For Elders With Dementia, Musical Awakenings
EnlargeMichael Rossato-Bennett
Joe, a nursing home resident, broke into song during a personalized music session. His story and others are documented in the film Alive Inside.
COMMENTS FROM THE NPR COMMUNITY
Wow, this was a driveway moment for me, I am a social service worker in a nursing home and I couldn%u2019t wait to get in the house to see the video. I sat at my home desk and cried as every day we all work hard to give our residents quality of life and enjoyment, and any social worker or activity worker can tell you there are many residents like Henry and would give just about anything to give them just a moment of happiness like henry. I can%u2019t wait to go to work and share this story.
Henry, an elderly Alzheimer's patient in an American nursing home, recently became a viral star. In a short video that has been viewed millions of times online, he starts out slumped over and unresponsive — but undergoes a remarkable transformation as he listens to music on a pair of headphones.
YouTube
The clip is part of a documentary called Alive Inside, which follows social worker Dan Cohen as he creates personalized iPod playlists for people in elder care facilities, hoping to reconnect them with the music they love. Cohen tells NPR's Melissa Block that the video of Henry is a great example of the link between music and memory.
"He is able to actually answer questions and speak about his youth, and this is sort of the magic of music that's familiar for those with dementia," Cohen says. "Even though Alzheimer's and various forms of dementia will ravage many parts of the brain, long-term memory of music from when one was young remains very often. So if you tap that, you really get that kind of awakening response. It's pretty exciting to see."
Cohen says his goal is to make access to personalized music the standard of care at nursing facilities. An early concern, he says, was that headphones might isolate the patients even further. But when he first implemented the project on a large scale in 2008, putting 200 iPods in four facilities around New York, he got the opposite result: a flood of stories from the staff about increased socialization.
"People wanted to share their music with others: 'Here, you've gotta listen to this,' or 'What was the name of that song?' " Cohen says. "The music is great, but to me, perhaps the even bigger win is people having better and more relationships with those around them."
DAN COHEN'S TIPS ON MUSIC AND THE ELDERLY
Get the playlist right. Find out the person's tastes and create a varied mix: no more than five to seven songs per artist. Have them weed out tracks that are so-so, so you end up with 100 or 200 songs that all resonate.
Keep it simple. Make sure the elder knows how to use the player, or that someone nearby can help. Use over-ear headphones rather than earbuds, which can fall out.
Be patient. It can take time to reach the music memory. If the person is responding, feel free to sing along. If someone doesn't like the headphones, try a small speaker at first and incorporate the headphones gradually over time.
Keep it special. Don't leave the player on all the time. Nursing homes are finding it works well during transitions: If someone is hesitant to take a bath or eat or get dressed, music may help move things along.
Cohen admits that the realities of funding and staffing mean that not all nursing homes will have the appetite for this level of individualized care. However, he points out that the pace of technological advancement is making iPods cheaper and easier to round up.
"My goal has been to find ways of bringing the cost down to zero," he says. "Since there have been so many generations of new digital devices that come fast and furious, we havethe old iPods — many of us in our drawers at home — so let's bring them in. On Long Island, there are five school districts that are running iPod donation drives."
Cohen says that, ultimately, the project is about helping people remember who they are.
"When you leave your home, you leave your family, you leave your surroundings and you go into a new environment; it's tough," he says. "So anything that you can maintain or stay connected with that relates to you [is helpful]. And what's more core to your being than music?"
"When you leave your home, you leave your family, you leave your surroundings and you go into a new environment; it's tough," he says. "So anything that you can maintain or stay connected with that relates to you [is helpful]. And what's more core to your being than music?"
Alive Inside screens April 18, 20 and 21 at the Rubin Museum in New York City. You can learn more, and see additional clips from the film, at the Music & Memory website.
Alzheimer's is thus a social disease. We around the labeled elder must resist the tendency to give up on competence, and actively look for remaining abilities and exercise them. If long-term memory lasts, then any activity relying on that ability fits the bill.
Music is certainly one of the best. But so is reminiscence, storytelling, memoir and autobiographical writing. I like the first two because you get social interaction as a bonus with using LT memory. Cooking and sharing traditional meals from the elder's childhood has a similar effect as music, in that our sense of smell is as powerful as hearing familiar sounds...and we physically nourish ourselves as we do it!
Imagine an art gallery displaying elder's visual art while playing music from the age cohort's time. A big garden space surrounding it, with wheelchair access and paths wide enough to let two chairs pass. In Portland we have Amy Henderson's Geezer Gallery, and similar community gathering places popping up everywhere.
Still gives me the shivers thinking about it today ...
From the early 1990s until the mid 2000s I worked as a volunteer sound engineer for the Merle Watson Memorial Bluegrass Festival held annually in Wilkesboro, NC. My job was to go out with my partner Gary and set up sound systems at schools, nursing homes, and other community venues so that festival performers could put on free shows for the people in the county.
One year we were doing a gig at a nursing home in Wilkesboro; the performer was George Hamilton IV, a gospel/country singer popular in the 60s. Nursing home gigs were set up in the community room or cafeteria, and as we are setting up and testing they start bringing in the residents. They generally arrange the audience such that the "awake" folks were in the front, with the level of "awakeness" decreasing until you got to the unresponsive ones in the back.
George IV kicked off his show, and about 20 minutes in he was doing some kind of train song (I'm not much into the 60's country scene). It was a typical song, lots of verses and a catchy chorus. A couple of choruses in, I noticed a beautiful strong baritone voice .. I scanned the front rows and didn't see anyone who looked like they could be making that much sound. continued..
1) You can buy one song instead of an entire album. That is HUGE.
2) Records, cassettes, and CDs can be damaged/broken and will lose sound quality over time. If you're going to let multiple patients share music, you'd be looking at replacing albums every several years or less.
3) iPods or any mp3 player will be easy to move from one patient's room to another and can be taken on the go or while exercising.
4) The patient doesn't have to deal with fast-forward/rewind like they would with cassettes.
I did wonder about how easily an elderly dementia patient can use an iPod, but apparently, it's possible.
El tiempo pasa y no te puedo olvidar (Time passes and I still cannot forget you)
There is a key somewhere in the structure of music, since the beginning of civilization, before the written word, that unlocks the door to our memories.
I wish the "iPod" thing hadn't taken over like "Kleenex" — well, esp. because it hasn't yet transferred to being a generic term that applies to any digital music player. The technology is great, and music is great, but Apple doesn't deserve any credit here.
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Especially when their stock is at $600 per share and they are paying $1.50 per hour for labor.
I wish the "iPod" thing hadn't taken over like "Kleenex" — well, esp. because it hasn't yet transferred to being a generic term that applies to any digital music player. The technology is great, and music is great, but Apple doesn't deserve any credit here. Furthermore, none of this even required the new digital technology really. Even CD players or cassette players would have worked here.