Music Therapy for Dementia Patients

Music therapy for dementia patients

A creative approach to cognitive stimulation therapy offers many holistic benefits to patients with Alzheimer’s. Music therapy for dementia patients offers a unique opportunity to help mitigate the debilitating effects of Alzheimer’s. 

There was a fire inside my grandmother that I could tell was slowly dissipating. The look in her eyes told me everything I needed to know about the progression of her cognitive state. She came back in cycles, unaware that she was ever gone. Unfortunately, she offers the perfect example of dementia and its debilitating effects on the life of an individual and family.  

Among the hospital beds, the IV needles, the difficulty remembering faces, and the lost words, one happy time stood out. The bright light came during the music sessions in the nursing home. There we would see the cognitive restoration not only for my grandmother, but also for all the residents, almost instantly.   

Recommended OT course: Alzheimer’s Disease and Related Disorders in Occupational Therapy Practice, 3rd edition 

Benefits of music therapy for dementia patients 

Music therapy is a type of group or individual participation referred to as cognitive stimulation therapy (CST). The efficacy of non-pharmacological approaches, in particular the efficacy of music therapy as a treatment for dementia, has been a particular interest of late within the field. Can this therapy be evidenced-based? Can creative approaches to therapy truly allow patients with dementia to maintain cognitive connections?  

According to Alzheimer’s Association, “Music and art can enrich the lives of people with Alzheimer’s disease. Both allow for self-expression and engagement, even after dementia has progressed.” There is a need for further empirical proof to support this claim. This research delves into the creative approaches to dementia and establishes that further research would be beneficial and warranted.  

Music therapy is most associated with soothing individuals with dementia who are agitated. It can also trigger memories of major life events and emotions. Memory, speech, and mood can be enhanced with the implementation of these programs. Music the individual knew between the ages of 18-25 is particularly likely to elicit strong responses. Unfamiliar music may be equally beneficial since the patient has no memory or emotion attached to the music, according to the Alzheimer’s Foundation of America.  

Music may arouse an individual through its rhythms and memory-inducing effects. Particularly in communal settings, music helps the patient recover narrative agency. It also allows both caregiver and patient to participate in a more meaningful and mutually engaging social connection.  

Understanding dementia  

Dementia is a progressive disease for which no cure currently exists. It’s characterized by cognitive decline in multiple domains: memory, language, attention, executive function, and visuospatial ability. These are severe enough to impair competence in daily living, occupation, and social interaction.  

The onset of dementia typically corresponds with Alzheimer’s disease, which affects over 70% of the population of those with dementia. Communicative abilities are severely compromised during the progression of the disease. This causes a modification to the vocal quality, or a complete cessation of speech, language, and vegetative functions.  

Research has shown that six areas of the brain experience degeneration during dementia:  

  • Bilateral temporal poles (left more than right)  
  • Left inferior temporal gyrus  
  • Left middle temporal gyrus  
  • Ventromedial frontal cortex  
  • Left amygdaloid complex  

Semantic deterioration among these areas relates directly with left anterior temporal damage.  

Research is ongoing into non-pharmacological approaches for suppressing concomitant symptoms of dementia. Treatments for dementia are chosen primarily to maximize the individual’s quality of life, rather than cure the disease completely. A major positive contributor to life quality is the ability to communicate effectively.  

Recommended PT course: Alzheimer’s Disease and Other Dementias: Medical Overview and Rehabilitation Management, 2nd ed 

Effects of using music therapy for patients suffering from dementia 

During volunteer observations at a dementia day care program center, there was an automatic, apparent “change” that occurred in the atmosphere and within the individuals when CST was initiated for the day.  

Storytelling was included within the specific program to a great degree. This approach is based on TimeSlips, founded by Anne Basting in 1998. According to the website, “TimeSlips offers an elegantly simple revolution in long-term care – a shift from ‘managing behaviors’ toward infusing creativity into care relationships and systems. In a time when we deny aging and isolate our elders, TimeSlips provides hope and improves wellbeing through creativity and meaningful connection.”  

Phillips, Reid-Arndt, & Pak looked at the efficacy of TimeSlips in comparison to emotion, communication, and quality of life in patients with dementia. They found that there was a positive effect during/post intervention. There was a slight increase in the individuals’ pragmatic language ability, and even larger increases in pleasure throughout and after the six-week program. TimeSlips causes the individual to be more alert and engaged.  

Music therapy and creative expression 

During the CST activities, individuals were given a certain painting with no other information but the painting. The discussion leader asked everyone questions on what they think this picture is about and what the “story” is behind this picture. Patients were asked what they thought the names of the people in the picture would be, what their occupation would be, the time period, the setting, the mood, etc.   

It was fascinating to hear and visualize the stories that these individuals created. Each one became so immersed in the lives of the people in the picture that they would paint scenes with their words on how these fictional characters lived their lives. This activity provoked these individuals to speak and use their voices in ways that they rarely could.  

When listening to music, the individuals were able to connect with the songs being played. Either they remembered the lyrics or sang along to the song. Others emotionally connected to the music by means of facial recognition (smiles and nods). The overall atmosphere of the room was changed almost instantaneously with the introduction of music.  

Literature review of music therapy for Alzheimer’s 

Memory and attention deficits are among the first clinical manifestations seen in Alzheimer’s disease. It’s possible that musical stimulation may increase temporary arousal, stimulating cognitive activity, suggesting a beneficial effect on cognition.  

Additional research has shown positive response from all individuals with dementia undergoing music therapy in four areas: interest, communication, enjoyment and mood.  

According to Richard Steel, MD, music therapy slows down any hyperactivity in the right hemisphere of the brain. This is the hemisphere that regulates activities. Hyperactivity causes a diminution of disruptive feedback in the brain that may cause an individual with dementia to find it difficult to speech. This allows the left hemisphere to operate without interference from the right hemisphere, which ultimately provides more competent speech and language production performance.  

In a research study conducted on 20 participants with dementia, communication performance was significantly better in conversation and comprehension during music therapy. The research also demonstrated that fluency lasts longer while involved in this type of program.  

Implications of CST research  

Much more in depth research is needed to confirm the efficacy of these types of programs long-term, rather than singularly. Note that these treatments can only provide the client with a positive, creatively enriching environment where they are free to express whatever comes to mind.  

Music therapy for dementia patients can help maintain cognitive connections in the brain so that the individual’s quality of life can either improve or sustain. 

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