Dementia patients may find peace, connection in music

Elaine Lebar became a TikTok sensation at age 92 when her daughter Randi posted a video of her playing “Moonlight Sonata” at her senior-living facility. At the time, Elaine had been living with dementia for nearly 10 years.

Randi Lebar said her mother had lost many parts of herself, but the music she began learning at age 3 was still there. “When she wasn’t playing, she was lost and confused, but at the piano, she was happy and grounded,” Randi said. Elaine passed away in September at age 97.

I met Randi, a retired orthopedic surgeon, at a patient advocacy conference I recently hosted. And she got me to thinking about the power of music to soothe and connect with dementia patients.

A 2018 study found that music activates parts of the brain that are more resistant to diseases like Alzheimer’s, including the prefrontal cortex. Other research has consistently found that memories of music, along with the ability to play music, are often preserved longer than language and other memory skills. Yes, the brain works in mysterious ways.

Music therapy is widely recognized as a valuable non-drug therapy that can help manage many dementia symptoms, such as depression, agitation, apathy and anxiety. It can also encourage speaking and social interaction, and even improve cognitive function. Family members and caregivers also enjoy the benefits of music therapy because it may make their jobs a bit easier.

There are some 8,000 licensed music therapists around the country who work with people of all ages and abilities, including those with physical and cognitive challenges. Whether or not a music therapist is on staff, some memory-care facilities incorporate music into their care of dementia patients.

Over a decade ago, residents at the Coler Memory Care Unit in New York were given iPods with personalized playlists. Results showed a decreased use of antipsychotic medications, reduced falls and fewer physical altercations, they reported. Not incidentally, staff morale improved and the approach was shown to be highly cost-effective.

There are two main types of music therapy.

• Active: Playing an instrument — even simple percussion instruments — and singing appear to be most effective for reducing depressive symptoms and improving cognition.

• Receptive: Just listening to music seems to reduce agitation and may be more suitable for patients in advanced stages of dementia.

While a structured music therapy program may involve weekly lessons, art activities and guided listening, you don’t need to be a music therapist to try music to help a loved one with dementia.

Here are some recommendations and caveats:

• Results may vary. Dementia patients are all individuals, and they may not respond in the same way to music. The stage of their disease, personal preferences and cultural background can impact a patient’s receptivity.

• Introduce it gradually. Experiment with an hour of music at different times of the day. You may find that evening or bedtime is best because many patients experience “sundowner” syndrome, which tends to increase agitation and anxiety.

• Personalization seems to provide the best outcomes. Did your loved one play an instrument? You could see if their muscle memory will let them play it. Otherwise, think about the kinds of music they enjoyed before their illness and prepare playlists just for them. Some baby boomers today may enjoy some soft rock more than classical.

• Be wary of loud or fast-paced music. This can increase the agitation that you’re trying to reduce.

• Observe the effects. Music may prompt a loved one to reminisce, improving their sense of self.

Remember that, as of yet anyway, there’s no cure for Alzheimer’s and other forms of dementia. All you can hope for, really, is a calmer, happier loved one who is perhaps reliving some fond memories or emotions.

As Randi said, “If it were not for her music, my mom would have just been another lost little old lady.”

• Teri (Dreher) Frykenberg, R.N., a registered nurse and board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones” and her new book, “Advocating Well: Strategies for Finding Strength and Understanding in Health Care,” available at Amazon.com. Contact her at Teri@NurseAdvocateEntrepreneur.com to set up a free phone consultation.