There Is No Magic Music For Alzheimer’s Disease – Part Three

This is the third of a three-part series. Click to read part one and part two.

Music is one of those things that can really make a difference for people living with Alzheimer’s Disease and related dementias. As a music therapist, I spend a lot of time in music with folks who have dementia, helping them to connect with their peers, with their loved ones, and with cherished memories; and providing a context for them to make music with others.

What I especially love, though, is when I can help caregivers discover those songs and experiences that really work for the person or people they care for. I say “discover” because I can’t really prescribe one song or one experience that will work like magic for everyone. No one can.

There is no magic music.

If the bad news of our recent series is that there is no magic music, the good news is that we really can use music within our caregiving relationships to make a significant difference in the lives of those we care for.

If there is “magic,” it is what happens in the relationships a person has with the music itself and with the caregivers engaging in music with them.

In fact, if you already have a good relationship with your care recipient, you probably already know some ways to bring music into your interactions. (Read more in part one.)

You can then take that a step further by thinking more about your caree’s relationship with the music itself. (Read more in part two.)

Then, you can become even more intentional about how you relate to each other in the music. (Read on!)

How you relate in the music matters.

What you do during the music, or how you experience the music together, definitely affects how well the music “works” for your loved one.

This makes intuitive sense. Think about it: imagine your favorite, most relaxing music. Imagine listening to those beautiful sounds while cuddled up in bed, with the lights dim and the rest of the house perfectly quiet.

Now imagine listening to that music in rush hour traffic, when you’re trying to negotiate five lanes of freeway traffic while running ten minutes late to yet another doctor’s appointment.

In which setting do you feel more relaxed?

I think you get my point. We can’t just turn on some music and expect the magic to happen.

Here are a few elements to consider for how you relate in the music:

Verbal interaction before, during, and after the music

Think about why you are introducing the music to the person you are caring for. Are you simply turning it on for background noise? Or do you want to encourage conversation and reminiscence? Are you trying to help your loved one transition to an activity, a meal, or bedtime? Or are you just trying to find some mental space for yourself to relax? Considering your purpose or desired outcome will help you to decide which music to play and how to talk about it.

Pairing other activities with music

Doing music together can be even more rewarding when you pair music with another activity. Here are some ideas:

  • Exercise – dust off those lists from the physical therapist, or use the exercises you know from aerobics classes
  • Expressive movement – stretch and dance, letting the music be your guide
  • Art-making – break out the paint, markers, or colored pencils and see what happens
  • Art-viewing – look at photographs and let the music and art work together to start a conversation
  • Personal care – pair music with those ADL tasks you have to tackle (showering, washing hair, dressing), then finish with lotion and a hand massage
  • Instrument playing – give each person a tambourine or drum, and add your own beat to the recorded music

Structuring the listening environment

Even if you just want to turn on some music for passive listening, you still need to consider the listening environment. First, consider the ambient noise level. As in the example above, if the environment is noisy, busy, or otherwise stressful, then no music will work for relaxation. Are there competing radios or TVs? Lots of people talking? Sounds of vacuums and floor polishers?

Also consider how playback is happening. Is your care recipient listening through headphones? Or is the music playing loud enough for an entire room of people to hear?

Taking a few moments to consider the listening environment will make your music experience together more enjoyable and more effective.

Even if there is no magical CD you can buy to get those cherished musical moments for your care recipients, music can make a HUGE difference, especially with a little extra thought and planning.

What things have you done together in music with your care recipient? What has worked best for you? Please leave your comments below!

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Homemade Recordings for a Family Legacy (My Top 5 Tips)

A few months ago, my husband put a CD in our car stereo and said, “you’re gonna love this.” Click the link below to hear what I heard:

Great-Grandpa On Tape

What I heard were voices from my family’s past. My mother-in-law and her sister were kids back then, trying out a new tape recorder, when that was the brand-new technology. Their mom (my husband’s grandmother) was trying to convince her dad (my husband’s great-grandfather) to sing for the recorder. He demurred at first, but with some gentle cajoling, he gave in, showing off a yodel, then singing a few old folk songs, with Grandma adding in the harmony. This recording was nothing formal, just the family playing around.

But yet this recording is unbelievably precious. Continue reading

Thoughts on “The Intouchables”

I believe we can all learn a lot from art – music, of course, but also film, literature, dance, sculpture, painting, and every other form of human expression. This knowledge is different from what we gain through scientific research, and although it is highly subjective, artistic knowing can have a great impact on how we live and work.

So, in the spirit of learning from art, I wanted to share some thoughts on a movie I watched recently.* “The Intouchables” is a French film starring François Cluzet and Omar Sy, and it is based on the true story of a wealthy businessman who was left a quadriplegic after a paragliding accident. The film starts with Phillipe (Cluzet) interviewing potential in-home caregivers. He needs someone to help him with dressing, bathing, exercise, and every other activity of daily living. Candidates parade through, touting their training and experience, and telling how much they love working with the disabled. Then, Driss (Sy) storms his way into the interview room. This young black man dressed in street clothes tells Phillipe that he’s tired of waiting, that he’s sure he won’t get the job, and that he just needs a signature to show that he applied for the job so he can pick up his welfare check. Phillipe tells him to come back the next day, and when Driss returns, another member of the household staff starts training him for his new job. Continue reading

Song Spotlight: “Yes, My Darling Daughter”

  • Mood: Nervous excitement
  • Themes: Parenting, Moms and Daughters, Dating
  • Tempo: Upbeat
  • Genre/style: Big Band era

I’ve been trying to think of a good song to highlight for Father’s Day, but the one that keeps coming back is a favorite from my Mother’s Day playlist. There’s a fatherly twist, though, so we’ll go with it.

Yes, My Darling Daughter” is a 1941 song written by Jack Lawrence and made famous by Dinah Shore. The melody Jack Lawrence used as the basis for this song has an interesting backstory. The music is based on the Ukrainian folk song “Oj ne khody Hrytsju,” which is thought to have been written by Catterino Cavos in 1812. This same folk song was published in translation in 1816, and its English version did gain some popularity in the United States. Interestingly, the final phrase of the melody, to the words, “yes, my darling daughter” follows the Hyrts sequence, a melody common in Ukrainian songs and one that was used by several classical composers, including Haydn, Mozart, Boccherini, and Liszt. Musical motifs really do travel across time and distance, don’t they?

Daddy, may I go out dancing? Yes, my darling daughter!

Anyway, let’s get back to Jack Lawrence’s lyrics. In this song, we hear the conversation between a nervous young woman on her way to the dance, and her beloved mother. Here are a few lines from the beginning of the song: Continue reading

“Still a Child” – A Caregiver’s Song

Last week, I received an email from Bakhus Saba, a caregiver who wants his song to be heard. Nine months ago, he placed his mother in a retirement home. She has Alzheimer’s disease, and he had lived with her for all of his 52 years and been her caregiver for seven years. He wrote “Still a Child” together with John and Michele Law, about what he went through as a caregiver when he placed his mother in full-time care. Continue reading

Take Off the Pressure: 7 Creative Experiences to Try with Your Loved One with Dementia

I heard a great story on NPR last week about a program that encourages creativity among people with Alzheimer’s disease as a medium for meaningful, enjoyable communication with others. In the TimeSlips program, a facilitator shows folks a photo and encourages them to make up a story about the characters in the picture. Without the pressure of remembering who people are or what is supposed to be happening (as might happen when you’re looking at a family scrapbook), someone with memory loss can have a fun time making up a story about someone else’s life. Plus, as one researcher pointed out in the NPR piece, you don’t have to be a trained therapist to try out storytelling with your loved one. In fact, you can try it out for yourself on the TimeSlips website.

I really love this concept, because it lines up with two ideas that I preach all the time:

  1. Creative activities – music, storytelling, dance, art – are universal human experiences that can be meaningful, even for a person with memory loss.
  2. Caregivers can engage in creative activities with their loved ones as a means of connecting with them.

Creative activities take the pressure off of both the caregiver and the person with memory loss. The person with memory loss may really want to remember the details of their personal history or their current circumstances, just as much as the caregiver wants them to remember, and knowing that they can’t remember can cause anxiety. At the same time, the caregiver is often distressed by their loved one’s declining ability to remember things. Each person’s anxiety can feed into the other person’s anxiety, and then time spent together is all about worry and fear instead of simple, fun, meaningful experiences.

When you’re making up something new, though, you don’t have to remember the details. The pressure is off both people. You don’t have to worry about creating a “stupid story” or “improvising wrong,” because the whole point is making up something new, in the present moment – something that only needs to last for the present moment, not for an eternity of literary critics and art historians.

You simply get to enjoy the act of creation. 

So, I had the fun of creating a list of creative experiences to try with your loved one. Continue reading

Song Spotlight: “Mama Tried”

Migrant Mother, Nipomo, California – Dorothea Lange

  • Mood: Regretful, Defiant, Wistful
  • Theme: Regret, Motherhood/Parenting
  • Tempo: Moderately Fast
  • Genre/style: Classic Country

Mother’s Day is coming up in a few days, and in honor of the holiday, I’ve been sharing many songs about motherly advice and love with clients in music therapy. In fact, a few that I’ve spotlighted before work well for this holiday, including Que Sera Sera, Shoo Fly Pie and Apple Pan Dowdy, Cuddle Up a Little Closer and Button Up Your Overcoat (although it’s a bit warm for that last one. Maybe it would work in the southern hemisphere?)

The fact is, though, that Mother’s Day isn’t always the happiest day, for the children or for the mothers. My heart goes out to mothers who have lost their children and children who have lost their mothers, as I know they are grieving at this time. My heart also goes out to the women who desperately want to be mothers but who have struggled with infertility or miscarriages. These losses leave holes in our lives that cannot be papered over.

And, I’m also thinking about the mothers who have been disappointed by their children. Parenting always involves ups and downs as children grow and life happens. Sometimes things don’t work out for the best, and sometimes children make serious and lasting mistakes, no matter how hard their parents tried to raise them well. This causes a different kind of pain, especially when you think that you are the reason why your child turned out this way. I’ve known mothers of adult children who have experienced this kind of pain. I’ve also heard the regret of folks who disappointed their mothers, who made those lasting mistakes and now can’t repair the damage. That’s the topic of this song spotlight: Mama Tried.” Continue reading

A Musical Response for When a Senior Says, “I Just Want to Die”

I just read an article on how a caregiver can respond to a senior who is saying, “I just want to die.” I appreciate the advice given by Margaret Sherlock, M.A., Clinical Director of the Behavioral Health Program & Assessment Program Services at the Visiting Nurse Service of New York, which includes not ignoring the statements and being realistic about a senior’s need to talk about death and dying, while still setting limits on such heavy discussions and monitoring for signs of clinical depression in both the senior and in yourself. You can read all of her advice here.

This is sound advice, but I do think there is one important piece missing: you must think about how to deal with all of the emotions you and your loved one are both feeling. In fact, this kind of conversation can be so emotional for both the senior and the caregiver that it can be difficult to tell who is feeling what. You might think, is this person feeling depressed? Or is he just ready to die? Or is this person saying she wants to die because she wants to make me upset or get more attention from me? Or am I interpreting all of this wrong because I am the one who is feeling sad, or tired, or frustrated? Or maybe it’s a mixture of all of the above feelings, and I’m not really sure how to put words to it?

Even just trying to identify these feelings is difficult. No wonder these emotional conversations can wear you out! As Ms. Sherlock advised, though, you can’t just sweep the difficult feelings under the rug: they’ll just build up and create bigger problems for you and the senior later on. That’s why I’m usually not a fan of just changing the topic or putting on happy music to avoid the conversation.

When someone says, “I just want to die,” you need to acknowledge their emotional expression and honor your own. Continue reading

Music Therapy Does More Than Address Non-Musical Goals: Part One

The idea of music therapy can be confusing. What does a music therapist do, exactly? A common answer is to say we use music to address non-musical goals. For example, we might employ a particular method to help someone regain walking speed after a stroke, or to help someone express and explore their feelings of anger, guilt, and sadness following a divorce.

This description – using music to address non-musical goals – is truthful, I think, but it’s also incomplete. Our focus is not only on physical, emotional, and social goals.

As music therapists, we’re also there to help you create, enjoy, experience, and live music. Then, through the music, people can find many other positive outcomes. Continue reading