Earlier this month, it was reported that dementia had overtaken heart disease as the leading cause of death in England and Wales. And caring for those with dementia is becoming the major social care challenge of the 21^st century – over 1 million people in the UK are expected to have dementia by 2021.

Despite significant research into the condition, there are no long-term cures. As a result, health and social care teams, and researchers into the health and well being of older people, have started to promote non-pharmacological ways of alleviating symptoms and reducing distress to the patient and their family.

Many of these techniques are widely accessible, require little to no formal care training and can take place either in the patient’s own home or in a care home setting. One of these techniques is the use of music as a form of therapy. While specially trained dementia and Alzheimer’s music therapists exist to give formal therapy, carers and family members can also use music to help improve the quality of life of a person suffering from dementia or Alzheimer’s.

Benefits of music therpay in dementia care

Research and experiences from practice regularly show similar outcomes when using music with dementia care patients. The benefits that are consistently highlighted include:

• Music evokes emotion – and this in turn can evoke memories which can help sufferers and family members to connect together.
• Musical aptitude and appreciation are two of the last remaining abilities in dementia patients – it is one of the first cognitive skills we develop as new-born children and is one of the last things to leave us in degenerative cognitive diseases.
• Music can bring an emotional and physical closeness – the association that a patient makes with a song can encourage them to complete actions such as dancing or hugging which they associate with that piece of music. It can also enhance feelings of security and safety among vulnerable patients.
• Singing can be used as a way to engage and to encourage people to express feelings, even if it does not include words or sentences. It can be a way to encourage participation and socialisation, as well as stimulating brain activity, dexterity and physical activity if actions are also introduced to go along with the words.
• Music has been proven to stimulate the release of hormones which gives it the ability to shift mood and manage stress.

“Come fly with me … Let’s make a cup of tea”

One project from Purple Angel music has rewritten and altered the lyrics to some well-known songs which are loaded onto an iPod and can be placed in a person’s home to remind them to carry out day-to-day tasks such as eating and drinking, locking their front door, turning off their fire and showering.

The pre-loaded iPod, which comes in a number of musical genres, contains two 12-hour tracks – one which plays the lyrically-amended songs at two hour intervals throughout the day to act as a reminder service, and the other which is 12 hours of silence, designed to allow the patient to sleep without having to remember to turn off the iPod.

Examples of the altered tracks include:

• L.O.V.E,  I’d love a cup of tea – a song to encourage rehydration via a cup of tea
• That’s Amore, That’s a bath day – a song to encourage taking a shower or bath
• Let There be Love, Let there be lunch – a song to encourage eating
• Can’t take my eyes off of you – a song to encourage night time requirements, like locking the door and turning off the fire.

A playlist for life

In August 2016, the Care Inspectorate backed a scheme called ‘playlist for life’ which encourages care homes to integrate music into their care for patients with dementia. Moving beyond just allocating a time to place headphones onto a patient and leaving them to listen alone (although at times this may be helpful too), the aim is for music to be a vehicle for connected care. It allows carers to use music as a tool to find out more about the person they are caring for and encourage them to engage through the music.

“Music can reveal previously hidden aspects of the patients to their carers; likes and dislikes, talents and memories – it all helps piece together the jigsaw of an identity obscured by illness.”

[vimeo 78719951 w=640 h=360]

As the video above shows, using music can also be a way for family members to re-engage with the person suffering from dementia. It also  allows them to feel like they are directly involved in a positive element of care, as they are often invited to create the playlist, using songs that they know will evoke specific memories or emotions for the patient, and then listen along with them, interacting as they do so.

Similarly, Music for Life, a project run jointly by London’s Wigmore Hall and the charity Dementia UK brings specially trained musicians into care homes to work with patients, carers and family members in group and 1-2-1 sessions, creating and listening to music. Musicians, care home staff and managers meet after each session to reflect on what they have learned about the patients – knowledge that helps in future care and treatment.

Music as a communication tool

Formal research has supported the use of forms of music therapy, whether they be formally delivered by trained specialists or integrated into day to day caring by family or social carers. As mentioned above, research has demonstrated the positive effect it can have, both on the patient but also on their family.

Over 800,000 people currently live with the condition and roughly 25 million people – nearly half the UK population – are affected by it through knowing someone with the condition.

Music offers a way to care for people suffering from dementia in a sensitive, person-centred and cost effective manner. It can also be a vital tool to support families who can reconnect with their loved ones through a piece of music, even when other forms of communication have become difficult.

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• Dementia’s impact on those who care
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• Assistive digital technology and older people: technology ‘bricolage’ in dementia care