Music

The story of Mrs F: how music therapy can benefit individuals with dementia, one memory at a time

Hannah talks us through the powerful medium of music therapy and how the intervention can help benefit those with dementia

How can dementia be treated? Can only pharmaceutical drugs improve the livelihoods of those with a dementia diagnosis? Or are there other interventions that are effective in treating the symptoms of dementia?

Dementia is not an illness itself, but is a syndrome where two or more cognitive capacities decline, causing impairment in function. There are many different types of dementia, such as Alzheimer’s disease, vascular dementia, and frontotemporal dementia, to name a few. These types of dementia affect the brain in different ways, but some symptoms remain fairly consistent, such as issues with memory. Music therapy is a medium that can help individuals with dementia cope with various symptoms that are problematic.

What is music therapy?

Music therapy is a non-pharmacological method of supporting the psychological, emotional, physical, cognitive, communicative and social needs of those who have been affected by injury, illness or disability. Performed by registered Health and Care Professions Council (HCPC) music therapists, music therapy is an established psychological clinical intervention which is used as a healing method through the physical properties of music (e.g. playing percussion instruments to treat physical disabilities), and creates a means to interact and express oneself.

“each client will have specific needs that the therapy would try to facilitate”

There is a lot of variation between music therapy sessions, as each client will have specific needs that the therapy would try to facilitate. (If you are interested in watching some sessions take place, I’d recommend visiting the Nordoff Robbins YouTube channel). Sessions can also take place in various settings, including mainstream schools, nursing homes, hospices, and specialised music therapy centres, and are performed either in groups or one-to-one.

What happens in a music therapy session dedicated to individuals with dementia?

A typical music therapy session for individuals with dementia usually involves singing and playing small percussive instruments. The music therapist would usually pick songs that were popular in their childhood, and encourage participants to sing these songs in the sessions whilst a therapist accompanies them on piano.

The use of familiar songs in this situation helps bring back memories of the dementia clients, and aids communication between clients and their family members through the singing in sessions. Additionally, playing small percussion instruments in sessions may help build co-ordination in clients, as well as act as a means of communication between clients and the music therapist.

The Story of Mrs F

One example of how music therapy can be used to benefit those with dementia is portrayed through the case of Mrs F, her name of which is a pseudonym created by the study’s researchers. Mrs F was diagnosed with Pick’s disease, a type of frontotemporal dementia, and her sister was growing more worried about her sibling as the disease progressed. Mrs F began to show aggression to her loved ones, became agitated easily, and struggled with daily tasks, such as eating and washing.

“she relaxed in her chair and smiled with the other participants during the therapy”

Mrs F’s sister decided to take her sibling to music therapy to see if the symptoms of the Pick’s disease could be controlled. The sessions were held in groups, and they sung well-known songs and were accompanied by a music therapist on the piano. Mrs F became more integrated in the sessions as the weeks went on, and she relaxed in her chair and smiled with the other participants during the therapy.

Perhaps the most important outcome of the music therapy was the decrease in aggressive behaviour both during and after the music therapy, as before the sessions commenced it was noted how Mrs F often had outbursts of anger and threatening behaviour.

“after four weeks of sessions, her heart rate had gradually decreased to 77.2 bpm”

Most intriguingly, it was noted that Mrs F’s heart rate had decreased over the course of the music therapy. Before Mrs F had started the therapy, her heart rate was recorded at 83.7 beats per minute, but after four weeks of sessions, her heart rate had gradually decreased to 77.2 bpm. Another study with a larger sample size and with different participants also showed a gradual decrease in the heart rates of participants over the course of music therapy sessions!

Music therapy and long-term effects

Mrs F is not unique in benefiting from music therapy; there are many other individuals with dementia who have gained something positive from this type of creative therapy. On one special care unit, the use of group music therapy sessions led to a greater food intake, improved sleep, and reduced the anxiety of many participants, days after the therapy had taken place.

“for some participants previous aggression was a symptom of hopelessness”

There are also more cases where music therapy has reduced aggression in dementia clients, and it has been acknowledged that for some participants previous aggression was a symptom of hopelessness. This feeling was reduced when undertaking music therapy, as it gave clients something to look forward to.

From a neuroscientific perspective it is unclear why music therapy has such a great impact upon those with dementia, but is has been discussed that psychologically the music gives people with dementia an opportunity to express inner feelings and to feel understood, and enables participants to re-enter a social world.

Hannah Pickard

Featured image courtesy of Mark Pearse via Flickr.

Image use licence here.

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Bibliography in order of reference

Rabins, P. V. & Blass, D. M., 2014. ‘Dementia’, Annals of Internal Medicine (In the Clinic), 161(3), pp. 1–16.

British Association of Music Therapy, n.d. What is music therapy? [Online] Available at:
https://www.bamt.org/music-therapy/what-is-music-therapy.html

Darnley-Smith, R. & Patey, H. M., 2003. Music therapy. London; California; New Dehli: SAGE Publications, p.
11.

Bunt, L., Hosykns, S. & Swami, S., 2002. The Handbook of Music Therapy. 1st ed. Hove: Routledge. p. 29, p 13-14

Vink, A. C., Brusinsma, M. S. & Schplten, R., 2003. ‘Music therapy for people with dementia’, Cochrane
Database of Systematic Reviews, Issue 4 (Review).

Ridder, H. M. & Aldridge, D., 2005. ‘Individual Music Therapy with Person with Frontotemporal Dementia’,
Nordic Journal of Music Therapy, 14(2), pp. 91–106.

alzheimers.net, n.d. What is Pick’s Disease? [Online] Available at: https://www.alzheimers.net/what-is-picks-disease/

Ridder, H. M., 2003. Singing Dialogue: Music therapy with persons in advanced stages of dementia,
Denmark: Aalborg University.

Thomas, D. W., Heitman, R. J. & Alexander, T., 1997. ‘The Effects of Music on Bathing Cooperation for
Residents with Dementia’, Journal of Music Therapy, 34(4), pp. 246–259.

Wigram, T., Pederson, I. N. & Bonde, L. O., 2002. A Comprehensive Guide to Music Therapy: Theory, Clinical
Practice, Research and Training. London: Jessica Kingsley Publications.

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