Illustration by Daniel Downey.
In your late teens and early 20s, what was your favorite type of music? Rock ’n’ roll? R&B? Jazz? Heavy metal? If you’re now “of a certain age,” you might want to dust off those old records (or cassettes or CDs) and develop a playlist of your faves. Down the road, it just might help you fend off dementia.
Nursing home staff members have long observed the devastating effects of dementia – depression, agitation, aggression, anxiety, apathy, withdrawal. They also know playing music can yield positive results – calming agitated residents, re-engaging withdrawn ones.
Gerontology researchers surmise that long-term memories of music lodge in parts of the brain that have been undisturbed by dementia. Now, a new project – the Music and Memory (M&M) Initiative – is exploring the music-brain connection, and a rigorous study is looking closely at how that connection works.
The M&M Initiative is being implemented across Wisconsin in 100 nursing homes via funding from the federal Centers for Medicaid and Medicare Services (CMS) through the Wisconsin Department of Health Services (DHS). Families of nursing home residents offer input, and care staff set up personalized playlists on iPods or other digital devices for residents to listen to.
Some local nursing homes jumped at the opportunity to be part of the program.
“We’ve seen with our residents that music does help to reduce the use of drugs –
antipsychotics, anti-anxiety medications, antidepressants – so we were delighted to be chosen for the DHS initiative,” says Kathi Roberts, activities therapy director at Lasata Care Center in Cedarburg.
“In my career as a certified dementia practitioner and nurse, I’ve found that meds are not the answer,” says
Lorna Gartzke, nursing home administrator at Shorehaven Health and Rehabilitation Center in Oconomowoc.
“This initiative has the potential to offer alternatives.”
Ten of the 100 nursing homes in the M&M Initiative have been selected to participate in an intensive study by faculty and staff from the University of Wisconsin-Milwaukee’s Helen Bader School of Social Welfare, led by assistant professor Jung Kwak. The team is conducting a randomized crossover design study to collect detailed data on residents, staff and families from the selected nursing homes.
“There is ample anecdotal evidence that music can trigger happy memories and evoke positive emotions that counteract the stressful stimuli of an institution and improve the quality of life of residents with dementia,” says Kwak. “But up until now, we have been unaware of a rigorous evaluation of this popular nonpharmacologic alternative.”
The UWM study is following six residents – some chosen by staff, some chosen randomly – in each of the 10 nursing homes for 14 weeks. Each resident is given an iPod Touch with an individualized playlist along with – and this is key – an app that tracks every single song being played, and the genre and tempo of the songs.
Residents also wear a wristband accelerometer (like a pedometer) that measures their physical activity in detail. The goal is to track what kinds of music results in what kinds of reactions. Student observers are also coding residents’ emotions, facial expressions, physical responses and interactions with others before, during and after listening to the tunes.
A later phase of the study will evaluate the outcomes on residents from all 100 nursing homes. “We’ll have rich data,” Kwak says, “and we’ll be able to see trends. As the music type changes, does agitation change?
Knowing what kind of music works better for different types of residents will give us better ideas about how to
Nursing home staff members participating in the study are eagerly awaiting the results, set for release in October. They already know the power of music.
Roberts mentions a resident who would start yelling when sitting in a chair for any period. As soon as she puts on the iPod, loaded with big band, country and easy listening tunes, she calms down and begins singing along with it.
Gartzke describes a woman who, nonverbal for two years, began speaking in sentences again after listening to her favorite religious music, and continued speaking even after the iPod was turned off.
“Music really touches that internal spirit,” Gartzke says. “It can enhance what people still have after so many losses.”
-- By Carolyn Kott Washburne