How can music support people living with dementia? 

It’s estimated that there are currently nearly one million people in the UK who are living with dementia. As well as experiencing memory problems, disorientation, behaviour changes and confusion, people with dementia are also more prone to psychological symptoms such as depression and anxiety. Whilst there is currently no cure for dementia, people can be supported to live well with the condition through the use of music in their day-to-day lives. 

As a Music Therapist working with people who live with dementia, I have the privilege of witnessing first-hand the powerful role which music can play. Music is accessible, providing a form of communication which doesn’t require language. It can enliven people, allowing them to express themselves spontaneously. For some, it evokes precious memories. As Dr Oliver Sacks puts it:

“Music imprints itself in the brain deeper than any other human experience.

Music evokes emotion and emotion can bring memory. Music brings back the feeling of life when nothing else can”

Why Music?

The qualities which make music so important don’t just apply to people living with dementia. Most of us can relate to the feeling of hearing a certain song and suddenly being transported back to a particular time and place. Sometimes music is irresistible; we instinctively feel we just have to join in by tapping our feet or moving to the beat. And shared appreciation of music can often be part of the important relationships in all our lives. 

However, some properties of music make it especially helpful for people with dementia: 

• Research has shown that music is processed in several different areas of the brain. This means that even if some areas are damaged by dementia, music can still reach others. In fact, music can help build new neural pathways around the damaged areas of the brain.

• Many people with dementia find that expressing themselves with language becomes more and more difficult, which can be incredibly frustrating. Music provides a way of expressing oneself which doesn’t depend on verbal ability. Additionally, it’s often the case that people who experience verbal difficulties are still able to remember and sing the words of songs, which can be highly rewarding.

• Music is intrinsically motivating and engaging. Most people enjoy some kind of music, and for many people, it has been important throughout their lives. 

• Music is often closely linked with people’s sense of personal and cultural identity. Whether it’s your favourite football team’s anthem, the song you remember your mother singing to you when you were a baby or the song that was playing when you met your spouse, these songs have external, personal meaning which can be very significant. 

• Music can provide a way of connecting with loved ones throughout the dementia journey. On one level, music is an accessible shared activity to take part in together. On another, shared musical memories can evoke reminiscence and powerful emotions.

Music therapy and dementia

Music Therapists harness these qualities of music in their work with people with dementia across every stage of the disease. Sessions might take place with individuals or groups, at care homes, day centres or in people’s own homes. No two people are the same, and consequently, Music Therapists tailor their sessions to each individual or group. Many sessions with people living with dementia use familiar music as a starting point, inviting the client to sing, hum or move to the music in whatever way feels comfortable. Some clients may prefer to listen to recorded music, or to the therapist’s playing and singing. The therapist might invite the client to use accessible percussion instruments, which could be used to play along to a well-known piece or become part of a freer improvisation. 

Music therapy can also be very helpful for someone living with more advanced dementia. At this stage, it can often be difficult to take part in other activities. Although the client may not be able to respond by singing or playing an instrument, the therapist can attune to very small signs, such as the person’s breathing or the movement of a finger, and play music in a similar rhythm or mood. The therapist will look for signs of response, such as eye contact, facial expression or vocal sounds. There’s evidence that hearing is the last sense to remain during the dying process, and so music can support people with dementia right up until the end of life.

Using music in care

If you care for or support someone living with dementia, you don’t have to be a Music Therapist or any kind of expert to use music. Here are a few tips to get you started: 

• Find out what kind of music the person likes. They may be able to tell you themselves, but if they can’t, the BBC Music Memories website is a great resource, providing clips of different types of music by genre, culture and decade. Try playing a selection of these clips and see how the person responds.

• Use the “Reminiscence Bump” to help you find appropriate music. The “Reminiscence Bump” is a finding from psychology research which shows that people tend to have stronger, more intense autobiographical memories between 10 and 30 years of age.

• Try to set aside time for music. It might be more beneficial to spend 20 minutes listening to specifically chosen music, instead of having the radio on all day in the background.

• Think about the sound environment. Can the person hear the music properly, or are there lots of noisy distractions? Do they need something to help them hear better, like hearing aids or headphones?

• Two other very helpful resources are the Playlist for Life website and the Music for Dementia Radio. Playlist for Life offers advice for creating personalised playlists for people with dementia, while Music for Dementia offers five themed radio channels playing music from different eras 24 hours a day.

• Finally, don’t worry about your own singing voice. Some people feel self-conscious about singing, but if you sing along confidently and unapologetically, it will help the person you care for to feel comfortable and join in.

Whether it’s part of a music therapy session or a sing-along to a CD, thinking about how to bring music into the lives of people with dementia can be hugely beneficial for them and their carers. 

Becky Dowson, Music Therapist, Chiltern Music Therapy

www.chilternmusictherapy.co.uk