There is a substantial body of research that provides evidence of the crucial role that music plays in support of people with dementia, writes Diana Kerr.
We all respond to music. Mothers sing to their newborn babies to calm and make them feel secure; adults turn to music to express emotions, reflect feelings, to make them happy and to make them sad. Music is a core element in all our lives.
This is no less the case for people with dementia. As other experiences become confusing and communication becomes difficult, the role and experience of music gains importance. Music stays with us long after speech and other skills have gone. Anyone who has worked with people with dementia will have witnessed people who have lost the ability to speak coherently, or find words at all, sing an entire song perfectly. It is not only the words but the musical memory that stays, so people will hum or whistle a tune even when the words to the song have gone.
One of the important aspects of supporting people with dementia is to minimise the impact of their losses and to play to their strengths. If people can sing then we should be encouraging this, so as to maintain the skill and the sense of achievement and joy that goes with it.
There is a substantial body of research that provides evidence of the crucial role that music plays in support of people with dementia.We know that music is effective in reducing a range of challenging behaviour. Playing calming music will reduce agitation (although, music should not be played for more than 20 minutes at a time as research shows it can become a source of irritation and carers need to monitor this); music can reduce aggressive behaviour, ‘wandering’, repetitive vocalisation and irritability
We know that if caregivers sing to people with dementia when carrying out intimate tasks the incidence of challenging behaviour can be significantly reduced. This may be the result of a number of factors. For the caregiver the mere act of singing reduces stress in them and this will be transmitted to the person with dementia. Also, the sound of the person singing may be calming because it is reminiscent of the mother singing to the child.
If we play the right music at mealtimes people will be more relaxed, will sit longer at the table and will eat more. Given that people with dementia have problems with eating, this appears to be an opportunity not to be missed. Remember to use music that is important to the person with dementia. Different people respond to different music. There is evidence that we remember best the music we heard between the ages of 16 and 24.
Using music appropriately can lead to an improvement in reality orientation scores, memory recall and social behaviour. The use of music will often trigger communication. It may trigger speech but it can also allow the person with dementia to sing something that reflects their mood or articulate something they want to say but can only sing. The lady who sang to me ‘Show me the way to go home’ is an excellent example of that.
Even at the end stage of the condition, when people are close to death, music will reach them. It is important not to assume that the person lying inert and apparently not responding is oblivious to the sound of music. Play or sing to people at end stage and you will see changes in their facial expression, even vocal activity and physical movement. Music can provide one last way to reach the person and enable them to respond at an emotional level.
Diana Kerr
August 2015
Resources
Singing Groups for People with Dementia. A guide to setting up and running groups in community and residential settings. (2015). By Diana Kerr. Published by The Choir Press. £10.00