Jen Hastings, Neurologic Music Therapist

The other day a good friend called to talk about her mom, Anna, who moved in with her five years ago after a dementia diagnosis. My friend was concerned that her mother was depressed.

Anna was an independent single mom who never missed a day of work at her small business. But once she retired, she seemed lost, and cognitive changes became more apparent. Anna struggled to find words and would ask the same questions at 5-minute intervals. Sometimes she confused family members, like the time she deeply upset her sister when she called her by their mother’s name.

Anna loved seeing family and could grow lively in their presence, but was less responsive in general. It seemed like she knew that her brain was changing, but was reluctant to talk about it. My friend wondered if I had some ideas on how to help, since I’ve worked with adults with dementia for about 20 years as a music therapist. She wondered if there were ways that she could help stave off cognitive and physical deterioration.

Here are some of the things I suggested:

1. Give purposeful work.

Many older clients express that without work, they feel “useless.” I would suggest giving them a job to do and praise their work regularly. For people with mild to moderate dementia, you can ask them to help with tasks such as cooking and cleaning, projects with grandchildren, anything at which they might enjoy and be successful. Even people with advanced dementia can help out: at some nursing homes, residents fold towels for the staff. You’d be surprised at how much calmer they appear while doing this activity.

2. Encourage hand use.

Along those same lines, don’t take away everyday tasks such as cleaning, lifting, folding, and cooking. I have observed that many older people tend to stop using their hands when they stop doing the tasks that make them independent.

Unfortunately, “Use it or lose it” is a grim reality. But these skills are not gone forever- we learn through repetition, so if we do a task every day, we will improve. Tread carefully, however, her hands are arthritic, because sometimes movement can make inflammation worse. When in doubt, consult a doctor, physical or occupational therapist.

3. Provide many sources for love and physical affection.

I work on Memory Care with people with severe dementia and bring them calendars with cute photos of cats and dogs. One day I left for a couple of hours and when I returned, I realized that the calendar I brought had circled the entire room! They all loved looking at it. This actually releases oxytocin and makes us feel good.

Give them experiences with children and pets if you can. If they’re allergic, show them pictures or movies with kids or pets.

4. Provide structure as much as you can.

Give her a sense of belonging to the world. Even if she doesn’t read anymore, still bring her a newspaper or magazines. She may not understand what she reads as she once did but having the paper can feel normalizing. Remember that she is feeling confused about her role and could use some cues. Besides, reading is a good cognitive stimulus and a useful skill worthy of retention.

5. Come together through music.

Dementia tends to leave musical memory intact, especially “overlearned” songs: ones we have sung many, many times.

Think about what she listened to when she was younger. If you can’t remember, consider that our tastes are usually developed in our teenage years, so google popular songs of that decade.

Put on some recordings and see how she reacts. Does she hum along, tap her foot, sing with you, maybe dance with you? Some people can’t talk very much anymore but can still sing. Others who are less affected may have memories that they would be willing to share if you ask the right questions. It might take a little time, but can be very worth it!

Ask her what she remembers about the song. Maybe she shared a love song with her spouse, and this can lead to a story about how they met. Even if you’ve heard these stories a million times, you would be surprised at new details that spring up from hearing recorded music.
Additionally, learning the music she loves can help calm them later on if she sundowns or resist care.

6. Manage your expectations.

With dementia, professionals usually set goals to maintain existing skills versus improvement. You can still work on improving skills, but remember that this is a progressive disease. With that in mind, it can be helpful to redefine your expectations of your loved one.

To me, the gold in any relationship is the connection, such as the moments you come together and laugh or talk or sometimes just make eye contact. I know that our relationships with family members can be complicated and difficult, especially after a lifetime of knowing one another. But this can be a time when this relationship changes as our loved one changes.

*Name has been changed.

Here’s a great article on how music therapy can help with Parkinson’s disease, compiled from Connie Tomaino’s 2018 presentation for the Parkinson’s Foundation. She worked for many years with Oliver Sacks and is a great resource. https://www.parkinson.org/blog/research/Music-Therapy-Parkinsons-Disease-Feel-Rhythm

I just wrote a new article on the use of music to teach emotional intelligence. We know that EQ is a tough thing to teach, and some people think you either have it or you don’t. It’s difficult to teach this in a classroom, because learning must be experiential, rather than cerebral, to truly learn and incorporate emotional intelligence.

View at Medium.com

I am pleased to announce that I moved to Manhattan a few months ago and have a few openings for new clients! Because my time is limited, I am focusing on working with the populations I am most passionate about serving, using Neurologic Music Therapy techniques with people who have:

• Parkinson’s disease
• Survivors of stroke
• Traumatic Brain Injury &
• Autism 

Goals can be physical ( such as working on fine/gross motor through drumming), emotional (ex: processing from grief through making music), social (such as practicing skills for everyday life such as ordering coffee after a Traumatic Brain Injury) and communicative (ex: recovery of speech through Melodic Intonation Therapy post-stroke).

Additionally, music therapy is a means to recover through joy and fun, which can be a goal in itself. If you or someone you know might benefit from music therapy, please email me at the link provided above, using the “Contact” button.  I would be happy to speak with you.

Originally, my aim in music therapy was not so much altruistic as to experience engaging musically in a safe space with another person. I was petrified of my peers hearing me play, due less to my lack of musicianship as my fear of being “heard”, exposed. Music therapy was a new way to engage with another person that felt safe. I was inspired to improvise with my clients, who would not judge my music and had a great time no matter how I played.

Thankfully, once I worked as a music therapist for some time, I realized that connecting through music was not actually about me at all. It wasn’t even about the client. It was about the space between us, the connection we felt that could not be quantified or even be described. And yet, there it was: tangible, almost solid.

I write this knowing that it can be controversial in the music therapy community to talk about the abstract concepts of connection and relationship. I am grateful that some aspects of music therapy can be described scientifically, and I know that I benefit from the tireless hours music therapists have conducting valuable research (often on their own dime). But I must confess that I find it equally exciting and frustrating that we can’t explain so much that happens during music therapy sessions, and that often the treatment does not affect groups of people consistently.

I think my relief in lack of total explanation is that this leaves room for the spiritual. My most profound experiences have been in the music therapy treatment room. I learned there to trust my gut, even when it made absolutely no sense, and it was usually right. Further, there is power in music to bring us to our most vulnerable and then build us back up, and doing this with another person can be a rare gift. My last thought: if this experience could be fully explained, would it actually lose any of its power?