“Music can heal the wound that medicine cannot touch”
These words by author Debasish Mridha hold true in every possible way. Dementia is a complex and debilitating neurodegenerative disease. It occurs when parts of our brain increasingly get damaged over time, causing a decline in multiple cognitive abilities. Loss of language and vocabulary slowly steals away the ability to connect, express and share feelings.
Management of dementia requires both pharmacological and non-pharmacological approaches. Music has an important role to play in managing persons with dementia (PwD). For the last 3-4 decades, various studies have been undertaken to understand the relationship of music with PwD and the role it plays, either educational, recreational or therapeutic. Many studies prove the efficiency of music as a complementary therapy with no known side-effects. The authors of ‘Nonpharmacological interventions to reduce behavioral and psychological symptoms of dementia: A systematic review (BioMed Research International, 2015)’, found that music interventions have a significant impact on biological, psychological, and cognitive symptoms of dementia. They focus on more relational aspects, therefore they should be considered as a primary intervention.
While every intervention we use needs to be evidence-based, this does not come as a surprise. Music has been a versatile companion through most of our lives. As babies we would fall asleep to lullabies, in school music or dance would be one of the first hobbies we pick up, as teenagers we cry though heartbreaks or get high on headbanging, and as adults, it is often a reliable stress-relieving companion. Music remains a constant companion throughout our lives.
Musical memory is often preserved, even in the later stages of dementia. There is enough research and evidence that talks about the fact that music is capable of evoking strong positive emotions. Music can lower the body’s level of cortisol (a hormone that can contribute to feelings of stress and anxiety), and it can also stimulate positive feelings by triggering other chemical reactions in the brain.
It is an engaging and emotionally powerful medium. Music provides behavioral, emotional benefits; and assists the elderly to improve his/her quality of life. We have seen enough instances in which music has a strong effect on an elder’s moods, cognitive abilities, and even their physiology, resulting in overall enhancement of well-being. For your loved ones with dementia, music promotes overall health & wellness, elicits positive memories, improves cognition and speech, encourages self-expression, increases self-esteem, dispels anxiety, assists in memory recall, as well as provides a communicative structure.
At our dementia care homes, we ensure that music becomes an integral part of the daily schedule and overall care plan. Caregivers can encourage their loved ones with dementia to interact with music in different ways throughout the day. Elders can start their day with spiritual or religious music of choice, ADLs (activities of daily living), which can be stressful such as bathing or grooming, but can be managed better by playing favourite tunes to build a positive association. During the day, it can be used as an active session of antakshari or karaoke or group sessions, and at evening or night it can help overcome sundowning or sleep cycle issues. One of the greatest roles that music plays is also to be a companion. It also helps to overcome the feeling of void, nothingness for elders, especially when they are to themselves.
The goal of music therapy in dementia should be to facilitate well-being and positive emotions. Through this, other symptoms such as agitation, anxiety and incoherence or confusion can be managed more effectively. Music therapy assists at the various stages of dementia, whether it is early or late stage. It helps develop a multisensory communicative environment for late-stage dementia, when communication is a huge challenge. Even in end of life dementia, music therapy is seen to aid in expression as well as providing a warm environment. Music is one of the main ingredients that adds colour to the lives of the elderly with dementia.
I would like to end with what the German poet Heinrich Heine once said, “When words leave off, music begins.”