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Music as Therapy for Alzheimer's

Martin Luther 

Martin Luther (1483-1546) one of God's great servants and author of the Reformation Period", tells of the powerful effect that music had in and on his life...

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"My heart, which is so full to overflowing, has often been solaced and refreshed by music when sick and weary."

 

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“Music is well said to be the speech of angels; in fact, nothing among the utterances allowed to man is felt to be so divine. It brings us near to the infinite.”  -   Thomas Carlyle

 

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Music has long been thought to have a relaxing, soothing and therapeutic effect on persons with Alzheimer’s disease. Now scientific research overwhelmingly validates the therapeutic value of Music for the victims of Alzheimer’s disease. A simple improvement in the quality of life for a person with Alzheimer’s is of great importance. This becomes of even more critical importance in the late and final stages of Alzheimer's where the quality of life is close to zero. The evidence of the value of music appears to be unimpeachable. It is frequently used as a part of hospice programs.

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David Berg with Violin(Photo on right is David Berg, June's (our) oldest son, practicing with his Grandpa Henry's  violin. - Ca. 1956... For June the Violin sounds had special meaning as detailed below) 

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Note:...On October 18th, 2012, our son David went home to heaven to be with his mother June!...it is hard for me to believe that our son who was age 9 in the above photo is no longer here! He died from lung cancer resulting from a lifetime of smoking...he could not break the habit until it was too late...he was much like  his mother June...he always sported a big smile with an outgoing personality...and like his mother June, I cannot recall having a cross word with him during  his entire life!

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Dr. Alice Cash of Healing Music Enterprises says: “Doctors have known for years that patients with Alzheimer’s and other dementias, respond powerfully to the music of the “courting years”. Even when the patient no longer recognized family members and friends, they can still hear the familiar music of their courting years and recognize it, sometimes sing along, but always they derive pleasure from the experience.”

Harvard University Gazette (Science/Research – 2000/11.09/01) reports: “Oliver Sacks, author and neurologist, has commented that patients with nervous system disorders who cannot talk or move are often able to sing, and even dance, to music, “I regard music therapy as a tool of great power in many neurological disorders (like) Parkinson’s and Alzheimer’s, because of its unique capacity to organize and reorganize (brain) function when it has been damaged.” .

Fred Silverstone, Music Therapist, MacLean Hospital Belmont, MA. (Affiliated with Harvard Medical School.)  Oldsters who suffer brain damage from Alzheimer’s can still respond to music. “It touches those parts of the brain that are uninjured, and can help Alzheimer’s patients communicate with others and lead a more social life.” (2002)

CNN, Stephanie Smith reported (27 December 2001) on a program at the Alzheimer’s/dementia ward of the Morse Geriatric Center in West Palm Beach Florida. According to Dr. Jeurgen Bludau, the medical director at Morse – “We’ve noticed that (the music) helps with hydration, it makes them thirsty, it makes them willing to drink,” says Bludau. “It helps them...get to bed better. We are able to stimulate an appetite. So, it definitely has a positive impact on these patients.” CNN also reported that “A study on the impact of music therapy on dementia patients, conducted by Eastern Michigan University, determined that patients consumed 20 percent more calories when music was played during lunch time.”

USA Today, “Your Health” (7/24/2006) reported on the experience of readers. ”Allen Pfenninger of Brooklyn Heights, Ohio: “Music is a wonderful balm for Alzheimer’s patients. My mother in law...didn’t remember my wife or myself, but she could recognize music from her past....listened to songs we knew she liked. She would hum along. She would laugh at the funny ones...When she stopped humming along about a month ago; we knew the end might be near.”

Dr. Ardash Kumar, University of Miami School of Medicine (Florida) reported on a study in Alternative Therapies (1999;5:49-57) “A music therapy program....improved behavior and sleeping problems in 20 male Alzheimer’s patients. The Alzheimer’s patents underwent music therapy for 30-45 minutes, 5 days a week for one month...the participants in the study also became more active and cooperative and slept better.”...”Relaxation with the type of music that calms you down is very beneficial...to promote a sense of calm and well being, you can listen to your favorite soothing music when you eat, before you sleep, and when you want to relax. Music therapy might be a safer and more effective alternative to many psychotropic medications.”

British Study reported April – June 2008 in Alzheimer’s Disease & Associated Disorders. 22 (2) 158-162.  “Efficacy of Music Therapy in the Treatment of Behavioral and Psychiatric Symptoms of Dementia.” Fifty-nine persons with dementia were enrolled in this study. Results were significant improvement when assessed at 8, 16 and 20 weeks. Specific BPSD (ie, delusions, agitation, anxiety, apathy, irritability, aberrant motor activity, and night time disturbances) significantly improved.  The empathetic relationship and the patient’s active participation in the music therapy approach, also improved in the experimental group. ..”The study shows that music therapy is effective to reduce BSPD in patients with moderate-severe dementia.”

British Study reported in "Dementia", February 2008 7: 95-108. Favorite music decreased agitation in residents with dementia.  “Agitation in individuals with dementia living in the nursing home environment affects care and quality of life. Relaxation techniques such as music...are showing promise to decrease agitation and improve quality of life in individuals with dementia. 41 residents with mild to moderate dementia participated in a study to test the effectiveness of favorite music....in reducing agitated behaviors....each treatment lasting 10 minutes...results suggest that favorite music is effective in significantly decreasing agitation immediately following the intervention and also one hour post intervention.”

The Medical Directors Association (AMDA) had a front page story in their December 2010 issue of “Caring for the Ages”. The story: “That’s Entertainment: In LTC Showtime Can Be Therapeutic.” – “Performances can fight depression, stir memories and just be fun. …increasingly, facilities are bringing in singers, dancers, bands, and other performers to entertain residents.”…”Charles Richardson, director of lifestyles and life enrichment for the Brookdale Senior Living center around the country, agreed that music is a powerful tool. For people with dementia, singing is a moment of clarity. They may not know what day it is, but they can sing, “Don’t sit Under the  Apple Tree” and dance around and have fun. It’s a moment of triumph for them,” he said.”

The July 2011 issue of “Caring for the Ages” again has a front page article headlined: “Music Therapy May Help Dementia Patients Especially”…”some evidence shows less agitation and depression after program.”…”Music may stimulate people with dementia in a way that language cannot said Jan Maier, RN of the Research Triangle Institute International in Durham, NC. In dementia the parts of the bran that have to do with music and emotional  memory are preserved, she said…”A handful of randomized controlled trials have shown reductions in agitation in patients with dementia who participate in Music therapy…Pick the music that person loved…if you don’t know, go to their early adult years.”

The March 2013 issue of the AARP Bulletin has an article "The Power of Music" by Sally Abrahms. The opening page outlines three areas for music therapy.

Music Therapy is used to (1.) Treat Illiness, It can also (2.) Enhance Moods and calm agitation, Why not use it for (3.) Caregiving?  The following opening statement then sets the stage for a three page discussion:

"Geriatricain Theresa Allison, M.D., can't talk with her grand-mother. Alzhiemer's disease has left her without the ability to see, converse or recognize her granddaughter. Yet the two are able to interact. Instead of talking, they sing. I've watched her babble  nonsense, but then bounce my son on her knee as we sing a folk song she taught me as a child. For 45 seconds, life is completely normal." says Allison. "Engaging this way is profoundly meaningful." Allision, a musicologist as well as physician and assistant professor in the Division of Geriatrics at the University of California, San Francisco, sometimes sings songs with her frightened or confused patients to get them to relax during a physical exam. And she encourages generous doses of music in caregiving, whether the loved one is cognitively intact or has memory loss..." 

Mayo Clinic: 15 October 2015:  Music and Alzheimer's: Can it help?...You may want to turn on the radio for a loved one with Alzheimer's. Research shows that listening to music can relieve stress, reduce anxiety, lessen agitation and more.

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 What type of music should be used?


a.  “Tunes must match the musical tastes of the residents – otherwise it could be harmful.” “They don’t relate to Bon Jovi,...These people have lived a long time...got to do their thing, their music”  (Cautions by the Alzheimer’s Association, Morse Geriatric Center and Eastern Michigan University.)

 

b.  “Play the music that has meaning for the patient....people find some kind of music that relaxes them, gives them pleasure, or takes their minds from obsessive thought and negative feelings.” (Harvard University Gazette.) 

 

c.  “Music of their courting years”  (Dr. Alice Cash, Healing Music Enterprises.)

 

d.  “The type of music that calms you down....favorite soothing music.” (Dr. Ardash Kumar, Miami School of Medicine.)... long time old religious favorites that promote comfort...

e.  “Favorite music” (British study 2/2008.)

f.  "Familiar Songs...Most people remember music from childhood or when they were in their 20's. Does Mom love opera or show tunes? What songs make her dance? (Geriatrician Theresa Allison, M.D.)

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 What type of music should not be used? 

a.  Loud high volume raucous music. This then becomes negative noise and can cause agitation and anxiety. (Alzheimer’s Association.) See essay this section on negative noise.

b.  Music that does not fit the musical tastes of the residents. Obvious examples would be “Rap” and “Hip-Hop”. Such music can hardly be called music in any event and is more of an assault on the senses. (Alzheimer’s Association and Eastern Michigan University.)

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June and Music 

Music has always been an important part of June’s life. She loved to play her organ and later her Clavinova. For years June played by ear. Later she took music lessons and learned to read and play from sheet music notes. June played her Clavinova up until the day she left home to go to the Wellstead Assisted Living facility .I remember well that dark day in our lives. (March 16th 2005.) We sat together on the living room couch that morning while she napped for a time with her head on my shoulder. When she awoke, she played the Clavinova for a short time before she had to leave our home forever. Although we moved the Clavinova to her room at the Wellstead, Alzheimer’s was closing in on her and she played it briefly on only one or two occasions thereafter.  


Photo below right is June in February 1998 just one month after being diagnosed with Alzheimer's - Location is San Francisco during a meeting of the American Academy of Forensic Science

June Berg 1998 SFJune had arranged in past years, for the installation of speakers in every room in our home. This permitted the music to be played throughout the house from a central CD music player.

June loved the music of the 40’s and the 50’s as well as classical country and gospel music. June also loved the piano music of Steve Hall and Lorie Line as well as the Mantovani Orchestra.

The sound of the violin was very special to June as it reminded her of her father Henry and a favorite uncle Jake, who both played the violin. I recall the time that June and I walked into a "Blue Grass" session just as twin violins struck up their strains. June looked up at me with a smile and said -  " I'm so happy! " June was starting into her middle stages of her Alzheimer's at that time. - Circa 2002.   

When music became available on CD’s, June quickly became a collector of the works of her favorite artists.

June soon built a collection of approx. 250 music CD’s. After June left home because of her Alzheimer’s, one hundred (100) of her CD’s were donated to the Alzheimer’s Villa at the Benedictine Health Center. Many were new and several were duplicates that she inadvertently purchased because of Alzheimer’s.

Kristen with Violin August 1975Photo below right is Kristen, June's (our) granddaughter with the violin that belonged to June's father Henry Rolstad. Photo was made in August 1975...same violin being played by our son David pictured above...


When June was in the final stages of Alzheimer’s  she was non responsive and did not talk.
Most of the time she sat with her eyes closed, shutting out a strange world she did not understand.


June had a small CD player in her room at the Benedictine. A few favorite CD’s are available for playing. (40’s and 50’s music, and also Elvis singing her favorite Gospel songs.)


I always started the CD softly playing for her at nap time in the early afternoon on each of the days that I was there. I felt it had a soothing and relaxing effect on her. I hoped that it added a spark of quality to a life that otherwise had none.

I would always join with Elvis to sing one of June's favorite songs, "Take My Hand Precious Lord" as June was waking up from her afternoon nap...I am not much of a singer, but Elvis helped to drown out or mask my inadequacies...June at this point was in the late stages of this terrible disease, Alzheimer's and was almost non-responsive. She would rarely even open her eyes...to read the story of "Singing for June", please click on the below link for the page on this web site that tells that story:

"Singing to June - Sweet Hour of Prayer"


I encouraged June's Nursing Assistant’s to turn the player on for her in the evenings as she went to bed and for any nap times when I was not there to do this for her.

 

William Congreve (1670-1729) tells us in his famous line -

          
"Music has charms to sooth the savage breast - 

     to soften rocks and bend a knotted oak."

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Photo below right is Jacob Varnes, June's favorite Uncle playing his violin - 1958

Jake Varnes 1958Note: On 23 October 2008, June passed away from the complications of Alzheimer's. This was the end of a long weary struggle of almost eleven (11) years.

"Take My Hand Precious Lord" was one of June's favorite gospel hymns. This beautiful hymn was written by Thomas Dorsey,  the man who coined the term "Gospel Music".

Thomas Dorsey also died from the ravages of Alzheimer's on January 23rd 1993 in Chicago. His death was almost precisely five years before the terrible day that June was also first diagnosed with Alzheimer's. Coincidentally, his death was on the same day of the month as June's.

"Take My Hand Precious Lord" was played and sang at June's funeral service at Redeemer Lutheran Church on October 27th 2008. The soloist Sharon DeVries was accompanied on a violin by Katelyn Ek.


Use the below link to listen to the beautiful sounds of this greatest of all gospel tunesand think of June carried away on the wings of song. As you listen to the music.

"Take My Hand Precious Lord"

This beautiful song was also played and sang at the funerals of President Lyndon B. Johnson and Martin Luther King Jr.


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The above Blue Grass Jam session with the violins that brought June so much Joy is a group that was organized by Barb and Gary Carlson in Ca. 1998. The first jam sessions were held in the back room at J's Cafe in Spring Lake Park. This is where June and I first heard the groupperform. (Later moved to Culver's in Coon Rapids.)  The group is still piloted by this dedicated husband and wife team. A very accomplished violinist, Greg Kelly has been a long time member of the group and was one of the two violinist's playing on that first day that June and I walked into the session. (Currently the following violinist's are regular performers at the Blue Grass sessions. - Katelyn Ek, Greg Kelly, Lee Cowan, Gilmore Lee, and Sheri Stambaugh.)

Thomas Jefferson and his ViolinThomas Jefferson loved music and loved playing the violin which he described as the - "Passion of my Soul."

Jefferson owned three violins. He even  designed a special saddle case to take his violin with him when travelling. 

Picture on right of Jefferson - Wall Street Journal 7/2/2009 

Jefferson is quoted (1771) as saying "There we should talk over the lessons of the day or lose them in music...the heart thus lightened, our pillow would be soft and health and long life would attend the happy scene."

June's Memorial - A Gift of Music


A special music memorial has been set up in June's behalf. A small music group provides an hour long quarterly music concert to the residents of the Benedictine Health Care Center in Innsburck on four special days in June's life. (Valentine's Day, Mother's Day, our Wedding Anniversary on August 16th, and June's Birthday November 8th.)  The Benedictine's Alzheimer's "Villa" is where June spent the last two (2) plus years of her life. Because the violin occupies a central and core position in June's music life, a violinist is always to be one of the members of the performing small group. This memorial is intended to be a love gift from June to the Benedictine residents. The music group is named in June's honor as "June's Benedictine Blue Grass Five." A more detailed description of this music gift from June can be seen on June's website on the listing under the label "June K. Berg Memorials" on the bottom blue navigation strip - or just click the below link:

  "June K. Berg's Gift of Music - a memorial"

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Note: The effectiveness of music as therapy for Alzheimer's is very directly related to the stage of the disease...it is very effective in early stages and effective in middle stages....however when the disease reaches late stages it's effectiveness is unknown...this is because of how the memory is lost in Alzheimer's...in early to middle stages, it is the short term memory that has been lost...the long term memory is still intact and stored...this is the memory, the long term memory that has stored the songs and music memories of our earlier years...by the time the disease's late stages arrive, the brain has been very severely damaged and is said to be only 2/3rds the normal size....the brain is the bodies control center...that is why most late stage Alzheimer's victims can no longer, walk, use their arms or hands, talk, have difficulty swallowing, are incontinent, have seizures and do not recognize themselves in a mirror...for June the first 7 years were relatively good years and we completed out bucket list...we simply accommodated her short term memory problems....beginning in year 8, the disease started taking control and it was downhill all of her remaining years...many of her friends did not know she had Alzheimer's in the early years...and yes, music was appreciated by June in the early and middle years...in the late years and especially in the last 2 years I do not know if music any longer reached her...I sang to her daily and played music for her but if it reached her I do not know as I saw no obvious responses...One will see many rave reviews of music and Alzheimer's but a careful review of the information will show that it is centered around the early and middle stages...the rate of progress varies from patient to patient but the stages disease are similar when reached. Some victims of the disease pass on from complications of the disease before they reach the late stages and they are perhaps the fortunate ones if that is possible with this terrible diseases...

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Reader's Comments

Shere Kerns Keegan - Dyersburg, Tennessee - (7 August 2012): "My mom was diagnosed with AD about 10 yrs ago. Listening to music seems to take her to happier times in her life. She loves to watch Dancing with the Stars, America's Got Talent, XFactor, Voices...I think DWTS is her fav. She always says "I thought I was a good dancer til I watched them!"

Sherril Cote  - Brookfield, Massachusetts - (7 August 2012): "My mom always perks right up when I put her music on... Glenn Miller is her favorite!! "

Ursula Zarecki Sypniewski  - Toms River, New Jersey - (7 August 2012): "Music is good therapy! It's very soothing! My Mom enjoys it! "

Alzheimer Society of Newfoundland and Labrador  - Newfoundland-Labrador, Canada - (7 August 2012):  "Great resource! Thank you for sharing! - Amelia White, Events Coordinator."

Christine Walend  - Ohio- (7 August 2012): "My cousin is a music therapist--and it does work wonders for patients, especially autistic children she has told me. My Mother always loved music--still does. At the home she is at, they have live music twice a week, and many activities going on daily, where they will have music in the background? Also, the one dining room, they play Sinatra, Martin, many of the oldies, and the patients love it!"

Elaine Wharmby  - Tamworth, United Kingdom - (7 August 2012): "The small home where I worked had a group of people who came in and played , danced and sung...they then got those clients who were able and wanted to to take part. It was amazing to see. Some would be dancing as though they were teenagers again and then they would begin talking about what they got up to when courting made your hair curl sometimes haha. One or two had beautiful voices as wekll. It helped clients on a number of levels memory and excercise to name but two. One or two clients loved to watch the old black and white films as well"...(16 March 2013): "We used to use music quite a bit. From the old songs to having people come in and getting residents to play them. The majority loved it even getting up and having a dance to some of the old tunes. But one or two could not take the "noise" and would become very agitated. As it was a very small home we diid not have a separate lounge for them to go into so sadly the visits stopped."

Denise Roberts  - Southend-On-Sea, United Kingdom - (7 August 2012): "Music is wonderful for therapy...My friend runs a theatre group that goes around homes in Scotland 3 people run it... Theatre Presto it is called... they love it."

Tracey Knight  - Southhampton, United Kingdom - (7 August 2012): "Agree with you here Stan, music is an amazing therapy tool for many."

 Linda Wallwork  - Portland, New South Wales, Australia - (7 August 2012): "We have a 92yr old lady with Alzhiemers and music has been her life. She played the Violin all her life. We often sing together and if she is becoming agitated she will settle straight away if we sing together. I asked her family to bring her Violin in, really to see if she would get some enjoyment from touching it and handling it...she picked it up and started trying to play it. It was wonderful and was a positive reinforcement for her family that 'Mum is still there' and that 'Mum' is well able to enjoy things. (YES....of course I cried tears of joy .) We also have a younger dementia sufferer who if placed at the piano will tinker away."

Hilary Halford  - Crewe, Cheshire, United Kingdom - (7 August 2012): "I'm often singing on our ward, and have had so many positive reactions from patients, especially when we sing the old ones."

Heather Pearson  - Southhampton, United Kingdom - (7 August 2012):  "Music for the brain...really keen on this therapy!"

Jan Burns  - Great Wyrley, United Kingdom - (8 August 2012): Music is the food of love - and any one who knows me knows that any opportunity to sing is never missed!!! On a more serious note since my early days, way back in the 80's when I first delivered care services I found music to be an excellent communication tool - singing Onward Christian Soldiers with a woman who was a former a church organist - she had late stages dementia and as I changed her and her soiled bed we sang - I went to take out the soiled clothes and I could hear her saying - I remembered- I remembered, from then I knew it had an impact from then its been 'don't stop the music' . Whatever tools we can use to deliver person centred care should result in the person being part of the delivery in what ever way possible communication - validation - inclusion - compassion = dignity."

Lisa Cope  - Burton-Upon-Trent, Staffordshire, United Kingdom - (16 March 2013): "Very interesting Stan! Especially about the importance of the music being from 'the courting years'/music that has meaning to them. It sounds like June was a huge fan of music - especially having speakers installed in every room!! :) how fun ... We play music for my grandad regularly, all his old Irish songs (I grew up hearing them so luckily I like them too!), and it definitely does work as 'therapy' for him as well. He often sits with a smile on his face and sings along (as much as he can!) and always tells me to get up and dance! He surprised me a couple days ago when a song came on the CD player and during the intro, possibly 5 seconds into it (no lyrics yet, just music) he said "Fields of Anthenry" which is a hard title to remember in the first place (I just had to google it myself), but the fact he knew the title of the song before the song even began, that really shocked me!"

Felicia Senz  - Naperville, Illinois - (16 March 2013): "Music brings my mom much joy, even when there is no sound I can tell that she hears music in her mind and it comforts her."

Emy Yokoyama De Almeida  - Toronto, Ontario - (16 March 2013): "Alzheimers Society Toronto in implementing the iPod project!!! I also believe in the power of music!"

Kristy Ballantyne Opswa  - Port Hope, Ontaria - (19 March 2013): "Ive shared this before but I really love it."

Sheila Konar  - Rochester, New York - (18 April 2013): "I have a music therapy program at Nazareth college for dementia, alz.autism run by Dr. Betsy King and a bldg going up. Your brain is hard wired differently to help with aphasia thats a fact/Your right on. If you have to have Alzheimer's Rochester is the best place to have it. I know! I live, eat, sleep it...Sheila"

Bernadette Brady  - Dublin, Ireland - (12 May 2014): "Thank you for sharing this page with me Stan. I have a friend...who is Harpist. She is currently doing a Masters Degree in Music Therapy with a view to working the Dementia patients in hospitals and long terms care facilities. I will share this page with her if I may? Because it would be a wonderful resource for her to learn about the impact that Music has with Alzheimer's Disease and also to learn about June."

 

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June's Passing

June 1994

 

June's funeral notice as published in the Minneapolis Star in October 2008 can be seen on this website under the "In Memoriam" label - Click on:

 

"June K. (Rolstad) Berg - In Memoriam"