Even when they are confused about which room they’re in, people with dementia may burst into perfect renditions of songs they first learned when they were young — typically about 14, a time of self-discovery and strong emotions, when the brain center, the amygdala, tagged memories as important.
When your memory goes, music sticks the longest.
Music affects mood in us all. If you like Frank Sinatra’s hit “My Way,” the very first bars click the on button in the amygdala and other parts of the brain that trigger dopamine, a chemical even scientists call happy juice.
The benefits may go much further than you’d imagine. Music has been shown to reduce depression and boost immunity. It can help tame chronic pain problems. Studies show that music, especially when it is pleasant and beloved, is more than a distraction: it seems to actually alter the body’s pain signals in the spine and elsewhere.
So you can cheer up a loved one with dementia if you give her the gift of familiar music that is triumphant, soothing, or peppy. In fact, studies are beginning to show that personalized playlists can help reduce anxiety in people with dementia and calm agitated behavior. It can even allow their doctors to cut back on antipsychotic medications. In 2013 and 2014, Wisconsin’s Department of Health Services introduced a program called “Music and Memory” in 250 nursing homes across the state. The program trains caregivers to create personalized playlists for people with dementia. Before it began, the state reports, 17.4 percent of residents were taking antipsychotics; a year later, use had declined to 14.6 percent.
If you’re living with a loved one with dementia, play a personalized playlist in the room where she spends the most time. If she’s living elsewhere, she may not be able to handle an Mp3 player by herself, but if you give her a simple one loaded with her favorites (and good headphones), a home care worker or staff in a facility can help. Visit and sing the songs she likes with her.
When I tried this myself, I saw an entire room of patients respond.
Over the last three years my dear friend — we'll call her Boe — has deteriorated rapidly. She was a joyous person, philosophical and kind and boisterous and dementia struck her young, in her late 60s. When she sees me she still smiles, and I think she recognizes me. She smiles at my boyfriend, Josh, too — even though I met him after she became ill.
The last time we saw Boe in her own home on a lake she was still her boisterous self. While we were swimming, she took the wallets out of our back packs and "put away" Josh's credit card with her CDs.
The next time she was in a care facility and she kept playing with a shoe, admiring the thickness of its sole.
On my last visit, she was sitting very quietly, and could only whisper to us. She still seemed happy.
But we couldn't have a conversation
So Josh and I sang to her, songs we thought she might know.
There were about 15 other residents in open area, mostly staring into space or talking to themselves. They seemed to be waiting. For a visitor? Some were reading, but mostly they were unoccupied and unresponsive.
I began with "Down by the Salley Gardens," a melody with the words of a Yeats song. It is a sad song, but one of her favorites, with a personal history for us. Boe and I had sung it together many times, once even in a rowboat in a lake in Ireland. We argued because she said I was off tune and I insisted I wasn't.
She seemed to recognize the song, for a moment, but didn't sing with me.
We sang Paul Simon's "Parsley Sage Rosemary and Thyme (with Canticle),” another of her favorites, and she gazed intently at me. Then we sang "Bridge over Troubled Water." I told her she had been a bridge over troubled water for me many a time, and she nodded, and I said "I know." Did she understand? I don't know.
Josh had the wonderful idea of singing two extraordinarily cheerful songs. He once sang them to me in bed to cheer me up when I was vomiting all night, and I remember the night as a happy one! Boe smiled but didn't respond as I know she would have before she began losing her mind. The old Boe would have adopted both songs as her own, and loved Josh completely.
Then we sang "America the Beautiful."
Boe was attentive, and several of the other residents looked up. They knew this song from football and baseball games and schoolyards.
We tried the "Star Spangled Banner." This time, Boe sang along in her whisper. She knew the words and she knew the melody. We had reached her.
Many people were listening. I wish I could say they all began to sing. I wish I could report loud applause. But that's the scene in the movie.
In life, we saw brighter eyes, nods, and heads that had been slumped to the side seeming straighter.
It's hard to visit old age homes. I invite you to go and sing your heart out.
October 12, 2016
Christopher Nystuen, MD, MBA