Week of July 27 - August 2, 2008

Barbara Jacobs during a recent music class in an Alzheimer's community

Throughout my twelve-year career as a therapeutic musician in nursing homes, I have witnessed the beneficial power of music for those with Alzheimer's disease. People in my classes who are virtually speechless and confused begin to sing, hum and sometimes dance once they are stimulated by music. The benefits of music and singing, such as mood improvement and calmer behavior, often persist for hours after the music has stopped.

Dr. Oliver Sacks, Professor of Clinical Neurology and Psychiatry at Columbia University, in his current bestselling book, Musicophilia, writes about the amazing therapeutic effects of music on people with Alzheimer’s disease and other dementias. He states,   "Music is no luxury to them but a necessity, and can have power beyond anything to restore them to themselves and to others at least for a while." In this eye-opening book he devotes a chapter to this subject entitled, "Music and Identity: Dementia and Music Therapy." For this population Dr. Sacks describes how familiar music is the key to eliciting emotions and unlocking words that have been silent.

Researchers have discovered that the teen years around the age of 14 are when musical preferences and memories are formed.  Daniel Levitin in his book This is Your Brain on Music states, "We tend to remember things that have an emotional component because our amygdala and neurotransmitters act in concert to tag as important the memories of these emotionally charged years of self-discovery." Therefore, people with Alzheimer's disease can often sing the songs they heard during their teen years, even when they can no longer remember the names of their children. This behavior is also well documented in people with advanced dementia.

During a recent music class in an Alzheimer’s community, I had a thrilling interaction with Lou, a resident with moderate Alzheimer’s including aphasia (loss of speech). I was playing a Judy Garland album, intending to reminisce with the residents before I played their favorite "oldies" on the piano for our sing-along. I randomly went into the audience and chose Lou to dance with me while Judy Garland was singing "Somewhere Over the Rainbow." He joined me willingly, and before long held me in an appropriate dance position, stared into my eyes and clearly said the last few words of the song," Why, Oh Why, Can't I?"

I was thrilled, but somewhat baffled when I saw staff running to get their cameras, because I knew nothing about him. The staff later told me that this was the first time they had seen Lou speak and show any semblance of his former self. Apparently, he had been a great dancer and music lover in his pre-Alzheimer’s disease life.

Success At Home or For Professionals

My formula for success is a two-part music session.

1. In the first part, provide a positive musical experience by beginning with a warm-up activity through reminiscing. I begin by playing CDs of favorite recording artists such as Judy Garland and Nat King Cole. When in a group setting, such as one led by an Activity Director or other care professional in a care facility, have a brief discussion of the artist’s background. (Most CD covers will give you a short biography and it is easy to find such information on the Internet). This will usually generate discussion and get people in the mood to sing. 
   
2. The second part of the class consists of an old fashioned sing-along in which I accompany the clients on the piano. Everyone is given large-print lyrics of each song so they can fully participate – and they do!

When conducting a music program, here are some activity suggestions to consider:

1. Visit your local music store to find CDs from the 1930s through the 1950s. Songs should be familiar, such as songs from the period when the clients were teens or young adults. Favorite popular artists, Broadway shows such as “South Pacific” and “Oklahoma,” and works of composers like George Gershwin are but a few possibilities.  (Please note that with the aging of the “baby boomers”, one should be aware of changing musical tastes as tomorrow’s older adults gradually shift more towards Elvis and the Beatles).
2. There are many ready-made sing-along DVD and video resources available at Amazon.com and found in senior product catalogs such as S&S Worldwide (1-800-243-9232) and Sea Bay Games (1-800-568-0188).
3. Your public library is another wonderful resource where you can borrow musical CDs or DVDs of an opera or familiar Broadway show.
4. If you play an instrument and want to have a sing-along, play it at a slower pace and in a lower key. You can obtain lyrics from the Internet and print them out in an enlarged typeface.
5. Create a soothing atmosphere by playing classical CDs such as Mozart and Chopin, or tune the radio to a classical music station. (Note:  Playing any kind of music for longer than one hour at a time can contribute to agitation. Give participants a 20 minute break from the music before continuing.)
6. Add singing and humming to your daily activities and encourage clients to join you in singing. Your participation in musical activities is bound to lift your spirits too.

I have always known that music can open hearts. Through my teaching experience, reinforced by recent research, I have seen how it can also open minds.

MORE INFORMATION:

Barbara Jacobs, M.S. is a therapeutic musician who has produced a series of musical sing-along DVDs for Alzheimer's patients and seniors. For more information, see her web site,  www.FrontRowSeatVideos.com,  or send an email to  Barbara@CustomVideoSF.com

BY:

Barbara Jacobs, M.S.

Edited by Peter Berger, Alzheimer's Weekly

SOURCE:

Musicophilia, by Dr. Oliver Sacks, Professor of Clinical Neurology and Psychiatry at Columbia University

COPYRIGHT:

© 2008 Barbara Jacobs. All rights reserved.