Mom kept her eyes down as I gently fitted the headphones on her head and pressed play. The iPod was preloaded with favorite songs from her youth. Having entered the late stages of dementia, she’d go hours and even whole days without responding to me. When “Over the Rainbow” started playing in her ears, though, the head lifted and those brown eyes widened. She looked at me with familiarity. The music made us our old selves again, sharing a connection. Her mind wasn’t gone, it still worked, we just needed to engage a different side of it.
Studies are showing that music’s effect on someone with dementia is striking. It’s like medicine. After 20 minutes of listening to music, people with Alzheimer’s in one study saw an immediate, measurable increase in happiness, eye contact, and talkativeness, and a decrease in fatigue. Neuroscientists have described the effect of music on subjects with dementia as “lifting the haze.” Regularly playing music for someone with Alzheimer’s or dementia can therefore be immensely beneficial. It’s called “Music Therapy.”
Singing and playing music both remain quite possible and should be encouraged for people in the early stages of dementia. The fun of music can be very motivating, eliciting feelings of accomplishment. This is also a good time to start compiling lists of favorite songs, when your loved one can still access memories that combine happy moments with certain pieces of music. (Later, when communicating becomes more difficult, these songs are enormously helpful in caregiving.)
In the middle stages, the actual playing of music may become frustrating as a person loses the abilities to remember and function physically at a high-enough level. Recorded music, though, can distract someone in the grips of a frustrating spell. Music’s distracting power also helps with physical activities like exercise; someone listening to music on a walk, for instance, will often walk farther and with a slightly better pace than someone without music.
The middle stages are also when sleep becomes more difficult, and music helps then as well. Regularly listening to music has been demonstrated to elevate levels of melatonin, a hormone that regulates sleeping. (Melatonin supplements are popular sleeping pills.)
In the late stages of dementia, those playlists you made in the earlier stages become useful. Beloved songs can relieve stress and reduce agitation and restlessness. People in later stages of dementia have been shown to perk up when they hear music they like, demonstrably relaxing and becoming more responsive, with better eye contact and talkativeness, and less fatigue.
As a caregiver, do not underestimate the affect your mood has on your loved one. Caregiving is difficult and stressful, and someone with dementia can pick up on physical cues of agitation even if you speak kindly or calmly. For this reason, caregiver stress should be accounted for and managed, and this is another area where music can help. Music works simply as a tool to lighten the mood, but it does more.
Combining songs with daily routine makes necessary activities, like eating and washing, easier. The practice develops a rhythm that helps recall memory of that activity, empowering someone whose body and mind needs all the help it can get.
Finally, music helps the bond that may be fraying against the stress of Alzheimer’s. One of music’s more delightful qualities is enabling communication between people without the need to speak. Enjoying it together creates a connection, so that you’re sharing something with no requirement to do anything but listen.
Memory care residences have long been utilizing the practical benefits of playing music. Music often plays in the background during light exercise, because it promotes participation and movement, and in community rooms, because it stimulates the brain in people who may be otherwise uncommunicative. Anecdotally, nurses have reported that singing to residents during bathing or feeding can have the effect of being both calming and encouraging. Residents who are mostly nonverbal, it’s been shown, will perk up and become expressive when hearing songs they like.
When you hear a favorite piece of music, it triggers a pleasant signal in the brain called Autonomous Sensory Meridian Response. It almost buzzes, like a natural reward. When scientists used MRIs to specifically analyze specifically where the response occurs, they found something incredibly relevant to Alzheimer’s patients and their caregivers: Those areas of the brain are not affected by the disease. This means that music accesses parts of the brain that are still functioning in these patients, activating emotions and even old memories, and the resulting sensation is pleasurable.
Music triggers both sides of the brain (listening on the right side, singing on the left). Studies where patients were tested after listening to music have shown that the effect of engaging the brain with songs demonstrably boosts thinking ability. Even something as basic as swallowing becomes easier. More on the science behind music’s impact.
What songs will help your loved one most? Familiarity can be important, because one of music’s most important powers for people with dementia is evoking memories of happier times. For this reason, ask other family members and friends for insights into making a playlist. Someone who’s religious, for instance, may be engaged by songs of worship. Of course, tastes can vary, so a little investigation is warranted; playing rock for a lifetime fan of classical opera might have the opposite of your intended effect.
Also consider the mood you’re going for, and save certain kinds of songs for certain activities. Calmer, more soothing tunes can help during routine activities like eating and cleaning. More upbeat music is helpful for moving around (like while walking for exercise) and boosting mood. If your loved one is up to it, encourage clapping, tapping feet, and maybe even dancing.
Music that was popular when your loved one was between the ages of 18 and 25 may be the best choice. Experts say this period of life is when we typically develop our musical tastes.
Monitor your loved one’s reactions to songs, being ready to turn off music that elicits an upset response and return to pieces that make them happy.
Avoid commercials, which can be distracting and confusing.
Playlist Suggestions for Persons with Alzheimer’s or Dementia
Some songs that are consistently mentioned as favorites of people with dementia:
“Moon River,” Andy Williams
“You Are My Sunshine,” Jimmie Davis
“Singing in the Rain,” Gene Kelly
“The Way You Look Tonight,” Frank Sinatra
“All Shook Up,” Elvis Presley
“Que Sera Sera,” Doris Day
Someone with Alzheimer’s or related dementia requires devices that are as simple as possible. Fortunately, there are music players and headphones built specifically with this demographic in mind.
Basic music players are designed for people with dementia. The interface is simple. Some devices require only that a thick handle be lifted to start the music playing, and then lowered to stop it. There are also speakers whose settings are configured behind a large button, so the songs and volume are preprogrammed, and a person need only press that button to start (or stop) the music.
Be sure to set the volume relative to your loved one’s ability to hear. Not too soft or loud. Also, large remote controls with only a few easily read buttons can allow someone (probably in the early or middle stages of dementia) to adjust the volume.
Radios can be programmed to be easy for elderly people to function, but again it’s important to remember that commercials can be distracting and confusing. Your best bet is to preprogram an elder-friendly device for your loved one, so the songs you’ve chosen can be played simply.
Music & Memory is a nonprofit organization devoted to putting music into the lives of elderly people, including those with dementia. With thousands of donated iPods, Music & Memory trains nurses, eldercare staff, and family caregivers how to create personalized playlists and regularly introduce music into their loved one’s lives. The organization has grown to nationwide, and a successful documentary about Music & Memory, called Alive Inside, has generated even more buzz. For more information, click here.
Streaming sites like Pandora and Spotify can expand on the musical tastes you already know about your loved one. Pandora, for instance, is full of stations related to practically any singer or genre. If your loved one likes Frank Sinatra or acoustic guitar, the site offers countless options similar or related.
Spotify has similar options to expand on musical tastes, as well as preprogrammed playlists (with dozens of songs) under titles including “Music Therapy: Dementia,” and “Relaxing Music Therapy.”
These services are available for less than $10 per month and will obviously require a caregiver’s help to load. But the simple devices listed above can make it easy to access good songs and their therapeutic value.
Speakers or Headphones
Speakers allow the music to fill the background, like a soundtrack for daily activities. Someone’s living situation, whether at home with a caregiver or in assisted living or memory care, obviously dictates whether speakers are a good idea. Many elderly people experiencing symptoms of dementia are also hard-of-hearing, and will want the volume turned loud. Headphones, therefore, may be a good choice.
With headphones, comfort is key. People have different preferences, such as the buds that go inside your ear canals. Seniors typically prefer headset-style “on-ear” headphones. Padding around the ear cups is a good idea.
Baseball therapy is something that’s caught on for residents with Alzheimer’s in various memory care facilities. Patients who liked sports when they were younger are encouraged to meet weekly and share memories from playing and watching baseball. They also listen to old broadcasts together.
The results of this therapy are striking, and similar to studies of music’s effect on the brain. If your loved one isn’t as responsive to music, or if you’re looking for an additional aid in caring for a sports fan, consider playing broadcasts of their favorite sporting events (many classic sports calls are easily found online).