“My mother used to sing that song with me when I was a little girl!”
– 89 year old Alzheimer’s patient at Holland Home’s Verblauw Center, after singing along with the old hymn “In The Garden.”
Our elderly friend would have great difficulty recalling events that happened earlier today or last week, but she has vivid memories of her mother singing that song with her over eighty years ago. Most other long-term memories are hazy at best. Why did the song evoke a response like this?
Music contains healing and restorative powers and it brings joy and hope to those who are living in the fog of dementia. Engaging with live music provides real, measurable, therapeutic value for the memory impaired in ways that nothing else can.
Music is good for the brain
Music is uniquely effective in restoring memories in Alzheimer’s patients. According to Alzheimer’s research at Dartmouth College, Hanover, N.H.,
“Memory, in particular, is where music helps most. There is a part of the human brain where music stays indelibly. Called the rostromedial prefrontal cortex and centrally located behind the forehead, this portion of the brain processes and tracks music. It is also active during memory retrieval.”
Dr. Oliver Sacks, author of Musicophilia – Tales of Music and the Brain (2003) observes that for those with severe dementia, music -- particularly familiar music -- can bring back "emotions and associations that had been long forgotten, giving the patient access once again to moods and memories, thoughts and worlds that had seemingly been completely lost. The power of music is very remarkable... In particular, the response to music is preserved, even when dementia is very advanced… music of the right kind can serve to orient and anchor a patient when almost nothing else can. I see this continually in my patients.”
We see this continually as well at Eldermusic Ministries, Inc. No matter which memory-loss facility we visit, the residents’ responses to live music are predictable and repeatable. Hearing the songs they loved earlier in their lives seems to “wake them up” from their dementia, at least while they are singing and keeping time with the music.
Some patients are motionless and speechless, in wheelchairs with thier heads down…until the music starts. I recall one woman who was quite unresponsive and I was hoping she was getting something out of the musical program. When we picked up the beat and played a bluegrass version of “Power In The Blood”, she lifted her head, started smiling and singing and clapping her hands in time with the music. For whatever reason, something in her past experience connected her with that song and made her feel alive again.
When we hear an old song we loved, memories of other things that were happening in our lives at that time come flooding back as well. When you hear an old song that was on the hit parade when you were a teenager, don’t you often begin reminiscing about where you were, who you were with and what you felt like at the time? The same is true for dementia patients. This can be a source of great joy and hope for them because it helps them think clearly about their identity. Accordingly, we hear responses like this from our elderly friends:
“Our family used to sing that song together around the piano in the living room.”
“That was my dad’s (mother’s) favorite song!”
“This reminds me of the hymn sings we used to have at our church.”
“I haven’t sung that song since I was a little girl in Sunday school.”
The expressions on the residents’ faces during music sessions convey a spirit of joy and contentment. Patients who are typically unfocused and uncommunicative seem to “come alive” when the music starts. Even if they are unable to talk or sing, their faces will brighten and they’ll begin moving their hands or feet, or rocking to the beat of the music. They truly are happier when they’re engaged with the music and the joy manifests itself in their general demeanor. Their caretakers also tell us that they’re more compliant and less likely to become agitated after participating in our live music sessions.
Alzheimer’s researchers M. Brotons and P. Pickett-Cooper investigated the impact of live music therapy in agitation behavior of Alzheimer's disease patients before, during, and after musical interaction. The music lifted their spirits significantly, and interestingly, the benefits extended well beyond the duration of the music sessions:
“Twenty subjects, aged 70-96, from four nursing homes, were used for the analysis. Results indicated that subjects were significantly less agitated during and after music therapy than before music therapy. In addition, reports from staff proposed that this decrease in agitation continued for the rest of the afternoon and into evening periods.”
Music is good for the body
Of course, all this singing and smiling makes people feel better too. These folks don’t get much excitement in their lives anymore, so helping make live music for an hour can be invigorating for them. Many of the residents we serve are in wheelchairs or have other physical limitations, and the workout provided by a sing-along can be focused on their remaining abilities.
We keep the songs coming one right after the other to help stimulate deep breathing. We also hand out percussion instruments so the residents can exercise their arms and hands by helping keep time. Not only do they remember the tunes and the lyrics; most can also keep a proper beat for each song.
The benefits of simple exercise are greatly enhanced when stimulated by live music. The music provides a rhythm that the body naturally synchronizes with, and it makes the work of exercise enjoyable and fun. Even the most uncommunicative patients will clap their hands and smile when they hear certain songs from their past. They simply can’t help but move with the music.
"Singing is a very physical process, and when you're making music your body responds as if you were giving it a physical workout," says Eric Roter, a physician and musician who runs the website ermusic.org, which reviews the connections between music and medicine. Dr. Roter points out that making music can actually provide pain relief as well:
“…other studies have found that making music--singing or playing an instrument--can benefit seniors by lessening the pain and stiffness of ailments such as arthritis. In fact, it's the multiple dimensions of music making--combining intellectual, physical, and social aspects--that appear to set it apart from other cognitively stimulating activities.”
The music stimulates the residents to move and sway with the rhythm, often with their eyes closed. Their faces are typically relaxed and smiling, as if they are not really there, but in their mind’s eye they’re somewhere familiar. The music allows them to escape for a while, to re-connect with their identity, an identity which didn’t include constant pain and confusion. They can forget about their aches and pains for a time and bask in pleasant memories associated with familiar songs. My elderly friend Jay put it best when he said, “Your music doesn’t cure me, but it sure makes me feel better!”
Music is good for the soul
The spiritual component of music provides a powerful re-connect for many Alzheimer’s patients. Many of these folks used to read their Bibles and pray every day, but dementia has left them unable to have devotions any longer. Singing the familiar hymns of their faith helps them to once again commune with God.
The old hymns played an integral part in their spiritual development. These songs provided them with a unique way to commit scriptural and doctrinal truths to memory. The lyrics and verses speak of healing, restoration, and grace. Singing the words has the effect of cleansing the soul and encourages elderly believers that otherwise may be totally disconnected from their faith experience. The lyrics to many of the old songs they love are in fact scripture and prayers; singing thus may allow dementia patients to meditate and pray in the only way they are able.
When I observe our elderly, memory-impaired friends singing the words to their favorite old gospel songs, I’m reminded of Psalm 119:11 “I have hidden your Word in my heart,” andPsalm 146:1-2 “Praise the Lord O my soul, I will praise the Lord all my life, I will sing praise to my God as long as I live,”