Music and us
Music can touch people in profound ways. It impacts a person mentally, emotionally and even physically. There has been research on how people can respond differently to the same piece of music. It is neither surprising nor new that music can be used to improve the well-being of individuals. In fact, music has already been used as a form of therapy during the World Wars decades ago, before it was formerly established as a treatment modality.
Music therapy
Music therapy is the clinical and evidence-based use of music interventions to accomplish individualised goals within a therapeutic relationship. Goals include that of:
- Alleviating pain
- Managing mood
- Enhancing memory
- Expressing feelings
- Facilitating communication
- Facilitating cognitive function
- Supporting physical rehabilitation
(American Music Therapy Association)
Music therapy reaches out to a wide spectrum of people. It can be harnessed as a therapeutic modality for the elderly who are coping with deficits in daily functioning, including physical, psychological or social functioning. It stimulates the senses and is able to evoke responses due to the familiarity, predictability, and feelings of security associated with it.
What to expect in a music therapy session
Anyone with or without music experience can be part of a music therapy session.
Persons can expect to be part of different musical experiences during music therapy sessions. They include:
(i) Music listening / singing
An old song can serve as a portal to old memories, awaking the person behind the façade of physical pain and illness. A common intervention with the elderly is to sing songs that are familiar to them. Usually, the song is sung in the mood and tempo befitting the person's disposition in the moment.
The person may choose to listen to the music or play an instrument / sing with the therapist. In the latter, the person and the music therapist recreate the song together, bringing about a certain sense of originality to the music, making it different from the popular recordings heard. It is often a beautiful surprise to witness how a person might forget what she has said, or done in the last hour, but remembers a song she learned and sang as a child.
(ii) Music improvisation (through singing or instrument playing)
Musical improvisation (creating music in the moment) is very often used in music therapy sessions. Most people do not have prior experience in playing instruments. The therapist receives and works with whatever musical ideas (e.g. rhythm) the person creates and together they create a larger musical work.
This process provides people the space to take charge of their musical decisions, express themselves freely and access their creative abilities. As musical improvisation is not fixed in a familiar song, persons have to be able to respond to changes (e.g. change in tempo of the music) initiated by the therapists and vice versa.
(iii) Playing of composed music
Another intervention applied would be the use of composed music that requires people to play at specific moments. This provides people with new musical experiences, and exercises their memory as they have to remember musical patterns and follow the direction of the music therapist.
(iv) Music and movement
Music and movement complement each other. Depending on the physical ability of the person, dancing or simple movements could be choreographed into the music. More often than not, this brings about quite a bit of laughter and fun to the session and is a non-threatening way to encourage physical exercise and expression.
Generally, the average length of a session could range anything from 30 to 60 minutes, depending on the needs of the person. Music therapists assess the individual and establish goals specific to him or her. Each session is person-centred and the therapist will constantly review the progress of each person before adjusting any of the music interventions used.
Simple musical strategies that could be used at home
Music therapy might not be accessible all the time. However, music can still be used by caregivers in dementia care. The following are some simple ideas that caregivers might explore at home with their loved ones.
(i) Song listening
Playing recordings of songs that the person likes or used to listen to has the potential to bring about a sense of familiarity and even memories, which could be comforting to the person. Besides, songs have structures – a beginning and an ending – which can give the person a better sense of time
Caregivers will have to do a bit of research to identify some of the songs that the person used to enjoy or the music that was popular during the person's youth.
(ii) Singing
Singing is the activation of a very personal and innate instrument – our voice. It connects a person to his inner self when he sings. It is also a simple exercise of the lungs and can be very expressive.
Caregivers can sing songs alongside the person. Even if the person is unable to recall the lyrics, humming the tunes of the songs is just as effective. It is important that the caregiver sings at a slower tempo, at a pace at which the person is able to comprehend the music. This means that there are times when caregivers would have to sing without the support of existing music recordings which might be too quick for the person to grasp.
(iii) Instrument playing
Instrument playing helps in promoting psychomotor exercise and facilitates a more physical engagement. Caregivers could invest in simple percussion instruments such as tambourines, which could be used during singing activities. Caregivers can also encourage or assist in tapping the pulse to the music that is being heard or sung.
(iv) Music and movement
Music can be incorporated into simple physical exercises. Caregivers should select songs that match the person's tempo. For instance, if the person is capable of slower movements, music of a slower tempo should be used.
While most people enjoy music, we have to be sensitive to the person's responses. Just like any other person, there are times when the person might just want to sit in silence, and it is important to acknowledge that as well.
It is also vital to note that through it all, the presence of the caregiver and his/her direct communication with the person during music, brings the most comfort to the person. It would not be as helpful if the caregiver simply played a recording and left the person to it. The caregiver's presence and communication provides the reassurance that the person is not alone in his / her journey.
Resources for more information
http://www.musictherapy.org/assets/1/7/MT_Alzheimers_2006.pdf
http://www.ageuk.org.uk/health-wellbeing/conditions-illnesses/dementia-and-music/
http://www.alzfdn.org/EducationandCare/musictherapy.html
Next Chapter: JOURNEY AS A CAREGIVER
