Music Therapy and Dementia. Alice-Ann Darrow Irvin Cooper Professor of Music College of Music Florida State University

Music Therapy and Dementia Alice-Ann Darrow Irvin Cooper Professor of Music College of Music Florida State University

Why Music? Characteristics of Music that Make it Effective as a Therapeutic Intervention Music s history Music s universality Music s ubiquity

Music s flexibility Music can be simple or complex Music can be adapted to individuals musical style preferences: Gospel Country Classical Folk Rock Motown Jazz

Music s flexibility Music can be adapted to individuals age. Music facilitates structure structures our days. Music facilitates integration and connection to society

I won t be happy until I hear you say

Why Music? Music facilitates integration and connection to society.

Why Music? Music is the great equalizer.

Intergenerational Rock Band Concert

Choosing Music for Older Adults Contributing Factors Age, cultural background, family influences, & previous involvement with music Most adults prefer music that was popular during their young adult years (20s) Considerations Tempo (speed), volume, lyrics/content Iso Principle

Use of Music to Address Disruptive Behaviors Music as agent to aid relaxation Reduce combativeness and aggression Reduce wandering Reduce insomnia Reduce Anxiety / agitation

Use of Music to Address Disruptive Behaviors Music Therapy Interventions Iso-Principle Active Music Making Techniques for Facility Staff Music to cue activities Singing with CD, dancing to music, exercise to music

Use of Music to Reduce Verbal Outbursts

Music to Reduce Wandering

Use of Music to Address Psychosocial Issues Music to improve mood and environment Improve quality of life Reduce loneliness & depression Music to decrease apathy Preferred music to engage patient Iso-Principle to increase energy Music to reduce anger Iso-Principle for relaxation Music-assisted reminiscence for resolution

Music Participation to Reduce Isolation

Alzheimer s Project: Preschool Program

Music Participation to Promote Socialization Eleanor, 92 years old Member of Intergenerational Rock Band

Music to Reduce Isolation and Aid in Socialization

Use of Music to Facilitate Physical Activity

Use of Music to Aid Cognitive Stimulation

Use of Music to Address Psychosocial Issues Music Therapy Interventions Active Music Making Song writing Music-assisted reminiscence Techniques for Facility Staff Recreational music Adapted rhythm instrument groups

Music Therapy Interventions that Address Mobility The role of music in adherence to exercise. Importance of musical choices Clients musical preference and tempi

Music Therapy Interventions that Address Mobility Rhythmic Auditory Stimulation (RAS) used to facilitate the rehabilitation of movements that are intrinsically biologically rhythmical, most importantly, gait.

Music Therapy Interventions that Address Mobility Rhythmic Auditory Stimulation (RAS) Evidencedbased outcomes for rhythmic cueing: Gait more symmetrical, more efficient, and better balanced. Weight bearing stance time improved. Reductions in double limb support. Gait velocity increased. Stride length increased.

Use of Music to Improve Caregiver Bonding Use of music to Reduce loneliness and isolation Reduce frustration and stress Increase frequency of meaningful interactions Increase quality of life

Use of Music to Improve Caregiver Bonding Music Therapy Interventions Singing of music that was meaningful to individual and caregiver Music-assisted reminiscing Songwriting Playing instruments together Social dancing Creating a Living Legacy Project with the family

Use of Music to Improve Caregiver Bonding Techniques for Facility Staff Encourage families to attend programs together in facility and larger community Encourage families to bring CDs from home

April 23, 2009, 8:00 AM The Songs They Can t Forget By Sara Davidson Tom was a wanderer. When his wife, Elsie, came to visit him at a care unit for patients with dementia, he would give her a perfunctory kiss, then wander off through the rooms and stare out the window. Elsie tried to walk with him and hold hands, but he would shake her off, leaving her heartsick. A music therapist at the facility, Alicia Ann Clair, was searching for ways to help couples like Elsie and Tom connect. Clair asked Elsie if she d like to try dancing with Tom, then put on some music from the 40s Frank Sinatra singing Time after Time. Clair said recently, I knew Tom was a World War II vet, and vets did a lot of ballroom dancing. As Sinatra began singing, Elsie opened her arms, beckoning. Tom stared a moment, then walked over and began leading her in the foxtrot. They danced for thirty minutes! Clair said. When they were finished, Elsie broke down and sobbed. I haven t been held by my husband in three years, she told Clair. Thank you for bringing him back.

Music Soothes Alzheimers from Health By Kim Painter My mother-in-law (who just passed away)... didn't remember my wife or me, but she could recognize music from her past. We took an ipod into the nursing home, split it with three sets of earphones and listened to songs we knew she liked. She would hum along. She would laugh at the funny ones (Hello Muddah, Hello Faddah by Allan Sherman, Tiptoe Through the Tulips by Tiny Tim). She would cry at the sad ones, and we learned to try to keep those to a minimum. I would throw her a curve every once in a while just to see what she might know: When she hummed along to the Notre Dame Victory March, I was amazed. When she stopped humming along about a month ago, we knew the end might be near."

Mother-Son Songwriting Exchange (Son s Rap: Just to Make You Smile) Just to make you smile. Ma, this is just to make you smile. Yo, yo, yo. Just to make you smile. Ma, this is just to make you smile. Yo, Mama, I remember when I used to be bad, you d come to school to tell me to behave myself. Some of the stuff I did I still ain t forgave myself. But you know, you re the one that picked me up when I was down and made me turn around. Told me I could have whatever I thought I could have just as long as I just reached for the stars. Man, big cars, fancy houses and all this stuff in the world that everybody got you taught me I didn t need it unless I really worked for it and I earned it. No drug dealers slinging crack to get money, man I handled that.

Just to Make You Smile Mama, man, I m gonna be honest, I m gonna be right here doing what you want me to do, what I know would be a pleasing sight for you. Huh, man, I m gonna always show the Lord that I m always on top of things and Lord, help me to do what my mama would say is the right thing. And Lord, and when you get her to heaven I hope you let her in, tell Saint Peter to greet her, and I hope that you have Moses to meet her. Cause Lord, she is the right, she is the wrong, sometimes she said stuff that I didn t agree with but I had to keep on, and go on and take it. But I deal with and believe that I could make it. Yeah, Lord, when I feel down just let me remember my mama then I betcha that my life will right

Mother-Daughter Therapeutic Singing (Million Dollar Baby)

This work was supported by HRSA Geriatrics Education Center grant No. D13HP08843 and the Florida State University College of Medicine.