The power of music in dementia care

Ellen Phipps

Almost daily, in my work and leisure, I am reminded of the transformative power of music. Whether sitting at my desk at the Alzheimer’s Association reading the latest research on the therapeutic value of music for persons experiencing dementia, or visiting my father, there it is. Walking into Room 209 at the nursing home, I can see that Dad is upset. “We need to go, we need to get the, the, the — we need to get to the table to lunch now!” “But, Dad, its only 9:30 in the morning,” I reply, knowing full well there is no point in reasoning. “Now, wait a minute — you don’t know, you don’t know; we need to do this now! I said, now!” he said. My father, 91, once a brilliant family physician, is living with dementia and struggles to hold a conversation. As part of the disease process — probably Alzheimer’s — he no longer has the ability to reason. He is confused; he is restless; he does not know what he is meant to do next. He is frightened when left alone. I walk over to the large computer screen we have set up in his room and quickly pull up Miff Mole on YouTube. Miff, of Miff Mole and the Molars, a once wellknown band, was my father’s trombone teacher in Brooklyn back in the 1930s. Without saying a word, I turn up the volume and Dad joins me at the computer. A big grin replaces the worried and confused expression of just moments earlier. Sophie Tucker begins to sing, “After you’ve gone …,” and, now, Dad is not only singing along, but tapping his foot. As I search YouTube, the next thing I find is Shirley Temple singing and dancing to “The Good Ship Lollipop.” This has worked in the past, but not today. He heads for the door. Frantically searching, I discover “Sing-Along-With Suzie.” Suzie, an attractive, middle-aged woman, is playing the piano and singing “Sentimental Journey.” She is looking directly at Dad. He is looking back. He is smiling again. There goes the foot. I capture the moment on my camera. I reach out my hands, and he takes them in his and rises. We are now dancing. And, so, the morning continues until 11:55 a.m., when I realize we’d better hurry to the dining room or we will miss lunch. I am reminded of my introduction to the use of music as an intervention in the healthcare setting. It was the summer of 1975, and I had just graduated from high school. I was volunteering in a nursing home. My job was to lead the patients in sing-alongs with my guitar. I approached a group of heavily medicated, often sleeping residents. Dementia had robbed them of their verbal ability, and so I was surprised they were not only singing, but seemed to recall the words of the songs and hymns. They laughed, and sang, and sometimes we even danced. I saw the magic firsthand. I would be forever a believer in the power of music.

Perhaps you have seen the inspiring YouTube video that shows Henry, a gentleman living in a nursing home who appears unresponsive but who “comes to life” upon hearing his favorite music from the past piped in on headphones. The clip is taken from a segment of the movie “Alive Inside.” The film by Michael Rossato-Bennett, featuring commentary by social worker Dan Cohen and neurologist Oliver Sacks, author of “Musicophilia,” captures the transformation that takes place when nursing home patients are handed iPods loaded with music from their youth. The program that Cohen developed is called Music and Memory and is now being offered at more than 4,000 facilities in the United States. From the Music and Memory website: “He used to always sit on the unit with his head [down] … he didn’t really talk,” said caretaker Yvonne Russell of an elderly man introduced in the film as Henry. Henry’s daughter describes the once fun-loving man she knew, who used to sing every chance he got, encouraging his children to sing along, even stopping sometimes to sing and swing around poles. Her memory is a stark contrast to the Henry we first see in the film, an old man who’s been in the home for 10 years and who now sits hunched over in his chair, incapable of answering questions beyond a yes or no. But when Cohen and Sacks put their Music and Memory theory to the test, handing Henry and other patients suffering from degenerative diseases an iPod full of music, a different person emerges. “Immediately, he lights up. His face assumes expression, his eyes open wide … he’s being animated by the music,” Sacks said, describing Henry’s reaction. He can even engage in dialogue with an interviewer who asks about the effect the music has on him. “It gives me the feeling of love, of romance. I figure right now the world needs to come into music, singing. You’ve got beautiful music here,” Henry said, before breaking into a version of “I’ll Be Home For Christmas” by an artist he said is one of his favorites — Cab Calloway. The documentary’s findings are not unlike previous ones. In 2010, researchers at Boston University found that music can not only arouse dormant memories, but also may help people with dementia retain new information.

Ellen Phipps is a gerontologist; vice president of programs and public policy for Alzheimer’s Association, Central and Western Virginia Chapter; and author of The Connections Activity Program for Persons with Dementia.