Music is everywhere!

Auditory Stimulation – Our ears probably provides us with our second most vibrant source of sensory stimulation. Our eyes allow us to enjoy the paintings of Rembrandt and the sculpture of Michelangelo. Our ears allow us to share in the genius of Mozart and Beethoven; to wake up to a symphony of birds on a spring morning.

Auditory stimulation for people with Alzheimer's and dementia is as effective for mood enhancement, relaxation, and cognition as it is for everyone else. The calming effects of music are well known. Farmers play music to their cows and the cows produce more and better milk. Music makes plants grow larger and healthier. Music is good for living things including people.

And it's not just music that benefits dementia patients (and everyone else, as well). The sound of water, from a babbling brook or from an artificial waterfall, is to the ear what a camp fire is to the eye. Both are mesmerizing and calming, as is the sound of a well tuned bell or wind chime.

Sounds for the mind and the brain

Natural sounds are probably the best for mood and meditation. A gentle rain, or the wind blowing through pine trees, can work magic. To stimulate cognition, a Mozart symphony is probably better. And the music that the Alzheimer's patient enjoyed when he or she was younger is best to stimulate reminiscence. Therefore, a variety of sound stimulation is important.

Sound doesn't have to be pleasing or melodic to be effective. Rattles and other percussion musical instruments are also good, especially if the Alzheimer's patient is playing them. The physical activity and the stimulation of listening to and following a rhythm both add to the benefits of the passive auditory stimulation. Even "white noise" has been shown to improve memory in Alzheimer's patients.

Ways to use auditory stimulation

Sound stimulation can be used in various ways and with various affects.

Reminiscence Music Therapy – An "oldie" comes on the radio – something you listened to in high school, and suddenly your back, cruising with your teenage sweetheart. Maybe your on the way to the Friday night sock-hop, or to the football game. Life is good, as it so often is in reminiscences. Anyway, you know what it is like to have your memory jogged by an old song. It's the same with people with Alzheimer's disease. Familiar music is stimulating on several levels.

Participatory Music and Rhythm – If the patient plays a musical instrument, help them to enjoy doing that as long as possible. Sounds produced on an electronic keyboard can be pleasing to them even if those sounds don't come together in recognizable tunes. Sing-alongs are fun and can stimulate memory (see the letter in the box below). Sing-alongs are fun when done with a leader, but can work with recorded music also. Rhythm sessions using drums, rattles, bells, washboards, sticks, etc. can accompany a sing-along, recorded music, or follow a leader. These percussion instruments can be found or made from things around the house. A water bottle filled with beans or gravel is a rattle. A coffee can is a drum. An oatmeal box is a drum with a different sound.

Background Sounds and White Noise – Stimulating sound or music playing in the background while other activities are going on improves the mood, and even the memory, of people with all forms of dementia. This background sound can be reminiscence music, classical music, recorded sounds of nature, or a table top fountain or waterfall. There are several series of recordings of natural sounds, like the sounds of the ocean pictured here. See more in our Amazon Store. These recordings are very good sleep and relazation aids.

Exercise to Music – Use music to accompany exercise or movement as you would in an aerobic class, or to encourage patients to dance. In a group, dancing is a social activity that is also exercise and can involve touching (tactile stimulation). Big band tunes and some of the old jazz standards are likely recognizable and inspire motion.

Music and Memory

In her column, Your Health, in USA Today, Kim Painter shared a letter written to her by one of her readers:

She wrote: "A volunteer would come to Dad's nursing home, attired in a straw hat and suspenders, with a banjo, to engage the residents in a sing-along session. My dad always sang the loudest, with great gusto, and despite his memory deficits, he knew the lyrics almost perfectly to the old-time popular songs of the '30s and '40s. ... My dad was happy then. ... It was as if this music brought him back to a realm of cognitive lucidity and anchored him in a firm time and place."

Kim Painter, USA Today, 7/24/2006

It's almost as if Ms. Tomainl was watching that woman's father when she wrote:

It is always remarkable to watch a person completely removed from the "present" due to a disease such as Alzheimer's.. come to life when a familiar song is played. The person's response may vary from a change in posture to animated movement: from a sound to verbal response. But usually there is a response, an interaction. Many times these seemingly disparate responses can reveal much about the preservation of self and the intact personal stories that may still remain. (Tomaino 2000, p. 195)

Tomaino, C. M. Working with images and recollection with elderly patients. In Music Therapy in Dementia Care (pp. 195-211). D. Aldridge (Ed.). London: Jessica Kingsley Publishers.

Wooden Music Box

This beautifully made wooden music box measures 7"L X 3"W X 5"H. Crank it (a good activity in itself) and watch the mechanical musical movement as it plays Small World. People with Alzheimer's often enjoy the repetitive movement that this item involves.

In The News

In a study reported in the Journal of Gerontological nursing, Ann Denney, a gerontological nurse, found that playing music at mealtime in a long term care facility decreased agitation in people with Alzheimer's. After a week of hearing Baroque music, both physically agitated and verbally agitated behaviors decreased by more than 55%.

Ms Denney's results were replicated in another study by Sandee Lynn Hicks-Moore reported in the same professional journal a few years later.

One of the frustrating aspects of Alzheimer's disease, for the patient and the caregiver, is the difficulty it creates in communication. Several reports, including one published in the Journal of Music Therapy, indicate that music therapy improves measures of speech content and fluency.