Music therapy uses music to work with individuals or groups of people with dementia to enhance their quality of life.
A person’s ability to engage in music often remains intact far into the advanced stages of dementia. This is because music stimulates the motor center of the brain, which responds directly to auditory rhythmic sounds. This does not require active cognitive processes to work well.
Music can be a great opportunity to provide another layer of emotional and physical support when caring for your loved ones.
What Music Can Do
1. Enhance communication
As dementia progresses, it often becomes more difficult for a person to share their thoughts and feelings with other people in a meaningful, intimate way.
Listening to music together can allow those with dementia to relax and share experiences with others that does not require them to express themselves verbally. They may still be able to join you in singing along to favorite songs. Or simply holding hands while listening may provide a chance for deeper intimacy.
A person’s reduced ability to share with others can also feel very isolating. Music gives a space for those with dementia to interact socially, either with their loved ones, therapists or with a music therapy group.
Even if someone with dementia is not able to express these memories anymore, they are still able to be moved by the feelings and associations in their own way.
2. Provide emotional support
Music can be closely related to many of our unconscious emotions. A person may be able to connect with emotions they may not be consciously aware of anymore by listening to a piece of music.
Research has shown that music therapy can help those with dementia improve their memory recall, create a more positive mood and gain a greater sense of control over their lives.
In addition, most music will have either a stimulating or relaxing effect on a listener. This can be used in different therapeutic ways depending on your purpose.
If your loved one is fairly advanced in their dementia and does not respond easily, a stimulating piece of music may help to rouse them in a way simple conversation no longer can. Some people may start tapping their toes or look up attentively to listen to the music.
Stimulating music can also be played in the background at mealtime or other daily activities when it’s helpful to promote wakefulness.
In contrast, music can also help with individuals who become agitated or more aggressive due to their dementia. It’s helpful to identify if their disruptive behavior has a pattern. For instance, many people with dementia will become more upset around the time the sun sets, known as “sundowning.”
Times like these would be ideal to play relaxing music to see if it can help create a calming atmosphere and diffuse any tense situations.
3. Promote physical benefits
Music is an excellent way to promote exercise for those with dementia who are still physically active. Dancing together is a great way to interact if they are able to stand. Even in a wheelchair, many people with dementia are able to move their bodies to rhythm in various ways, from swinging their arms to moving their feet.
Many with dementia are also able to participate in physically making music. They may be able to use drums, bells, harps or other instruments. This can clearly improve their mood and enjoyment of interaction, but it will also help them build muscle strength.
Many studies have shown that familiar and well-like music can have more positive outcomes than medication for older adults with various types of dementia. Music has been able to reduce depression, lessen agitation, decrease problem behaviors and increase sociability, movement and cognitive function better than medications.
Music has also been found to act as an effective non-pharmacological way to manage physical pain.
How to Use Music With Your Loved Ones
A professional therapist can help you plan specific care for your loved one based on their history and personality. If you live in the United States, the American Music Therapy Association can help you find a therapist in your area. For other countries, there is often a similar local association you can contact.
If your loved one is in a care facility, they may already have a music therapy program in place. If they don’t, try discussing it with facility staff.
There are many general ways you can start using music to interact with those who have dementia, such as:
- Dance with them, either at home or go somewhere they feel comfortable. Make sure to play music they really love.
- Try a karaoke machine or use song sheets so you can sing along together.
- If they are farther along in their dementia and more interactive activities are unrealistic, at least spend time listening to music with them. Do your best to find what types of music they enjoyed earlier in their lives. Watch for their reactions to different music choices and stick to ones that seem to either calm them or make them happy. If they show signs of irritation, such as facial grimaces or tensing their muscles, stop the music and try something different.
- Sing to them, especially if they are unable to sing along themselves. And if you can sign to them in their first language, this often has the most positive effect.
- Find out if there are any local music therapy groups you can join with your loved one, or start your own.
Posted: Oct 03, 2014 1:41 PM MST
Updated: Oct 04, 2014 7:00 AM MST
By Erin Timony
For some, childhood memories include an attempt at mastering some sort of musical instrument — whether by choice or because a parent thought it an important life skill to master. For some, it stuck.
For others … it takes years and countless hours of sitting down to practice before it becomes clear that no amount of lessons or sitting down to practice will change the feeling of torture that may accompany the attempt of creating music. Despite any grudges that may linger from learning or trying to learn how to play an instrument, evidence shows merely listening to music may have health benefits, and music therapy is a small, but growing field in West Virginia.
Healing properties. Simple sounds can be a powerful force in the human body.
Music therapy can be used as a tool for treating individuals suffering from a wide range of ailments, including abuse issues, cancer, chronic pain, post traumatic stress disorder and substance abuse, according to Amy Rodgers Smith, chairwoman of the West Virginia State Task Force for Music Therapy West Virginia.
Smith is a board-certified music therapist as well as the founder and executive director of On A Better Note Music Therapy LLC. She is one of only 15 board-certified music therapists in West Virginia.
Results from music therapy include but are not limited to: reduction of pain, anxiety and stress as well as improvement in symptom management, communication skills, social skills and developmental skills.
So what, exactly, is music therapy?
Like any therapeutic program, Smith said music therapy entails an individualized treatment plan and data tracking. Progress reports give indications of strides gained through the program. As stated by the American Music Therapy Association, “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional, or MT-BC, who has completed an approved college degree program and additional clinical training hours.”
Since the Music Therapist-Board Certified credential is a national certification granted and monitored by the Certification Board for Music Therapists, anyone from any state who has completed at least a four-year undergraduate degree program in music therapy and 1,200 hours of clinical internship under the supervision of a current MT-BC can sit for the board examination and become certified.
Music therapists use both instrumental and vocal musical activities that can include performing, composing, listening and improvisational experiences to implement a vast continuum of results.
However, Smith said that because the Mountain State does not currently have any undergraduate or graduate programs in music therapy, those in the Mountain State today still have to leave the state to pursue a degree in music therapy. With West Virginia University in the process of developing an undergraduate degree program that is scheduled to open in fall 2015, Smith said the unavoidable exodus of students may change.
Because of music’s role in many peoples’ everyday lives, Smith said individuals are usually highly motivated by therapy interventions that involve music therapy and are able to better engage in the therap
She explained that music functions differently in the brain than other types of therapy because of neuroplasticity — an umbrella term that refers to changes in neural pathways and synapses which are due to changes in behavior, environment, neural processes, thinking and emotions, as well as changes resulting in bodily injury.
Due to the neurological intricacies tying the brain and music together and how it relates to neuroplasticity, Smith said using music as therapy is “a unique resource.”
In 2013, the WVU School of Medicine highlighted Cindy Lewellen, a certified music practitioner who volunteers her time to play the harp for patients at Ruby Memorial Hospital in Morgantown.
“There have been studies about pain and how much pain medication people need and that, you know, a half hour of music can reduce the need for pain meds and there are many fewer side effects from harp music,” Lewellen said in the WVU Health Report. “Sometimes I’m playing for people who are in pain, and I’ll play very quiet, slow music, simple music. Sometimes if it’s somebody who has had a heart problem, I’ll play very rhythmic music.
“If I’m playing in the (Intensive Care Unit) and I know somebody who has had a heart attack, I don’t want to mess with that. My music is going to be nice, steady heartbeat music. At least when I started, it seemed like every other patient I played for went to sleep. And that was the biggest gift I could give them because a hospital is a very noisy place.”
How it’s done
A visit to On A Better Note Music Therapy LLC’s Facebook page shows examples of the personal stories of music therapy beneficiaries, like Keeley Drabish. While watching a video of Drabish and Smith interacting, Smith sings while Drabish plays along with an instrument. Smith said the focus of the session was to work on Drabish’s “social skills” by targeting “turn-taking” and “waiting skills.”
Smith said she works with children and adults with special needs or who are recovering from some neurological event that has happened in their lives. One client is an older patient who survived a stroke and, with Smith’s help, is working on some neurological music therapy rehabilitation.
“Ultimately, the goal is to work on nonmusical skills such as communication, behavior or academic learning concepts,” Smith said in one video. “The purpose is not necessarily to teach the instrument, but to use music as a tool in treatment.
“In a normal session we use a variety of interventions — singing, playing instruments, sometimes song writing or lyric analysis, depending on what the nonmusical goals are for that client or that patient.”
Drabish’s parents, Anissa and Scott, discuss in one video the ways they’ve witnessed the therapy’s benefits firsthand. At first, they said it was hard for their daughter to sit still due to a short attention span. Now, they say they’ve seen “enormous progress” as far as her ability to sit still and follow the directions and instructions that Smith gives, “It’s just been a very good program,” they said.
Because Keeley Drabish “was singing since she was two,” the parents said they thought using music as a therapy technique would be something she would enjoy, while building social skills and interaction skills. Drabish stays very engaged with Smith, keeping eye contact and staying attentive, they said. “We are very, very happy with the progress,” they said.
Not a new idea
According to Smith, using music as therapy has been happening in the United States for more than 60 years with the governing body of the American Music Therapy Association overseeing educational programs in 33 states. “Probably more states than not have been using (music therapy),” Smith said.\
In order to be credentialed as a music therapist, one must sit for the National Board and become board certified while meeting continuing education and recertification requirements every five years.
Under the Individuals with Disabilities Education Act, or IDEA, signed into law in 1990, music therapy is considered a related service. A related service is a service that falls into certain categories and guidelines. When that service is deemed necessary for a child’s education, it must be put into IDEA’s Individualized Education Plan, with its costs covered by the school. However, the “deemed necessary” stipulation often becomes a sort of a barrier because many schools don’t understand the potential benefits of music therapy, Smith said. In order to rectify that, Smith advocates educating school personnel and the public just what the benefits of music therapy are by introducing it to the school environment.
According to Smith, some school districts in the Mountain State provide music therapy for their Pre-K-12 special education students. “It is my understanding that these schools are in the Martinsburg, Wheeling and Huntington areas,” she said.
Coming back home
Over the last two to three years, Smith said more young, professional music therapists have moved back home to their native Mountain State. Raised in Parkersburg, Smith took a long and winding road before ending up back “home.” She received her bachelor’s degree in music therapy with a minor in psychology from Ohio University. She completed her music therapy internship at Palmetto Health Baptist Hospital in Columbia, South Carolina, and after her internship, Smith founded On A Better Note Music Therapy in Houston, Texas. Smith became the director of music therapy at Alvin Independent School District and began earning a master’s degree in early childhood special education at the University of Houston-Clear Lake. Smith followed her husband to Alexandria, Virginia, and taught preschool there, but the couple recently returned “home” to Morgantown. Not only is Smith excited to be home but also to have the opportunity to provide access to music therapy. She’s also optimistic about the jobs the music therapy niche could create.
One of the goals of the Task Force is to request the music therapy profession and the Music Therapy-Board Certified credential receive state recognition. Another Task Force objective is to have music therapy added to all West Virginia Medicaid waivers so all clients can access musical therapy. Under the three different West Virginia Medicaid waivers, music therapy is currently reimbursed at a rate of $1,000 per year under the “Goods and Services” section only available under the “Self-Directed” waiver participants. For West Virginians on the traditional form of waiver, music therapy is not recognized or paid for in any way. By seeking full inclusion, music therapy would be listed as a therapy service option on all types of waivers, both self-directed and traditional — the same as occupational, physical and speech therapies are currently listed.
Several states have created licensure and registries including: Rhode Island, Wisconsin, North Dakota, Nevada, Georgia, New York State and Utah.
Music 4 Life® Founder and President/CEO, Judith Pinkerton is dedicated to spreading the benefits of both music therapy and wellness accredited programs and products. She teaches young and old how they can convert their music assets into a powerful, portable command center for stress reduction.