The University of Utah health care system gathered evidence using MRI scans that showed that listening to familiar music increases connectivity in the brain region known as the salience network. This part of the brain selects which stimuli a person chooses to focus on and remains unaffected in people with dementia.
Although this analysis provides evidence that may lead to further research, music therapy in Dallas has been an alternative to drugs for years. Dallas County has about 200 facilities that are certified as providers of a music and memory program established in 2010 that offers dementia patients portable music players so they can listen to personalized playlists.
For the most part, these patients listen to music from the decades they remember most, meaning memory becomes a key factor in music taste. In rehabilitation centers like Monarch Pavilion, which treats both young and old dementia patients, it’s hard to find an artist or genre that both age groups share interest in. Andrea Jones, activity director, says the age gap becomes more apparent in playlist music choices.
“My older residents, they don’t like today’s music, I can tell you that,” Jones says. “I don’t know a lot of music back from maybe the '60s and '50s that my younger crowd likes. A lot of our younger people just like playing what’s on today, the '80s and '90s. Maybe Michael Jackson, everybody can agree on him. But my older 60- and 70-year-olds, they don’t like the fast-beat type of music.”
The environment a patient grew up in can have an influence on musical preferences as well. As Jones explains, not everyone is open to new sounds.
“When I do play music from a different culture, they don’t want to hear it," Jones says. "They’re used to their culture, so I think that does make a difference.”
An important aspect of a patient’s playlist is the emotional connection that comes from the songs. It becomes crucial to get to know the patient and dig deep into his or her background to find what has meaning. If a person is unable to explain his or her musical interest, families are usually aware of the music the person liked. Other times, what’s in a patient's home might generate some ideas.
After this information is collected, playlists can be created and tested on patients. At Traymore Nursing Center, life enrichment coordinator Quie Williams sees how the selected music improves the mood of each individual.
“We play music that relates to the resident,” Williams says. “We have some that like spiritual music, Christian gospel music — a lot of country, classical, soothing music, nature. When you give them headphones, they smile and show that they’re enjoying the music. They may even verbally sing it out loud.”
Live music can also be integrated into the therapy. Monarch Pavilion and Traymore Nursing Center are among many establishments in Dallas that have local musicians and volunteers perform. Patients show signs of happiness when the music feels right for them.
Music Starz Studios, a branch of Serenata Strings, owned by Karen Lim-Smith and her husband, has performed for dementia patients in assisted living and memory care facilities since 2015. Smith teaches the violin, viola, and piano and performs with students from grades four to 10, and she teaches children as young as 5. Every Sunday, the group plays at three or four facilities in the Flower Mound and Lewisville area. It starts at 11 a.m. at Avanti Senior Living and ends around 4 p.m. at Arbor House Assisted Living Memory Care.
Smith has seen the positive effects the performances have on the patients. She describes how song selection influences reactions.
“We go in, and we perform selections they love, such as patriotic songs like ‘God Bless America,’ ‘My Land is Your Land,’ ‘Star-Spangled Banner’ and ‘If I Had a Hammer,’” she says. “We also perform hymns, recognizable tunes that they all can remember, and that’s what helps them — because these tunes trigger a memory. The tunes become sort of like an oral stimulant that triggers something in their memory and it brings back memories.”
On May 10, seven of Smith’s students won awards at the Sun & Star Legacy Award Dinner, hosted by the Japan America Society of Dallas Fort Worth, for their volunteer performances. Smith says the visits benefit both the patients and the students.
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“It is a win-win situation,” she says. “Every time that we go [see the patients], they want to hug us [and] kiss us. You can imagine how lonely they are. They crave companionship. You can’t get that with an iPod. You can talk music therapy in terms of [being] medical and scientific, but I think music therapy is a two-way communication, interactive therapy. I think that it brings them far greater joy to be able to share that with somebody else than a machine, although both ways work. They want interaction.
"Learning an instrument or even singing while the music is being played already provides a lot of stimulus — and it’s not just stimulus for the brain. If you are learning how to play piano, it’s getting your muscles active as opposed to just listening to music.”
Places like Home Care Assistance of Dallas are considering teaching dementia patients how to play instruments. General manager Jared Caplan recounts how he learned about the treatment.
“I’m a member of the franchise advisory council for our organization,” Caplan says, “and at our last meeting, the owner of the Cincinnati franchise was explaining that there is research and anecdotal evidence that when people with dementia actually participate in playing the music, there’s an ever more dramatic positive impact. What has been reported is that the therapeutic benefit of playing music versus listening to music is off the charts. Playing the music is very impactful.”