As the Babyboomers age, more and more people are being diagnosed with Alzheimer’s disease.  Although it is far from inevitable, it is also happening to people every day and is being diagnosed earlier and earlier.  Currently, there is no cure for Alzheimer’s disease, music is one of the few interventions that actually can make a big difference.

For over 20 years I have played the piano for Alzheimer’s patients in both group settings and for individuals in their homes.  The results have been nothing short of amazing as people who are depressed and despondent suddenly recognize a familiar song and begin to smile, relax and even sing along. 

Numerous studies have been done using music with Alzheimer’s patients that have tracked the cognitive decline while documenting that even after patients no longer recognize friends and family nor remember where they are or the facts of their lives, they can still hear the music of their “courting years” and enjoy singing along with peers or even alone.

I want to offer all of my readers a special deal on my Alzheimer’s products, including the cordless headphones, programmed with the Alzheimer’s music, and other CD’s, book and tape!  Please let me know if I can help you or advise you on help with a friend of family member with this diagnosis. 

Click here to learn more about this special offer!

by Steve Toll and Linda Bareham

What better “medicine” than a “treatment” that has only positive side effects and “therapy” that is actually enjoyable? That is the “miracle of music” when applied with intention. Music is shown to have the ability to help organize the brain; especially vital to those who are afflicted with Alzheimer’s.

Usually after twenty minutes of music, there are observable effects, such as singing, foot tapping, and clapping. Studies have shown that the results of a musical therapy session last for several hours afterward. Positive results include elevated mood, increased socialization and appetite and reduction in agitation. These benefits are attributed to the stimulation the brain receives during a music therapy session, a sort of “cognitive workout” inspiring us to coin the phrase, “What exercise is to the body, music is to the brain.” The power of music often inspires physical movement and can be used in combination to encourage gentle exercise.

As speech, writing and traditional forms of communication are compromised, music provides an alternative means of maintaining a connection, thereby helping to normalize interaction between caregiver and patient. Music used therapeutically creates an environment where the patient can be nurtured and cared for in a way that is safe, gentle and appropriate. Music is central to maintaining human bonds when those with dementia have lost the ability to initiate communication or to respond verbally.

The powers of music when focused and used therapeutically are many. Critical to maintaining quality of life for those with Alzheimer’s is management of emotions and preserving the connection with others. Music is conducive to keeping those connections strong as long as possible while helping the participant to focus, increase awareness and orient to the environment. A number of research studies have looked at music therapy as an important adjunct to medical treatment and findings suggest a possible link between the use of music and slowing the progression of dementia.

From the rhythms of the heartbeat experienced in the womb to the stirring sounds of a marching band, rhythmic patterns and music surround us. Language itself has a musical quality to it and from the beginning of mankind, as expressed through chanting and drumming, resembled music more closely than speech. Music is primal to life and expressed by each of us every day whether through dancing to a favorite tune, keeping rhythm with a pencil or remembering a special time when hearing a forgotten melody. It is central to our lives and is embedded in our culture, defining how we acknowledge milestones, rites of passage and celebrations as well as providing comfort, transformation and inspiration. Music links us to our world and provides a pathway back to our past.

You don’t need to have any special musical training to institute a therapeutic music program. You will need to select appropriate music, however. This music consists of familiar tunes from the 30s, 40s and 50s with more contemporary music included, depending on the preference or age of the participant. Before you invest in any CDs, check in your own home for possible sources of music. Your local library is a good source. Consider individual preferences and select music that is singable and upbeat.

Steve Toll, a professional musician and trainer, and his wife Linda Bareham, a writer and researcher in the area of alternative therapies for seniors with dementia, formed the company Prescription-Music. Mr. Toll is on the Speaker’s Board for the National Alzheimer’s Association and trains professional and family caregivers in the development of music therapy programs where his intent is to spread the word of the healing power of music for those afflicted with Alzheimer’s.

Click here to purchase music for Alzheimer’s

According to Wikipedia, 

“Albert Benjamin “Happy” Chandler, Sr. (July 14, 1898 – June 15, 1991) was the 44th and 49th Governor of Kentucky, a U.S. Senator, the second commissioner of Major League Baseball, from 1945 to 1951 and a member of the Baseball Hall of Fame. His jovial attitude earned him the nickname “Happy,” which stuck for the remainder of his life.^[3]

Chandler’s first term as governor is still regarded as one of the most productive of any Kentucky governor.^[4] Following on this success, he unsuccessfully tried to unseat Senate Majority Leader and fellow Kentuckian Alben Barkley, but was appointed to the Senate shortly after the election due to the death of the state’s junior senator. He would later resign this position to become Commissioner of Baseball, steering it through the difficult period of integration, which many contend led to his not being offered a second contract for the position. Instead, twenty years after his first term as governor of Kentucky, Chandler returned to the Governor’s Mansion using the slogan “Be Like Your Pappy and Vote For Happy.”^[5]

Later in life, Chandler’s commitment to civil rights was questioned as he supported Dixiecrat Strom Thurmond’s bid for President. Having been elected to his first term at the age of 37, Kentucky’s “Boy Governor” was both the last surviving governor of any U.S. state to serve before 1939 and the last living Senator to have served before 1940 by the time of his death in 1991.”

So when I saw a YouTube video of him on a friends FB page, I knew I needed to share it with you!  It’s a touching rendition by a man who must have been well into his 80′s!  I’d love to have your comments!

Yesterday, we had an overview of the components of healing music.  It’s always important to remember that what is healing to one person might actually be distasteful or anxiety provoking to another.  Music is very personal so understanding the components and how they function within music can help you to choose the music you want to listen to more intentionally.

Today we talk about “melody.”  The simplest definition is probably “a tune, or series of notes, sung or played one at a time, that is memorable and pleasant.”  Simple melodies that everyone probably knows include:

Twinkle, Twinkle Little Star

Mary had a little lamb

Happy Birthday to You

Amazing Grace

and so many more! 

Some melodies are more memorable and appealing to people than others, but if a piece of music is to be “healing” then you’ve got to like, enjoy, and react positively to the melody.  But melodies can vary greatly!  We can have simple “nursery rhyme” melodies or we can have complex, classical music melodies like Mozart’s or Mendelssohn’s melodies.  These are often long and winding and are repeated with slight variations each time.

Then there are the popular music medodies that so many people love and associate with “falling in love” and good times.  Think of:

Unchained Melody

Wind Beneath My Wings

Chariots of Fire

Theme from “Rocky”

Stairway to Heaven

People who need people

Of course these tunes represent my generation…people who came of age in the 60′s.  Every generation has their favorites though and that’s been true for centuries.  Think of your grandparents music and their grandparent’s music.

I even made a CD called “Music for Memory Care” that features me playing on the piano the popular songs of the 1900-1940′s so that old people can sit and listen and reminisce about their youth and time of “falling in love.”  Melody is an important component of healing music so think about the melodies you love and how you can enjoy them more in times of stress and anxiety.

Tomorrow we’ll take a look at harmony!

A Key for Unlocking Memories

Music Triggering Memories in Dementia Patients5: With the help of some old familiar tunes, advanced-dementia patients at Beth Abraham Family of Health Services in New York are reconnecting with their memories and with each other in ways that may seem surprising for those with degenerative brain diseases.
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But with stroke and dementia patients, iPods and other MP3 players are having just the opposite effect.

Listening to rap and reggae on a borrowed iPod every day has helped Everett Dixon, a 28-year-old stroke victim at Beth Abraham Health Services in Bronx, N.Y., learn to walk and use his hands again.

Trevor Gibbons, 52, who fell out of a fourth-floor construction site and suffered a crushed larynx, has become so entranced with music that he’s written 400 songs and cut four CDs.

Ann Povodator, an 85-year-old Alzheimer’s patient in Boynton Beach, Fla., listens to her beloved opera and Yiddish songs every day on an iPod with her home health aide or her daughter when she comes to visit. “We listen for at least a half-hour, and we talk afterwards,” says her daughter, Marilyn Povodator. “It seems to touch something deep within her.”

Edel Rodriguez .
Caregivers have observed for decades that Alzheimer’s patients can still remember and sing songs long after they’ve stopped recognizing names and faces. Many hospitals and nursing homes use music as recreation, since it brings patients pleasure. But beyond the entertainment value, there’s growing evidence that listening to music can also help stimulate seemingly lost memories and even help restore some cognitive function.

“What I believe is happening is that by engaging very basic mechanisms of emotions and listening, music is stimulating dormant areas of the brain that haven’t been accessible due to degenerative disease,” says Concetta Tomaino, executive director of the Institute for Music and Neurologic Function, a nonprofit organization founded at Beth Abraham in 1995.

Dr. Tomaino, who has studied the therapeutic effects of music for more than 30 years, is spearheading a new program to provide iPods loaded with customized playlists to help spread the benefits of music therapy to Alzheimer’s patients even at home. “If someone loved opera or classical or jazz or religious music, or if they sang and danced when the family got together, we can recreate that music and help them relive those experiences,” she says.

Music for MemoryListen to clips of some ’60s tunes recommended by the The Institute for Music and Neurologic Function for individuals with Alzheimer’s Disease or other memory impairments:
“The Times They Are A-Changin’” by Bob Dylan “Dawn (Go Away)” by Frankie Valli & The Four Seasons “Come a Little Bit Closer” by Jay & The Americans “California Girls” by The Beach Boys “(I Can’t Get No) Satisfaction” by The Rolling Stones See the full list and get more recommendations from the Institute’s Web site..
Dr. Tomaino says she frequently sees dementia patients make gains in cognitive function after music therapy. In one unpublished study she led a few years ago, with funding from the New York State Department of Health, 45 patients with mid- to late-stage dementia had one hour of personalized music therapy, three times a week, for 10 months, and improved their scores on a cognitive-function test by 50% on average. One patient in the study recognized his wife for the first time in months.

David Ramsey, a music therapist and psychologist, holds twice weekly sessions at Beth Abraham, where small groups of patients can sing and dance to familiar songs like “Under the Boardwalk” and “Swing Low, Sweet Chariot.” Mr. Ramsey will sometimes stop singing and let residents fill in the blanks on their own. When they do that, he says, “they are exercising their cognitive function—just like they are exercising in physical therapy.” And unfamiliar songs quickly become familiar, another sign that even advanced Alzheimer’s patients are forming new memories. “One of our therapists played, ‘Who Let the Dogs Out?’ I know they had never heard that one, but it became an anthem,” he says.

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Bryan Derballa for The Wall Street Journal David Ramsey leads music sessions at Beth Abraham Services, meant to stimulate positive memories and physically engage dementia patients.
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In addition to benefiting Alzheimer’s patients, decades of studies have demonstrated that music can help premature infants gain weight, autistic children communicate, stroke patients regain speech and mobility, dental, surgical and orthopedic patients control chronic pain and psychiatric patients manage anxiety and depression. Now, neuroscientists are starting to identify the underlying brain mechanisms that explain how music connects with the mind and body, and they are starting to work hand in hand with music therapists to develop new therapeutic programs.

There’s no single center for music in the mind—the brain appears to be wired throughout for music, since it engages a wide variety of functions, including listening, language and movement. But Petr Janata, a cognitive neuroscientist at the University of California, Davis’s Center for Mind and Brain, recently located an area of the brain—the medial prefrontal cortex, just behind the forehead—that seems to serve as a hub for music, memory and emotions.

In a study published online in the journal Cerebral Cortex in February, Dr. Janata had 13 UC Davis students listen to excerpts of 30 songs chosen randomly from “top 100″ charts from years when they were 8 to 18 years old, while he recorded their brain activity using functional magnetic resonance imaging, or fMRI. Songs that were unfamiliar evoked reactions in the auditory processing parts of the students’ brains; those that elicited emotional reactions stimulated other brain areas. When songs conjured up a specific personal memory, there was particularly strong activity in the medial prefrontal cortex. That’s where what Dr. Janata calls “a mental movie” seems to play in the mind’s eye, with music serving as its soundtrack.

And, it turns out, this same medial prefrontal cortex had been identified in earlier research as one of the last parts of the brain to atrophy as Alzheimer’s disease progresses.

.Dr. Janata hopes to study whether the same phenomenon occurs, in the same part of the brain, with older test subjects and eventually with Alzheimer’s patients. He says that activating memories with music cannot reverse or cure neurological diseases like dementia. But playing familiar music frequently can significantly improve a patient’s mood, alertness and quality of life.

Music therapy isn’t used more widely with Alzheimer’s and dementia patients largely because of a lack of manpower and money, experts say. There are only about 5,000 certified music therapists in the U.S., and fewer than 20% work with geriatric patients. That’s why the Institute for Music and Neurologic Function is trying to bring music therapy into patients’ homes.

Caregivers or family members can use records or tapes at home, or program their own iPods. The institute provides suggested songs by era and genre on its Web site, www.imnf.org. But those who don’t have the time or technical skills can send an iPod to the institute after filling out a questionnaire about the patient’s musical tastes, and the institute will program a customized iPod for them. (See the Web site for prices and package information.) The institute is also seeking donations of iPods that are no longer in use to load with music and send to Alzheimer’s patients who can’t afford their own.

What to Do: Old iPodsYour outdated or unused iPods or MP3 players could bring healing music to an Alzheimer’s, stroke or pain patient. Send donations to the Institute for Music and Neurologic Function at 612 Allerton Ave., Bronx, NY, 10467. They must be working and still able to hold a charge.
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Dr. Tomaino advises caregivers to listen as long as the patient seems interested. A patient may want to listen alone through headphones or through speakers so that a friend or family member can listen along. “Then they can reminisce together about what the music reminds them of or just hold hands to be more connected,” she says. She also suggests involving the whole family in interacting with the music. “The kids can drum along while Grandpa listens to Big Band sounds,” she says.

One possible downside: Dr. Tomaino says sometimes a song can evoke unhappy memories, such as the death of a loved one or a relationship gone bad. She recalls a Holocaust survivor at Beth Abraham who became very upset upon hearing a Wagner opera.

“If family members don’t know what music would be appropriate, think in generalizations,” she says. “If a parent loved to go dancing in their teens, picking the most popular songs from that era tends to be pretty safe.” Music from a person’s teenage years seems to be especially evocative of memories, for reasons not well understood.

About Melinda Beck.As The Wall Street Journal’s new Health Journal columnist, Melinda Beck is returning to her love of reporting after a seven-year stint as the editor of Marketplace, the paper’s second section. Before joining the Journal in 1996 as deputy Marketplace editor, Melinda was a writer and editor at Newsweek magazine, and wrote more than two dozen cover stories on topics ranging from the Oklahoma City bombing to the O.J. Simpson trial to liquid diets and the dilemmas of long-term care. She’s always found covering health-care issues particularly exciting, as evidenced by awards she’s won for her stories from the Arthritis Foundation, the AARP, the American Society on Aging, the American College of Emergency Physicians, the National Institute of Health Care Management and the American College of Health Care Administrators. Melinda graduated from Yale University and lives in New York City with her husband and two daughters.

For the past 20 years I have worked actively with elderly patients suffering from Alzheimer’s disease and other dementias as well. Let me tell you that the treatment and methods have really changed and improved during that time too.

What brought me to this work was actually an assignment from my department chair and mentor, Dr. Joel Elkes. We were a part of an Arts and Medicine program at the University of Louisville School of Medicine and were researching the use of music and other arts interventions with a variety of illnesses and health challenges.

Dr. Elkes decided that he wanted me to do a formal scientific study on the “Therapeutic Use of Music with Alzheimer’s Patients.” We were able to get into a state-of the-art Alzheimer’s unit in Louisville, KY; a facility that was brand new and had a special locked area for Alzheimer’s patients that allowed them to safely wander and pace (as they tend to do) in a garden area outside and in a circular area inside!

Over the course of the next six months we worked with 30 actual subjects, but we also had the participation of family members who were visiting as well as medical and support staff. At the end of the study we had learned that although music certainly will not cure, or even slow down the progression of Alzheimer’s disease, it definitely does provide a wonderful quality of life intervention that allows people to enjoy and remember the music of their “courting years!” Yes, we found that even in the latter stages of Alzheimer’s disease, after patients no long recognize their friends and family members, they can still hear the music from their “courting years” and sing-along, tap their toes, nod their heads in time to the music and sometimes, get up and dance for a minute or so with their spouse. Music is a beautiful way to temporarily “get back” some of the person’s former self…even if just for a few minutes!

So here are seven of my top tips for using music with an Alzheimer’s patient:

1. Determine what decade (approximately) would have been their “courting years.” I usually define this as the time they were 15-25 years old and were dating, falling in love, getting married and so forth.

2. Go to Google or any search engine, or any university music library and find some of the popular music for that particular decade. For example of I Google “top 40 hits of the 1930′s” I get things like “Over the Rainbow,” “Begin the Beguine,” “Will the Circle Be Unbroken” and lots more. I get not only the names, but links to those on iTunes, Rhapsody and other sites. I also have a whole CD of this music on my website.

3. Once you have found the music for your patient or loved one, you play it for them during a quiet time during the early part of the day…before or immediately after lunch are very good times.

4. If possible, play the music for them live on a piano, guitar, autoharp or other such instrument. Live music is always more powerful than recorded. If not possible, a CD or MP3 is also good.

5. Begin to interact with the patient as you listen. sitting across from them, taking their hands, making eye contact and singing along to the music is very beneficial.

6. If possible, get the patient up out of chair or bed and move to the music with them. You don’t have to formally dance, but get them walking or stepping to the rhythms of the music.

7. Finally, repeat these same 5 or 6 familiar songs with them several times a day for at least a week. The next week you can take a different 5 or 6 songs.

You will begin to see the benefits almost immediately. Our study showed that patients who had an individualized 30-minute music session each day:

*slept better
*ate better
* were more sociable during the day
* were less combative during the day
and
*required less sleeping or calming medications

Is it worth the trouble? Absolutely! I have seen Alzheimer’s patients literally “come to life again” during their music session. Give it a try and let me know if I can help you in any way.

Recently, I have been working with a gentleman in this 80′s who is in the advanced stages of Alzheimer’s disease.  He is a retired minister and was and is much beloved in our community.  Each week I go to his home and he sits on the couch, facing the piano, with his wife on one side and an adult daughter on the other.  With a lightweight drum in his lap and a stack of hymnals and songbooks on the piano, we begin singing his favorite, familiar songs.  

Sometimes when I arrive he’s sleepy or just confused and a little grumpy.  Nevertheless, by the time I leave he is invariably sitting upright on the coach, smiling, beating the drum in perfect rhythm and singing most of the words to most of the songs!  What do we sing?  Well, these were some of yesterdays highlights:  ”Stouthearted Men, Marine’s Hymn, I’ve Been Working on the Railroad, She’ll be comin’ Around the Mountain, Stand up, stand up for Jesus, Onward Christian Soldiers, and many more.  One of the things I look for is familiar songs that have an upbeat tempo and and a steady, pulsating rhythm.

If you know someone with Alzheimer’s, please consider using music as a therapeutic intervention with them!  And remember that I do have a CD with music for memory care and Alzheimer’s patients in particular.  Click on the link to my website to purchase the CD or a download of it!

You’ve probably heard of how powerful familiar music is with Alzheimer’s patients.  When I first stepped into the field of music medicine, one of the first research studies that I did dealt with “The Therapeutic Use of Music with Alzheimer’s Patients.”  In a nutshell, it seems that the music that you listen to during your “courting years” is the music that remains most powerful in your brain and your body for the rest of your life.  As Dr. Joel Elkes put it to me, when people are diagnosed with Alzheimer’s, it is as though the “doors” to knowledge, awareness and memories close.  For some reason, the “door” to music remains open, therefore people who are in the late stages of Alzheimer’s disease can still hear the music of their “courting years” and respond by tapping their feet, their fingers or nodding their heads.  Occasionally people will even begin singing along even though they never or rarely talk anymore.

For this reason, I recorded at CD of many of the old songs from the turn of the 19th century though the 40′s.  It contains songs such as “Tip-toe through the Tulips,” “In the Good Old Summertime,” “Ain’t She Sweet” and many, many more.  If you’re interested in getting this CD, click HERE.  You can also listen to some samples of the songs at the same place. 

If you have a friend or loved one with Alzheimer’s please play their favorite, old familiar music for them.  Live music is always best, if possible.  I do travel around the country speaking about this and other healing music topics.  If your organization, church, school or association would be interested in having one of these programs, click HERE.  Hope to visit your town soon!