Читать книгу Connecting in the Land of Dementia - Deborah Shouse - Страница 14
ОглавлениеFly to the Moon with Music Therapy
Embrace the Duet of Music and the Brain
Come Alive with Personal Playlists
Sing Along and Find Your Voice
Weave In Rhythm
Unearth Life’s Lyrics
Encore
“Music expresses that which cannot be put into words and that which cannot remain silent.” —Victor Hugo
During my mom’s dementia journey, music often inspired and connected us. Here is one of those melodic moments, in a paraphrased excerpt from my book, Love in the Land of Dementia: Finding Hope in the Caregiver’s Journey. The story is set in my mom’s memory care community.
Rochelle, the activity director, sticks in another tape and soon “Stardust” is playing.
“Let’s dance,” she says, motioning everyone to stand.
Mom looks up, and I offer her my hand.
“Want to dance?” I ask her.
“What?”
“Want to dance?” I repeat, making a swirling motion.
“What else,” she says, standing up.
My parents have danced to this song many times, my mother coaxing my father onto the dance floor. I hold hands with Mom and move back and forth to the music. She laughs and does the same. I twirl her, and she walks around in a jaunty little circle. For a moment, her energy and charm have returned. I feel like I have found my long-lost mother. If my father were here, he would not be surprised. He is certain she will return to him and takes every word, every gesture of affection, every smile as a sign of hope.
“Hope is everything,” Dad told me just last week. “I find something hopeful and I milk it for all it’s worth. If it doesn’t work out, then I search for something else. Otherwise, I am in despair.”
I twirl my mom again. It is actually our first real dance together . . . .
From dancing to creating personal playlists, this chapter sings with music and rhythm-related ideas. According to numerous studies, music improves the lives of those living with dementia by reducing the need for psychotropic drugs, increasing socialization, and relieving depression.
Fly to the Moon with Music Therapy
“Where words fail, music speaks.” —Hans Christian Andersen
Mollie is not in the mood to sing. Her mouth is in scowl position as she slumps onto our sofa and says, “I wish I could die.”
Mollie has been wishing this for some months, but despite her ninety-seven years of life and difficulty in seeing and hearing, despite the maddening encroachment of forgetfulness and confusion, despite increased frailty and physical decline, Mollie lives on.
I sit beside Mollie, holding her one-year-old great-granddaughter Annabelle. At the sight of Annabelle’s rosy cheeks and winning smile, Mollie says, “What a pretty baby. How old is she now?”
“One year,” I tell her.
My life partner Ron, Mollie’s son, brings Mollie a tissue and a glass of water. A knock on the door and Emily, the music therapist, comes in. She sets down her guitar case and reintroduces herself to Mollie. “We met a couple of weeks ago,” she says. “I sang you songs, and we talked about your travels.”
“Whatever,” Mollie says, shrugging.
“Shall I sing more songs today?” Emily asks.
“If you want to,” Mollie says, closing her eyes.
For the last two months, we’ve added a hospice team to the assisted living staff who care for Mollie. Emily is part of their arts program, and Ron and I want to experience this session with Mollie, thinking it will be something meaningful to share.
Emily has brought an array of bells and rattles. As Emily plays “Down by the Old Mill Stream,” Annabelle eagerly takes two strings of bells and shakes them. Mollie’s eyes are still closed, but Annabelle looks right at Emily.
“Mollie, would you like to hear ‘Just the Way You Look Tonight’ or ‘Fly Me to the Moon’?” Emily asks.
Mollie doesn’t respond, and I figure she’s fallen asleep. I am about to request, “Just the Way You Look Tonight,” when Mollie pipes up, her eyes still shut.
“‘Fly Me to the Moon,’” she says.
Emily’s voice is sweet and melodic; Ron and I can’t resist singing along, humming around the lyrics we’ve forgotten and skirting the high notes. Annabelle moves on to mini-rain sticks, adding in a soothing percussion.
You’ve flown a lot of places, haven’t you Mollie?” Emily asks, when the song is over.
“I have.” Mollie opens her eyes. “I’ve been around.”
“You’ve been to France and England, is that right?”
“And India and Russia,” Mollie says.
“Mom’s also traveled to China, years ago, when few Americans were going there,” Ron tells us.
“You’ve led an adventurous life,” Emily says.
“I really have.”
“What shall I play next? Would you like to hear ‘I Left My Heart in San Francisco’ or ‘Oh What a Beautiful Mornin’’?”
“‘San Francisco.’” Mollie sits up; she and Annabelle both look at Emily as she sings the nostalgic tune.
“That’s a city I’d like to visit some day,” Emily says, resting her guitar across her lap. “Have you been there?”
“Many times,” Mollie says.
Song by song, story by story, the hour unfolds. Emily quietly offers a choice of old standards, and the soothing familiar tunes lead into a pleasant reminiscence.
At the end of the session, Annabelle is mellowed into sprawling slumber and Mollie is sitting straight and alert. For Annabelle, the music was a lullaby and for Mollie, it was an affirming wake-up call.
Embrace the Duet of Music and the Brain
“Music is what feelings sound like.” —Author Unknown
Concetta Tomaino hugged her guitar close as she walked the grim corridors of the nursing home’s advanced-stage dementia unit. It was 1978 and Concetta, a graduate student in music therapy at New York University, tried not to stare at the residents, many of whom were slumped on tattered sofas or tied into wheelchairs. Some were screaming; others were calling out for help.
Concetta walked into the dayroom, where many residents were gathered in a circle. She had no idea how she could connect with these people but she sat down, calmed herself, and began playing “Let Me Call You Sweetheart” on her guitar. As she sang, something fascinating happened: The people who were agitated calmed down. Those who seemed catatonic woke up and began singing along. Concetta wondered, How can people with such severe cognitive brain damage respond so quickly to music?
The Power of Music
Early on, Concetta met Oliver Sacks, the neurologist and author who’d observed an amazing awakening triggered by music with his Parkinson’s patients. She asked herself, How about people living with dementia? Why do they respond to music? Can we use music to maintain or even retrieve brain function?
These questions fueled her research and inspired her pioneering work in music therapy and the use of familiar songs with people living with end-stage dementia. She earned a doctorate in music therapy and was a founder of the Institute for Music and Neurologic Function (IMNF). This internationally recognized nonprofit offers music therapy programs to restore, maintain, and improve people’s physical, emotional, and neurological function.
“We believe music has unique powers to heal, rehabilitate, and inspire.”
Concetta and other researchers discovered a strong link between music, emotions, and memory. The human brain’s auditory cortex is connected to the limbic system, which processes emotions and controls various aspects of memory. Areas of the brain associated with long-term memory and emotions connect quickly with sound.
“We believe music has unique powers to heal, rehabilitate, and inspire,” Concetta says. “We’re trying to understand how the melodies reach areas of the brain so we can create programs that draw out the fullest function, even when there is complex neurologic damage.”
Why Music Matters
According to Concetta, music is an art form people associate with major life moments. We link songs to historical and personal events. The associated memories and feelings are preserved and evoked when we hear those tunes again.
“We may forget facts, but we never lose feelings and associations,” she explains. “Shared music can forge a sense of connection between people. Care partners can experiment to see which songs mean the most to their partners and why.”
Even when people are nonverbal, the right tunes can lead to deep moments of bonding and can create a sense of belonging.
Using a Big Band to Move Forward
Here is how one care partner used favorite songs to connect with and soothe his beloved wife:
“Besides reducing agitation, research shows that music improves memory. I have yet to meet someone who isn’t responsive to the right music.”
David was dedicated to caring for Arla at home. But getting her to take a bath was becoming increasingly difficult. He simply could not coax her out of her chair and into the bathroom. He thought back on their life together, trying to figure out what could motivate her to move. Then he remembered listening to Duke Ellington’s big band. Arla loved the Duke, and she was always the first one out on the dance floor. David put on one of Ellington’s CDs, and as the orchestra swelled, he held out his arms. Arla smiled and stood right up, seeming to float into his embrace. He had to grin as he danced her into the bathroom to the sound of the Duke playing, “Don’t Get Around Much Anymore.” Two days later, “It Don’t Mean a Thing (If It Ain’t Got That Swing)” came to his rescue. Day after day, the Duke inspired David’s “Satin Doll” to dance her way to the bathroom.
“Besides reducing agitation, research shows that music improves memory,” Concetta says. “I have yet to meet someone who isn’t responsive to the right music.”
Creative Sparks
Put together a catalogue of songs your partner likes and a list of family and friends the music connects her to. If the grandchildren are visiting, and Grandma used to take the kids to Disney movies, play or sing those Disney tunes. With adult children, revisit favorite childhood melodies.
Take advantage of conversational openings the lyrics might inspire. For example, if your partner asks, “When is Dad coming?” after hearing a song from his teenage years, ask, “Are you thinking about your dad? Did he like this song? Did you ever sing to it together?”
Seek community concerts and dementia-friendly singing groups.
Invite friends to share relevant songs.
Explore opportunities to engage with music therapists.
To reduce resistance and increase a feeling of safety, sing during daily care routines, such as bathing or getting ready for bed.
Use music, along with dancing and singing, to reduce anxiety.
Create your own personal playlist and share it with friends and family; listening to these songs is a wonderful way to relax and stay connected with yourself and your own history.
Come Alive with Personal Playlists
“To love a person is to learn the song that is in their heart, / And to sing it to them when they have forgotten.” —Arne Garborg
Just an hour earlier, Henry was staring vacantly at the television set in the memory care unit. Now Henry is grooving, feet tapping, fingers snapping, head bobbing. His headphones block out distractions, and he hums along, blissfully engaged in his favorite songs from the 1940s.
Henry is one of thousands of people who benefit from MUSIC & MEMORYSM, which is now used throughout the world.
Seeking Musical Solutions
One afternoon in 2006, Dan Cohen, a social worker with a background in high-tech training and software applications, was listening to a radio show that discussed the MP3 player phenomenon. As he listened, Dan wondered, Would I have access to my favorite sixties music if I ever needed to live in a nursing home?
