The Benefit of Music for Dementia: Workshop.

I promote music as a healing agent,. Music can help us become healthier, happier and more humane. This blog will talk about how music can help with dementia prevention and progression and how caregivers can use music. I also conduct workshop with this topic. 

Have you heard of non-verbal dementia patients being able to sing along, when a caregiver sings them their favorite songs? “Alive Inside” documents the power of music on dementia patients. Here is the trailer.

What is behind the power of music on dementia patients? One is the fact that aurality has a lot to do with our survival instinct.

Our sense of hearing is the sense that would most likely save our lives by detecting a life-threatening warnings. It is the only sense that remains alert when we sleep. Our brain wiring to process sound is very simple, so that the brain can process it in a tenth of the time it takes to process visual information. It skips logic and conscious thoughts, and appeals directly to our emotions, to our reptilian brain – the primal part of our brain. That part of our brain remains intact, even when we suffer from dementia.

The other thing that gives music its power is its ability to bring people together. When we listen to music, our hearts start to beat to the pulse of the music, our breathing coordinates with the phrasing, and even our brainwaves synchronizes to the music. The sense of bonding we experience when we share a musical experience, whether at a concert, singing together, etc. really starts on the physiological level. Humans cannot survive alone. We are social animals, meant to help each other thrive. Music helps us feel connected, making us feel safe and secure to belong to each other. Music lowers our blood pressure, heart rate and stress hormone (cortisol) induction, It also helps reduce our perception of pain. For example, it significantly lowers the perioperative prescription of pain medication. Having dementia is, in itself, already adds stress and anxiety to your daily life. Music can help alleviate some of these negative affects of the diagnosis and symptom progression, giving the patients sense of security and relaxation.

World Health Organization Promotes Music for Dementia!

On November 2019, WHO announced its findings between arts and health, based on their examination of 900 studies from all over the world. Let me quote some of their statement specifically on dementia and music. Here is the link to the original source.

“Music, in particular, has been found to support cognition in people with dementia. A number of studies have found beneficial effects of listening to and making music for global cognition as well as for verbal fluency, visuospatial skills and speech (805–807)…Singing, in particular, has been found to improve a wide range of cognitive skills including attention, episodic memory and executive function (810)..。 In relation to mental health in dementia, many studies have found benefits of music and dance for reducing anxiety (including stress hormones) and also some evidence of their benefits for depression, particularly if individuals engage regularly over long periods of time (e.g. three months or more) (805,816,817,826–828). Music has been found to enhance the effects of reminiscence therapies on stress, anxiety and depression (829) … Long-term group music has also been found to reduce increases in blood pressure and support the maintenance of physical health (830). Relatedly, active engagement with music and music listening have been found to reduce agitation (e.g. repetitive acts, wandering, restlessness and aggressive behaviours) and behavioural problems in people with dementia (805,826,827,831,832). Notably, these results have been found for many types of dementia, including Alzheimer’s disease (827).”

http://www.euro.who.int/en/publications/abstracts/what-is-the-evidence-on-the-role-of-the-arts-in-improving-health-and-well-being-a-scoping-review-2019

Great news, isn’t it? Now, let’s think about how to implement the effect of music down below, briefly.

Dementia Prevention

There is a study on twins. They took twins where one of the twins had dementia, and asked questions. The resulting findings were many, but one of them was that if you play an instrument, your are 64% less likely to develop dementia. Other studies reveal that playing an instrument can quicken your reaction time. It can even change the structure of your brain, if practiced long-term. I am sure you have heard that practicing an instrument is good for children’s brain development, and your abilities with languages. What is behind these magics of playing an instrument?

Playing an instrument requires you to coordinate different parts of your brain and body: eye-hand coordination, left and right side of your body linked to the different hemispheres of your brain, your sense of hearing and touch, pitch and rhythm recognition and execution… It’s a full-brain workout! It requires you to concentrate. Most importantly, the reward for a successful execution is beautiful music. It’s fun. Enjoyment enhances your focus, helping you improve, making the practice even more fun. It’s a win-win virtuous cycle!

In addition, moving your hand works your brain. Your whole cerebrum and cells of your hands are closely linked. The image below is an embodiment of amount of brain dedicated to sensory perception of each part of our body. See how big our hands become?

One more thing. You notice in the sensory homunculus that our mouth and tongue are also closely linked to our brain. That’s one of the reasons why singing is so effective. Moving your mouth actively to enunciate, controlling your breath and projecting your voice… All these things do not only activate your mouth and facial muscles, but it increases blood circulation, encourages you to breath deeper. And always learning new pieces for your next concert helps your production of new synapses.

Music to Help Address Symptoms of Dementia.

There are so many variables, such as the type of dementia, degree of the disease’s progression, the personal circumstances and personalities. Here, I will make very simple and broad general suggestions, briefly.

Having dementia in itself is stressful. Your future prospects are greatly influenced. You become insecure about your own memories. One study reveals the links between chronic stress and PTSD increases the “statistical risk for various forms of dementia.” Long-term exposure to stress can have destructive effect on “immune, metabolic and cardiovascular systems and cause damage to the brain.” Furthermore, “anxiety may hasten the demise of people diagnosed with mild cognitive impairment into Alzheimer’s disease.” Please use music to alleviate your stress. Listening to music with beats slower than your heart will help you relax. Moving your body to music with beats slightly faster than your heart beat will lighten your mood.

More you enjoy your music, easier it is to incorporate it in your daily life! What is the most enjoyable musical activity for you? More actively engaged you are with music, the better. If you are listening, don’t just passively expose your body to the music. Rather, visualize the music in colors, images, characters… Perhaps, draw them as pictures after listening to each piece. Maybe a scene or a story, rather than an image, will come to your mind with a piece. Develop it! Moving your body to music, clapping your hand, shaking your head, and stepping your feet would be fantastic. Break into a dance! You can also learn to play an instrument. How about a drum? Whistling is perfectly fine! Choral singing is great, too. Find a musical activity that is most enjoyable to you. Perhaps you want to compose a song! One of the great benefits of musical activity is the induction of oxytocin, the so-called love hormone. Music is fundamentally a communal activity. And the ill health effects of loneliness is increasingly quantified as data. Some suggest the connection between isolation and dementia. Music encourages social behaviors, and also can act as an anti-depressant.

Music to Support the Caregivers.

The same report by World Health Organization I quoted above in regards to music and dementia, recommends the use of music for hospital staff and caregivers. (On Page 26-28 in the report) Here is a brief summary.

Arts classes have been found to improve emotional recognition, cultivation of empathy and awareness of multiple perspectives in clinicians (440,441), and music and dramatic arts can enhance relatedness to people from different backgrounds (442)… (Among the caregivers,) [the] development of empathy through music and movement has been linked with lower stress and burn-out and higher resilience (452–454)…Music has been found to improve mood and reduce stress while working, as well as improving levels of concentration, efficiency, enthusiasm and ordered working.

The well-being benefits of the arts extend to informal carers. Arts programmes can support interactions between carers and those receiving care and can help with humanization of the person being cared for, thereby improving care strategies (468). Relatedly, joint carer–care recipient arts activities have been found to improve communication and carer intimacy behaviours towards a care recipient, leading to closer emotional responses and physical behaviours (469,470). Joint carer–care recipient arts groups can also help to remove strain from caregivers, provide respite care, and give opportunities for emotional support, practical networking and the sharing of resources (471–473)… Arts classes can be used in care settings as a way to understand carers’ needs and impart important caring information (475). They can also build a positive sense of personal identity and self-efficacy (472,474,477,478). Finally, activities such as drumming, singing or listening to music have been found to improve relaxation and well-being for carers, and decrease their levels of anxiety and stress (479–482).

https://apps.who.int/iris/bitstream/handle/10665/329834/9789289054553-eng.pdf

The stress felt by the caregivers transfers to the ones receiving the care. Self-sacrifice by the caregivers can result with two people in need of care. Remember how in the emergency procedure drill on airplanes, they always tell you to put your own oxygen mask first before aiding those around you? It is, ultimately, in the best interest of the patients for the caregivers to care for themselves. Please use music to alleviate your stress.

With the progression of dementia, communication gap becomes inevitable. Music can help you transcend some of these gaps. Make a playlist of “your” songs. It will not only be enjoyable for both of you, but help aid their episodic memory of the patient. Participate in musical activities. Sing together. Move to music together.

I hope my blog entry can help you. Please do contact me, if you have any questions about any of what I wrote above. My first “Brain Workout with Music” workshop is scheduled to start this summer.