INDIAN RIVER COUNTY — Music therapy is a big part of a resident’s daily life at Clare Bridge of Vero Beach, a Brookdale Senior Living residential Alzheimer’s and dementia care community. No matter what time of day, recorded or live music can be heard at the center.
In addition to daily music therapy sessions for people of varying degrees of dementia, Clare Bridge has incorporated music into all sessions even if it just means there’s music playing in the background during exercise, craft-making and baking classes.
“It’s fascinating,” says program coordinator Moreen Bosch, who is a board certified music therapist. “Many of these people don’t remember their children’s or husband’s name but they’ll remember the lyrics or melodies of certain songs.”
“It’s wonderful to see them come alive with music,” said Bosch, 27, who did her training at Augsburg College in Minneapolis. “Music activates multiple areas of the brain. They can still find music in there.”
Music has been a form of medicine for centuries. The first documented reference to music therapy was in 1789 in a published article in Columbian Magazine entitled, “Music Physically Considered.”
In the early 1900s, associations formed to promote music therapy but it wasn’t until the 1940s that a clinical profession evolved.
Also during this time, the first music therapy programs were established at educational institutions, the first offered by Michigan State University.
Music therapy got greater visibility during and after World War II when it was applied to treat soldiers. Presently, Walter Reed National Military Medical Center uses it as a tool for treating wounded soldiers.
Studies show the benefits of music are multiple. For those with Alzheimer’s and dementia, it can calm their mood, stir up emotion and give them more confidence because they can grasp something, actually speak words that they otherwise can’t pull from memory in conversation.
At Clare Bridge, Bosch selects music from participants’ childhood, which tend to be from the 1930s and 1940s, choosing folk songs and popular show tunes that they sang as children sitting around the piano with their families. Tunes from their childhood are the ones they tend to remember best.
For the residents – who range in age from 76 to 100 – the favorites tend to be: “Que Sera Sera,”“Daisy Daisy” or “Bicycle Built for Two,” “I’ve been working on the Railroad,” “You are my Sunshine” and “The Band Played On.”
Each day, there’s a music therapy session, the focus of which changes depending on the day of the week.
For example, one day the theme will be dancing, motivating seniors to get a rhythm whether inspiring them to tap their feet, or rock about in their wheelchair, or get up and dance.
Another day will be a sing along to the piano, as Bosch plays it live for them in the room. Another day they’ll have a game of ‘Name that Tune’ in which residents try to name the song or melody that Bosch plays on the kudzu or hums.
On other days, they are given various instruments including rhythm sticks, tambourines and bells to play along with the music.
Bosch said one Alzheimer’s patient – who frequently wandered during sessions – actually stayed still for 20 minutes to take in the music. “It was a great success! For others, too, who really gravitate to music, it gives them something to enjoy. They engage more.”
A lot of the agitation and depression associated with the disease comes from an individual’s inability to verbalize thoughts and emotions, Bosch explained. Therefore, music can be a major outlet for them.
“It makes them happy,” she said. “It can reach them when nothing else can. It elicits emotions and memories that they otherwise can’t communicate anymore. It’s a mood-booster and a comfort.”
When a person has dementia, specific areas of the brain are affected. Because music is stored in numerous areas of the brain, even people in the most advanced states of the disease are able to recall lyrics and memories connected with songs.
Emily Tremml’s aunt, Nancy Reeves, is a resident at Clare Bridge. She has short-term memory loss.
Reeves, 88, earned a master’s degree in music, and played piano and the organ all of her life. She has responded naturally and extensively to music therapy.
“It’s amazing to watch,” said Tremml of Vero Beach. “There are people who are totally non-communicative, they won’t talk but they know the words to every song. They will mouth the words or sing and dance. When you first meet some of them, you don’t think anyone’s ‘home.’ But then you see them experiencing the music and they tap toes, dance and come alive!”
Tremml is pleased with her aunt’s response to music therapy.
“She rediscovered the fun of it,” Tremml said. “The interactive nature of music is so important, to hear music, dance. It’s another element of joy. It opens up some sort of curtain.”
Al Bumanis, a music therapist and director of communications for the American Music Therapy Association based in Silver Spring, Md., described music therapy “as a health profession that uses music as a treatment method to address non-musical goals.”
AMTA represents over 5,000 music therapists in 30 countries who use music therapy as a way to help people who suffer problems associated with many things including stroke, Parkinson’s and Huntington’s Disease, and learning disabilities.
Music therapy is offered in nursing homes, mental health facilities, school districts with special needs students and hospitals.
One challenge is that only about 25 percent of who apply for reimbursement from health insurance companies get reimbursed. However, Bumanis added. “As more evidence-based practice is presented, more research, the trend is looking positively.”
Seventy-two colleges and universities offer a degree program in music therapy, requiring intense study and musical training, and proficiency in guitar, piano and voice.
Bumanis pointed out the widespread attention music therapy got due to its use in the treatment of U.S. Rep. Gabrielle Giffords after she was left in critical condition when a bullet entered her brain.
The Arizona Democrat suffered from aphasia, the inability to speak because of damage to the language pathways in her brain’s left hemisphere. By layering words on top of melody and rhythm, she trained her brain to use a less traveled pathway to the same area and eventually relearned to talk.
The idea is that if you can work with areas of the brain that are in better shape, then you can retrain the other areas, or develop other pathways to do the same functions. The general concept is neural plasticity. The brain has a way of retraining itself.
“We reinforce the areas that are still intact and re-strengthen,” said Bumanis.
When applied to people with Alzheimer’s or dementia, it is “a quality of life issue there,” he said.“You can see dramatic sessions in which a person who doesn’t verbalize begins singing. It isn’t a cure, but it brings back a moment for the patient and caregiver, to communicate with the client when no other form of communication is possible.
“Also, it lessens the anxiety of isolation. Being part of a group, communicating, all of these have a positive impact on a person. “
Music therapy sessions can start off as non-verbal communication, but is also a form of emotional communication, he said. “The goals include getting people to talk more, engage more, move more. It’s a form of emotional release, a form of cognitive rehabilitation that can be used for learning purposes.”