Some things are never completely forgotten. Your first love, the overwhelming feeling of holding your first child in your arms — and certainly not your favorite melodies from years gone by. They accompanied the first dance with a loved one or they formed the soundtrack of the first summer holidays you went on without your parents. Just hearing these melodies brings the past back to life.
As it turns out, the same holds true for patients with dementia. A project by the Friedrich Schiller University Jena in Germany, led by Gabriele Wilz, PhD, and by the National Association of Statutory Health Insurance Funds, is relying on music's power to awaken memories. Evidently, it can send people with dementia on a journey through time, just as it does for people whose memories are intact. Whether it is a hiking song or church choir, a marching band, or grand opera, often each favorite song is associated with a significant stage of life.
The connection has been known for some time now, explains the working group. However, there has not been a controlled, randomized study to date. The project, Individualized Music for People With Dementia: Improvement in Quality of Life and Social Participation of People With Dementia in Institutional Care, has addressed this gap and has achieved astounding results.
The Jena project took place in five nursing homes in Thuringia, Germany, and included 130 residents with dementia. After hearing their favorite music, the residents were calmer, more cheerful, and more communicative. The project ran from 2018 to 2021.
Since 2021, the project has been expanded to include patients with dementia who are being looked after at home by their relatives.
Bach to Armstrong
It was particularly difficult to find suitable music for the seniors. With the help of patients' relatives and their memories of their mother's or grandfather's younger years, the university associates were thrown into detective mode to draw up three lists of potentially suitable music for each patient. The lists included the hiking song of Thuringia, "Das Rennsteiglied," the sea shanty "Eine Seefahrt, Die Ist Lustig," the Louis Armstrong hit, "What a Wonderful World," and the Bach hymn, "Ah! Lord, How Shall I Meet Thee?"
"A total of over 1000 pieces of music were listened to," said Doreen Rother, psychologist and scientific associate in the project. Three lists of music were compiled for each patient.
Over a period of 6 weeks, the seniors listened to their favorite music via headphones and an MP3 player for 20 minutes at a time three or four times a week.
The Jena-based researchers describe how even the most severely afflicted patients still had some musical memory. Music that has been known for a long period activates a broad cerebral network. However, it is not the music per se that is helpful. Other factors are whether there is a connection with the situation in which it was heard or whether it suits the listener's taste in music exactly.
This explains the effects that the beloved melodies have on the seniors. "The female patient, who otherwise says nothing for weeks on end, begins to laugh," nurses reported. "At Beethoven's Ninth Symphony, she seemed touched, clasped her hands, and shed a tear," observed another nurse. Social contact with the elderly people has become "significantly more intimate and rooted," according to another person. The music alleviates the patients' restlessness, and some "look forward to listening to the music all day long," reported another nurse.
At the same time, there were few negative effects from the music. "Extremely rarely did the patients react to the music with displeasure or impatience, causing us to stop," reported Rother.
Expanding the Program
The music had a positive effect on care. The participants became more amenable. "But we do not want to use the music excessively," emphasized Rother. "Still, music is a cost-effective, low-risk, and relatively easy-to-use way to improve people's well-being. It can offer people suffering from dementia a moment of joy, of memory, or of well-being."
Nurses observed relaxation and calming in almost 28% of seniors, improved mood in around 26%, and more frequent reactions and stronger social communication in 13%.
Because of the good experiences, for patients with dementia who are being cared for at home, the patient's favorite music is also being played. The use of an app and a tablet computer should make it easier for the relatives and patients to apply the method.
"There's absolutely nothing negative I can say about this," said one participant. "I can only say that what they have just done with me has touched me deeply. I also really wanted to get up and dance properly."
This article was translated from the Medscape German edition.
Lead image: Toa555/Dreamstime
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Cite this: Music Improves Quality of Life for Patients With Dementia - Medscape - Dec 27, 2022.