For those who have watched a loved one descend into severe forms of Alzheimer’s disease, the sense of loss is deeply tragic. Gradually the disease robs a beloved parent, spouse or friend of their memories, then their personality, and often their very life. Along the way, many dementia patients lose completely their ability to respond to the sound of a human voice, so that even the most basic communication becomes impossible.
But in recent years, in a growing number of programs across the nation, there are surprising and encouraging signs that a communication breakthrough can be possible. The medium used to bridge the memory gap isn’t the spoken word: instead, it’s the language of music.
Like many of you, we at the AgingOptions Blog have watched the 2014 documentary Alive Inside which shows through several touching examples the power of music to animate dementia sufferers who had been completely uncommunicative. More recently, we came across this 2022 article from HealthDay in which reporter Dennis Thompson describes new research findings that music can restore a dementia patient’s ability to communicate, even in limited and non-verbal ways.
While this hardly represents a reversal of Alzheimer’s symptoms, it is definitely encouraging news for family members who feared they would never again see a happy smile on the face of someone they love – a loved one lost in the depths of dementia. In fact, we find the idea so uplifting that we’re bringing the story back for another look.
Music Therapy Restores Connection to Loved Ones
Thompson begins the HealthDay article with the story of Wes and Susan Mika of Chicago. Wes has dementia and lives in a memory care facility where he and Susan, his wife, recently participated in a music therapy program to help dementia patients connect with loved ones. According to Susan, it was a powerful experience.
“He’s in a wheelchair, and it was just a nice, close connection for both of us,” Susan said. “We both enjoyed it. I would sing the lyrics I knew, and at times I would see him moving his lips. He doesn’t speak loudly but he would move his lips, so I think he knew the words and was connected with the music.”
Thompson writes, “The program, Musical Bridges to Memory, has been shown to enhance patients’ ability to non-verbally interact with their caregivers, according to a study published in the journal Alzheimer Disease and Associated Disorders. The music therapy also reduces troubling dementia symptoms like agitation, anxiety and depression.”
Familiar Songs from the Patient’s Youth
“The music program was developed by the non-profit Institute for Therapy through the Arts, and is designed to help dementia patients who are losing their ability to communicate verbally with loved ones,” Thompson explains. “In the program, a live ensemble plays music from a patient’s youth. The patient and their caregiver are encouraged to interact with the music together by singing, dancing or playing simple instruments like shakers, drums or tambourines.”
According to one of the study’s lead researchers, neurology professor Dr. Borna Bonakdarpour, dementia doesn’t seem to affect a person’s ability to enjoy music until much later stages of the disease. As a result, patients who are largely non-verbal can still retain their ability to dance and even sing.
“They can process music, they can get it, they receive it, they respond to it, they can dance with it, they can play with it, they can sing along with it,” Bonakdarpour said. “These are components that are pretty much intact, which is amazing.”
Today, music is taking its place as a vital non-drug therapy for dementia, so much so that even the Alzheimer’s Association is implementing and studying it. Sam Fazio, senior director for psychosocial research and quality care at the Association, said, “You’re accessing different parts of the brain that may not be affected by the disease’s symptoms. Sometimes when people can no longer express themselves in words, they can still express themselves with lyrics of a song or feel the melody.”
Both Patients and Caregivers Experience Benefits
Thompson writes, “For this study, Bonakdarpour’s team asked 21 patients and their caregivers to take part in the Musical Bridges to Memory program once a week. The study was unusual because earlier music therapy efforts have tended to focus solely on the patient, while this involved both patients and caregivers. The program included 45 minutes of music, as well as a 15-minute talk beforehand so the music therapist could discuss specific communication skills to be addressed during the time together.”
As the article explains, patients took part in 12 sessions over three months. During the study, the patient/caregiver pairs were videotaped for 10 minutes before and 10 minutes after the therapy sessions were over. This way the researchers could track the effect the music therapy had on the way they interacted.
Notably, the therapeutic benefit wasn’t just for the patients. It was also for the loved ones, the caregivers. The therapy sessions were meant to counsel caregivers on ways to engage with the patients in a more patient and loving way.
The emotional drain on the caregiver of someone with Alzheimer’s disease is well documented. Bonakdarpour explained, “Things can get escalated between the patient and caregiver because the care partner doesn’t know what to do with abnormal behaviors. A patient with a memory problem may ask the same question 10 times, and the partner can get exasperated.” Music therapy can reduce stress and build a positive connection.
“Significant Increase” in Patient/Caregiver Interaction
As the HealthDay article relates, the study’s results were very promising. Thompson writes, “The researchers found that non-verbal social interactions significantly increased between the patients and caregivers who took part in the program, while communication declined among eight patient/caregiver pairs who did not participate and served as a control group. In group conversations after the music, patients were more socially engaged, the researchers said. They maintained eye contact more often, were less distracted and agitated, and were in an upbeat mood.”
One patient in particular stood out to Bonakdarpour: “[He] was very hyperactive and during the sessions would get up and wanted to dance with everybody. The wife was kind of embarrassed, and she would get mad at him. But then as the sessions moved forward, and by the middle to end, this guy was sitting down during all the sessions with his wife. They’re communicating. They’re using percussion instruments to participate. They dance together. So it really changed their relationship.”
Three-Year NEA Grant Ensures Further Study
“Based on these results,” Thompson writes, “Bonakdarpour’s team has received a three-year grant from the National Endowment for the Arts to expand the program and perform another clinical trial involving more patients.”
Fazio of the Alzheimer’s Association is among those praising the study, especially because of the professional and organized way it was conducted. “Sometimes people think they’re doing music therapy by just playing a record in the background, when that’s not really true,” he said. “To have the outcomes we want, like increased engagement and less anxiety or agitation, the correct protocols need to be in place by trained music therapy professionals who understand how to use music to accomplish non-musical goals.”
Could Music Replace Drugs for Some Patients?
Music therapy is proving so effective that it may even be a better choice than drugs, especially for patients in the later stages of the disease.
“For some of these psychiatric issues of people with dementia, we don’t have great drugs,” Bonakdarpour said. “When we’re really desperate, we have to use some drugs that have side effects. Some of them can really affect the heart. It can even shorten people’s lives. And if you can avoid using these toxic medications, wouldn’t that be great?”
And what about Wes and Susan Mika? Susan was so amazed at Wes’s reaction to the therapy that she now brings an Amazon device with her to play a list of songs during her regular visits to the facility. Susan said, “Alexa plays those songs and then we just play along with the instruments. I try to find songs that he’ll remember. It just makes him happy.”
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(originally reported at https://consumer.healthday.com)