Sometimes individual work can be most effective, and sometimes small group work can bring a sense of community to those who find it difficult to connect and for whom 1:1 work can be too challenging as they feel exposed.
I have worked with the patient and the carer together to have a different experience of each other - perhaps playing drums or xylophones, singing and dancing together, creating a mutual shared experience that can be talked about and reflected upon, or pictures taken and referred to in engaging between sessions about our experience of self that is so often fractured through disempowering illness.
In working with Dementia and Alzheimers here's what to expect:
Familiar songs are used to stimulate memory.
Musical improvisation enhances self–expression when meaningful words are not possible.
Rhythm based activities increase attention and focus.
Phrases are put to music to aid memory recall.
Music Therapy can provide results including:
Increased attention and focus
Improved cognitive skills
Increased awareness of self and others
MUSIC AND CREATIVE THERAPY WITH THE ELDERLY
being in rhythm create wonderful joyous sessions of sharing and enjoying music together. The therapists bring a collection of percussion instruments to explore and play and support with guitar, accordian, piano, ukulele and voices.
Sometimes individual work can be most effective - at the bedside or front room, and sometimes group work in the care-home can bring a sense of community to those who find it difficult to connect.
Music engages the whole: our body, our spirit, our personality, our voice
We can also work with patient and carer together to have a different experience of each other - perhaps playing drums or xylophones, singing and dancing together, creating a mutual shared experience that can be talked about and reflected upon, with pictures taken and referred to in engaging between sessions about our experience of self that is so often fractured through disempowering illness.
being in rhythm
• Promote social interaction such as turn-taking, eye-contact
• Encourage a sense of self through improvised music
• Reminisce through the use of song and talking
• Aid relaxation
• Encourage the expression of feelings
• Enhance exploratory and creative abilities
• Use familiar songs to stimulate memory
• Develop rhythm based activities to increase attention and focus
• Put phrases to music to aid memory recall
• Move and dance
• Listen and share
• Be playful
‘Music provides people with ways of understanding and developing their self-identity, of connecting with other people, of maintaining wellbeing and of experiencing and expressing spirituality, and that it provides strong associations with and memories of a person's life. Specifically, the results show how music is used as a source of entertainment as well as a forum to share and interact with others. Music was described as a personal experience to which people assigned meaning and emotions. The informants also described how music allowed them to engage in imaginative play and to escape from some of the hardships experienced in later life. The results reveal that music promotes quality of life by contributing to positive self-esteem, by helping people feel competent and independent, and by lessening feelings of isolation and loneliness’.
From: The contribution of music to quality of life in older people: Hays and Minichiello
‘People who are concerned about memory loss, have mental health problems or dementia, can all benefit from music therapy’. British Association of Music Therapy
Elderly people can feel socially isolated when they are recovering from illness
and are away from neighbours, family and friends.
Music therapy can improve self-esteem and encourage memory recall.
How the intervention might work
‘Music therapy mostly consists of singing, listening or playing musical instruments. Music and singing may stimulate hemispheric specialization. Clinical observations indicate that singing critically depends upon right-hemisphere structures. By contrast, patients suffering from aphasia subsequent to left-hemisphere lesions often show strikingly preserved vocal music capabilities. Singing may be exploited to facilitate speech reconstruction when suffering from aphasia (Riecker 2000). Singing can further help the development of articulation, rhythm, and breath control. Singing in a group setting can improve social skills and foster a greater awareness of others. For those with dementia, singing may encourage reminiscence and discussions of the past, while reducing anxiety and fear. For individuals with compromised breathing, singing can improve oxygen saturation rates. For individuals who have difficulty speaking following a stroke, music may stimulate the language centres in the brain promoting the ability to sing. Playing instruments may improve gross and fine motor coordination in individuals with motor impairments or neurological trauma related to a stroke, head injury or a disease process’. (WFMT, 2010) From ‘Music therapy for people with dementia’ by Vink, Bruinsma, and Scholten.
Whereas cognitive functions decline during disease progression, receptivity to music may remain until the late phases of dementia (Adridge 1996). Listening to music itself may decrease stress hormones such as cortisol, and helps patients to cope with for instance pre-operative stress (Spintge 2000). Music therapy can bring relaxation and has a positive effect on enhancing communication and emotional wellbeing (Brotons 2000). Music therapy enables the recall of life experiences and the experience of emotions. Many important life events are accompanied by music. Most of the time these „musical memories" are stored for a longer time than the ones from the same period that were not accompanied by music (Broersen 1995;Baird 2009). If words are not recognized any longer, familiar music may provide a sense of safety and well-being, which in turn may decrease anxiety. While language and cognitive functions deteriorate during the course of the disease, many musical abilities appear to be preserved for a longer period (Adridge 1996;Baird 2009). The responsiveness of patients with dementia is a remarkable phenomenon. Even in the latest stage of the disease, patients may remain responsive to music where other stimuli may no longer evoke a reaction (Norberg 1986). Explanations are difficult to find for this phenomenon. Possibly, the fundamentals of language are musical, and prior to lexical functions in language development (Adridge 1996). Musical rhythm may help Alzheimer's patients to organize time and space. People with dementia may lose their verbal skills first but both general musical and rhythmic skills remain for a long time (Cowles 2003). Patients are able to experience group contact through musical communication with other participants, without having to speak. Through music, contact can be established, especially as language deteriorates during the latter stages of the dementing process. Owing to its non-verbal qualities, music therapy might help people with dementia at all levels of severity to cope with the effects of their illness’. From ‘Music therapy for people with dementia’ by Vink, Bruinsma, and Scholten