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Music Therapy and Dementia

Every month, prior to COVID, Donna brought her husband Brian to the community center for “drumming and singing,” a music therapy program designed specifically for individuals with dementia, their loved ones, and care partners. 

Since the mid-1950s Certified Music Therapists (MTAs), have facilitated a wide variety of music experiences connected to specific goals including singing, listening to music, counselling questions, songwriting, and instrument exploration. 

Music Therapists support individuals living with dementia and their care partners by ensuring everyone in the session has an opportunity to feel heard, connected to others, and experience moments of feeling good. When music therapists use music one can expect to witness repeatable impact from week to week and month to month. 

What does music do for our wellness?   

It’s long been known that music triggers powerful recollections, but now brain-scan studies show us even more. The part of the brain known as the medial pre-frontal cortex sits just behind the forehead and helps us travel down memory lane. “What happens is that a piece of familiar music serves as a soundtrack for a mental movie that starts playing in our head,” suggests Petr Janata, a cognitive neuroscientist at the University of California.  

Back in the music therapy session the MTA has carefully placed drums and percussion instruments in the middle of a circle of chairs. By 10:00 a.m., ten couples, including Donna and Brian, enter the room and select their seats. Donna and Brian are the youngest members in the group (58 and 62 respectively). Donna is usually vibrant while mingling around the room, making others laugh while helping out some of the others. On this day Donna arrived looking unusually tired – so does Brian.

Is music always effective?

In the book Wellness, Wellplayed Dr. Laurel Young, a music therapist researcher at Concordia University in Montreal, Canada, reminds us that music is not always positive – and that means we need to pay extra attention.

Young critiques the oversimplified portrayal of music as a nonpharmacological “magic pill” to be “prescribed” to people living with dementia. “Although neuroscience research helps us to understand cognitive processes underlying music, individuals’ musical experiences, cultural backgrounds, and personalities influence how they respond. Music that I perceive as happy or pleasurable may be experienced very differently by others. We also cannot assume the music one wanted to hear yesterday will be the same music you want to hear today. If music becomes irritating or overwhelming, it needs to be turned off or changed immediately. If it evokes strong emotions, whether happy or sad, someone should be there to provide support. Music must always be used with care and genuine understanding of each listener’s current needs and preferences. When this happens, music may serve as a bridge via which persons living with dementia feel connected to their sense of self, their environment, and others.”

After Donna found two chairs side-by-side, the music therapist walked over to her, pointed to another chair across the circle and said, “Donna, that chair and drum is available. I will sit next to Brian today.” 

Although music therapy will not heal Brian of dementia, it can provide moments of clarity, autonomy and relief when music is used intentionally in the right way and at the right time. The music therapist will sit close to some members to provide verbal, non-verbal and musical cues of support. For Donna, the music therapy session will create a space around her worries – even for a brief period of time, allowing her to get as much  rest and renewal possible within the hour. 

As the session continued, Donna went through a visible transformation. First, Donna closed her eyes and within a few minutes, you could hear her drum above all the others. After 20 minutes, the drumming came to a stop. She leaned back in her chair but kept her eyes closed and her face looked much more relaxed. 

Why does music therapy work? 

Music is effective and very efficient at fostering positive social interactions by promoting trust and cooperation within even the most diverse gathering of people. Dr. Alan Harvey puts it this way: “In a group context, music-related activities … encourage the formation of bigger social networks, help to define cultural identity, and may represent a ‘safe-haven’ in which individuals can interact and share experiences.” In his research from 2020, he goes on to document the links between music and the hormone oxytocin and the influence they have on physical and mental well-being, the key roles they play in bonding and feelings of attachment, and their positive impact on social recognition and social memory. 

As people’s lives and the world becomes even more complex, society continues to seek new ways to feel more connected and feel well. The informed music therapist, and the diverse sessions they provide, help to artfully and skillfully build that bridge of connection and wellness. Each session is designed with several factors in mind, including the client’s physical health, communication abilities, cognitive skills, emotional well-being, and interests. After an initial assessment and after the mutually agreed goals are established, the music therapist will embark on either the creative or receptive process – and in both cases no previous music experience is necessary. 

“In the creative process, the music therapist works with the client to actively create or produce the music. This may include composing a song, engaging in music or song improvisation, or drumming. In the receptive process, the therapist offers music listening experiences, such as using music to facilitate a client or group’s relaxation. Clients or groups may then discuss thoughts, feelings, or ideas elicited by that music.” – Dr. Annie Heidersheit, Past President, World Federation of Music Therapy 

How important is the relationship between the music therapist and group members? 

The therapeutic relationship is considered one of the strongest predictors of successful therapy. Establishing such a relationship requires training and experience.  

American psychologist Carl Rogers defines a ‘helping relationship’ as “a relationship in which at least one of the parties has the intent of promoting the growth, development, maturity, improved functioning and improved coping with life of the other.”  

Certified Music Therapists (MTAs) are members of the Canadian Association of Music Therapists, a professional organization that ensures MTAs have all the necessary education, resources and guidelines they require to ensure best care practices and public safety. 

After the drumming stopped and there was a brief moment of silence, the music therapist picked up their guitar and strummed a few chords leading into a song both Donna and Brian loved. Brian sang every word, frequently looking at the therapist in the eyes with a warm smile of recognition. When the song ended, the music therapist asked Brian, “How did the music make you feel today?”  Donna took a deep breath ready to answer for him from across the room when Brian smiled knowingly and said, “music makes me happy.” You could hear Donna’s audible breath of relief. 

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