choosing music.
If the person is more impaired, and cannot clearly direct you, you will need to experiment with different types of music.
Knowing the person’s cultural background, personality and hobbies (ballroom dancer or choir singer for example) can help you narrow the music choices. An aunt who enjoyed going to the symphony monthly may enjoy classical music. An uncle who took salsa or rumba classes after a divorce may enjoy that style of music.
Music can also be used to reduce agitation and dementia-related responsive (challenging) behaviours. Playing soothing tones and sounds, such as those used in spas, may help a person who is agitated be more receptive to dressing or bathing. A person who has a need to fidget or pace restlessly due to agitation may enjoy big-band tunes and clap along.
Older memories are often the last to be lost with Alzheimer’s disease, so songs the person enjoyed earlier in life may bring a pleasant sensation. Sometimes people with advanced dementia revert to their mother tongue (if bilingual), so song choices may involve their first language.
At Baycrest, the music therapy department has produced a free educational resource to help professional and family caregivers create effective music listening opportunities for those with dementia. Download the guide at baycrest.org.
Another resource that has been very popular is the Alzheimer Society’s Toronto Music Project. The society provides iPods to caregivers that are loaded with individualized music to engage a person with dementia. For information, go to alz.to.
I hope you find more occasions to use music in your visits with your aunt so that you both can enjoy the experience together. Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia: A Caregiver’s Guide available at baycrest.org/ dacg. Email questions to caregivingwithnira@baycrest.org