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

Photo by moodboardphotography via Flick.com

Photo by moodboardphotography via Flick.com

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

The fact that music can profoundly affect people with dementia is not news, but finding exactly what music “works” for people with Alzheimer’s Disease and related dementias can be a challenge. What is important to know is that there is no “magic music” for Alzheimer’s Disease – no one-size-fits-all recording or musical experience that can do what almost looks like a magic for someone with dementia.

In the first post in this series, you read that relationship matters in music therapy and any use of music in caregiving. Next time, we’ll look at the relationship between the caregiver and care recipient in a musical experiences, but for now, let’s look at the relationship the listener has with the music itself.

Their Relationship With The Music Matters

Basically, what I mean by this statement is that it matters whether your care recipient has heard a particular song or type of music before, whether they like it, and what memories it brings back.

Music Preference

In the music therapy world, we often talk about music preference – whether someone likes opera or rap, Frank Sinatra or Taylor Swift. Music preference certainly matters. We know, for example, that it is difficult to relax to music you don’t like. If you hate the sound of the soprano saxophone, then Kenny G is not easy listening for you.

Musical Associations

There is more to your relationship with music than liking or disliking a particular song, though. In addition, it matters what associations someone might have with a particular kind of music. For example, your mother may love to hear “Rock of Ages” and “The Old Rugged Cross,” but for her tablemate in the dining room, those songs might bring back painful memories of parents who died when she was a child. Or, your loved one might love country western music but hate Hank Williams, because he was an alcoholic and a druggie. It doesn’t matter that Hank Williams is a country music icon if his music brings up reminds them of an alcoholic relative or personal struggles with addiction.

Familiarity

Another aspect of a person’s relationship with music that can be important is the person’s familiarity with a particular musical selection. I often recommend looking for familiar music to share with your loved ones with dementia, because familiar music can help people connect to good memories. That’s what we see at work in the viral video of Henry.

Still, believe it or not, familiarity is not always a requirement, and it is not always sufficient to bring about those amazing moments we’re all looking for. That’s because it also matters how you spend your time in music with your loved one.

We’ll dig deeper into that aspect in the next post, but for now, what have you observed about how a person’s relationship with music affects what “works” for them? Please leave your comments below!

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Forgiving Forgetfulness

Here’s what happened to me yesterday:

I led a music-making group at a nursing home in one part of Kansas City. It went great! Everyone was really clicking with the music, playing drums and singing while I played guitar, and they all seemed to be enjoying our discussion about baseball and the All-Star Game to be played in Kansas City last night. After the music ended, I finished my documentation, chatted for a moment with the activity director and the receptionist, then let myself out the door, loaded up my equipment in the back of my car, and drove off to another part of the metro for a business lunch.

Fast forward two hours. I arrive at an assisted living home for my next music therapy group, unload my equipment, take it all in the home, start unpacking and realize…

I don’t have my guitar.

My stomach sank. I was thrown off by not having things in their proper places, and I felt kind of dumb for forgetting my guitar somewhere. After all, it’s kind of bulky and heavy, and I carry it almost everywhere I go. I thought, “I shouldn’t have forgotten that.”

How could I forget this?

It didn’t take long for me to figure out that I had left my guitar at the first nursing home. I called them to confirm that it was still there, which it was, safe and sound. I led my music therapy session at the assisted living home using hand percussion instruments and body percussion, which, incidentally, led to some interesting and out-of-the-ordinary musical interactions. I then rescheduled my next session so that I could pick up my guitar before my last appointment of the day. Everything worked out fine. People were understanding, and no one accused me of being a horrible person or ruining their day.

“So what does this have to do with caregiving and music?”  you might ask. “Have you forgotten what this blog is about, too?”

Don’t worry – I do have a point. It’s this:

Be forgiving of your own forgetfulness. 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

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

How Music Therapy Brought a Couple Together Again

I started seeing this couple because he was on hospice and she was his caregiver. He had dementia, and his disease was causing him to be agitated and angry and sometimes even aggressive towards his wife. She was invested in keeping him at home as long as possible. As a nurse, she knew what she was getting herself into, and she wanted as much help as possible in helping her husband to stay calm. That’s why the hospice called me, the music therapist.

In our first session, he was dozing in his recliner, late in the afternoon following a dose of something sedating. I asked her about his music background and preferences, and she showed me his collection of CDs and the Bose stereo system that made him so proud. Continue reading

Why You Might Want a Music Therapist, Even If You Don’t Need One

Perhaps one of the most confusing things about the profession of music therapy to many people is why it even exists. People have been playing music for centuries to manage various problems, right? Why would you need special training for that? Why can’t I just use music on my own to feel better?

That’s a fair question, in my opinion. It is certainly true that people often find musical experiences they need, whether that is listening to Metallica when they’re angry, singing in a church choir for a richer spiritual life, writing songs to get over a break-up, or turning on some Rossini to wake up in the morning. These are valuable skills, and you don’t need a music therapist to put them into practice. We even have a lot of research now showing ways that people use music to improve their well-being, even without a music therapist involved. These studies tell us things we already know from experience – people (especially healthy people) can find ways to use music to improve their lives.

Sometimes, though, it seems that the person of the music therapist can make the crucial difference in the music experience. A 2011 study* published in the Journal of Music Therapy looked at a music program designed to be implemented by caregivers with their family members who have dementia. Continue reading

What Happened in One Group Music Therapy Session

Music therapy with seniors is incredibly valuable, but it can be difficult to understand and to explain. How is what a music therapist offers different than what any musician could offer as an entertainer?

Let me describe the session I just had today as one example.

Today’s music-making session was with a group of seniors who meet in a church basement once or twice a week for a day program that offers a range of activities, including exercise, craft projects, games, music, and a meal.  These folks live in their own homes but have some long-term health concerns, incuding the cognitive difficulties that accompany the early stages of dementia.  Group members generally need some extra social support, especially the opportunity to share their lives with other people.

I come to this group twice a month for music-making sessions. Today was the group’s Valentine’s Day party, so the room was already decked out in red and white. We started our session as we usually do, with “He’s Got the Whole World in His Hands” as our welcoming song. I then told the group that we were going to have LOVE songs for Valentine’s Day, an announcement met with smiles and perhaps a few eye rolls. Continue reading

Song Spotlight: “How Ya Gonna Keep ’em Down on the Farm?”

  • Mood: Lighthearted, Goofy
  • Themes: Country life vs. City life, Returning from War
  • Tempo: Upbeat
  • Genre/style: 1920s popular song

Something you find out about songs is that if you ponder them long enough and share them with enough people, multiple layers of meaning begin to emerge. Those layers may be deliberate on the part of the songwriter, or they may come from the personal experiences of the individual hearing the song or the context in which they hear it. Today’s song spotlight is on the 1919 song “How Ya Gonna Keep ‘Em Down On The Farm,” and it works in two ways, one that is more on the surface level, and one that is more profound. I’ll start with the easy one.

If you take this song at face value, with 21st century eyes, it’s just a goofy song about returning to farm life after spending time in the big city. Here’s the chorus:

How ya gonna keep ’em down on the farm after they’ve seen Paree?

How ya gonna keep ’em away from Broadway, jazzin’ around and painting the town?

How ya gonna keep ’em away from harm? That’s a mystery.

They’ll never wanna see a rake or plow

And who the deuce can “parley-voo” a cow?

How ya gonna keep ’em down on the farm after they’ve seen Paree?

Hearing this song, you can picture someone traveling to the big city for the first time, seeing all of the bright lights and beautiful people, taking in the sights at the Eiffel Tower and the palace of Versailles, then coming back home to be somewhat let down by the chickens scratching in the yard and the cows waiting to be milked.

I like to include this song in a session with older adults on the theme of living in the country versus living in the city. Most of my clients have been city-dwellers for a while, but a good number of them also lived in the country as kids. That means they have stories to share on both counts, perhaps including the culture shock involved in moving from world to the next. We also talk about taking vacations to places like Paris and Hawaii and maybe even Egypt or Russia then returning to the Midwest, and what that feels like. Some folks can also relate to what their children might experience by living in more exotic locales then coming home to visit their folks in Olathe, Kansas or Independence, Missouri. Overall, the song helps the discussion to stay lighthearted and not too negative about the country or the city.

Simple enough, right? It turns out that this particular song gets more interesting after you learn about its history. You see, this song came out in the last days of the first World War and was wildly popular in the years following the war.

Here’s the scene: after the first World War ended in 1919, a generation of young American men came back home to the U.S. to return to the farms and jobs and families they had before the war. Of course, the same thing happened again after World War II, and it has happened again (in different ways) after every war since then: young men and women have come back home after life-changing experiences overseas. For all of these military members, they come home with a disconnect between the experiences of life in a war zone and life back home. While in a combat zone, decisions had to do with life and death; back home, it’s about what to cook for dinner and what clothes to put on the kids. While overseas, they had to be on alert at all times for possible threats to their physical safety; now they have to be able to handle the noisiness of modern American life without paranoia. While at war, they were surrounded by people who also had direct experiences of being at war; now, people at home are sympathetic but rather clueless, and they wouldn’t want to share the horrific details of what they saw anyway.

So, really, even in its humorous way, this song asks a serious question: how can soldiers return to life as usual after going through the life-changing experiences of being at war? For veterans of the first and second world wars, it certainly wasn’t an accepted practice to continue thinking and talking about the horrors of war after returning home, and post-traumatic stress wasn’t really a topic of discussion. (It was called shell shock back then.) Today’s returning veterans have more resources available for dealing with the transition back to life in the U.S., but it will always be a difficult transition to make. What’s more, the pain that comes from experiencing war can last for a lifetime – I’ve had more than one elderly client tear up remembering his service in World War II.

There are many ways to cope with the trauma of war and the transition back to civilian life, and certainly music is one tool to use. I bet that some of this song’s popularity came from its very quiet acknowledgment of the difficulty of returning home from war in the package of a cheesy, goofy, funny song (complete with cartoonish sound effects in this version.) Perhaps allowing that song to express and contain some of the pain of transition helped, at least a little.

What are your thoughts on this song? Which other songs do you know that work on multiple levels of meaning? What other songs do you know that have been particularly helpful to veterans and their families? Please leave your comments below.

This post is part of an occasional series on special songs to share with your loved ones. For more song spotlights, click here.