Music provides window back into patients’ minds
When communications between Alzheimer’s patients and the outside world have been virtually cut off, music therapy can reopen doors to memories, laughter, and feelings of being connected.
"Its role with the Alzheimer’s patient is unusual in that the Alzheimer’s patient that we typically serve is really not cognitive or communicative by the time we admit them into our program," says Paul Brenner, MDiv, MMU, executive director of Jacob Perlow Hospice of Beth Israel Medical Systems in New York City. "Music therapy is one of the services which seems to bring the person out and reconnect the person with their family and their own life again."
Rima Starr, MA, CMT, is Jacob Perlow’s music therapist. A classically trained singer who has shared the stage with opera singer Luciano Pavarotti, Starr travels the country conducting workshops on music therapy for Alzheimer’s patients. She brings a keyboard with her to therapy sessions, although the choice of instrument can vary by therapist. Many use guitars.
Music seems to reach patients when little else can, Starr observes. "The music center of the brain is the most primitive area of the brain, so when they [Alzheimer’s patients] have deteriorated down to five words or less, the music center is often quite intact."
Music therapy offers many benefits for Alzheimer’s patients and their caregivers. They include:
• Relaxation.
"That will help with pain control and stress management" for the patient, Brenner says.
• Communication and socialization.
Many Alzheimer’s patients can no longer communicate and are totally cut off, which is painful for patients and their families. "For someone who is isolated, it helps them to become connected. There’s a sense of community and family again," Brenner says.
• Control.
While there is very little family can do to reach Alzheimer’s patients at the terminal stages of the disease, music seems to re-establish contact. "Usually with Alzheimer’s, the disease lingers and family is at their wits end in terms of how we can help. They often feel very out of control; then here comes music, and there is plenty they can do," Starr says.
• Self esteem.
Having lost control of most of their bodily functions, speech, and memories, being able to hum along to a song, beat a tambourine, or remember a childhood lullaby gives Alzheimer’s patients a sense of accomplishment, Starr says.
• Pleasure.
Although not everybody enjoys music, most have at least a pleasant association with songs learned in childhood, and many patients have loved music all their lives. One Alzheimer’s patient, a 76-year-old woman who did not speak, would "throw back her head in joyous laughter" when she heard music, Starr says.
If you are thinking about starting a music therapy program, consider hiring a certified music therapist, Starr suggests. They have been trained in using music as part of the overall therapeutic process.
If hiring a music therapist isn’t in your budget, draw from your own background, Starr says. "It’s really a gift of love when they sing to a patient." Staff and volunteers don’t need to have Carnegie Hall-quality voices or music training, she adds.
To find what kinds of music would be most appreciated, ask the patient’s family about their earliest memories of music in the home. Did the patient like classical music or folk songs? Which nursery rhymes or lullabies did the patient sing? Find out if the patient is from another country or has a strong ethnic identity, and try to learn a simple song in that language.
Plan to spend about 45 minutes for each music session. That is the average amount of time Alzheimer’s patients benefit from the music, Starr says, although some can listen for hours.
[For more information on starting a music therapy program contact Rima Starr at 57 W. 75th St., Apt. 2D, New York, NY 10023. Telephone: (212) 787-4993.
Or contact one of the following:
American Association for Music Therapy, P. O. Box 80012, Valley Forge, PA 19484.
National Association for Music Therapy, 8455 Colesville Road, Suite 930, Silver Spring, MD 20910. Telephone: (301) 589-3300.]
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