By Chelsea Mackinnon
“This song brings me so many emotions,” said Sally*, a long-term care resident who was listening to one of her all-time favourite pieces. Sally has dementia, and musical moments like this one have become highlights within her day-to-day routine.
I have witnessed Sally, among many other residents, find peace, joy, pain relief, happiness and love within their musical experiences. Music is an invaluable tool in long-term care. It connects people with memories, emotions, and with their loved ones. Out of all of our activities of daily living, music activates the most brain areas, which explains why music can have such powerful and diverse effects.
The effects of music begin in the brain, and from there, they project to all parts of our body and soul. Our ears detect sound waves from the environment, and use an encoding system of neurons that is 100 times more powerful than the one our eyes use to encode colours and shapes. Our auditory system is extremely precise. Once our ear has collected and encoded all the information from the airwaves, the coded information travels into our brain through a bundle of neurons appropriately named the auditory nerve. Once the information reaches our brain, it projects to many different areas, which are responsible for the effects of music.
The brain relies on neurons that connect and communicate with different areas in order to function properly. In dementia, neuronal communication is jeopardized, leading to symptoms such as memory and communication challenges. Interestingly, music is the last type of memory to deteriorate in dementia. Research shows that brains of individuals with dementia are able to respond to musical stimuli to a far greater degree than other brain networks, at the same stage of dementia. For example, an individual with dementia who is not able to recognize their children or spouse, quite often can sing every word to many songs from their youth. In this way, music can provide a moment of peace and familiarity in an otherwise unfamiliar world.
Even though we have not answered all the questions about music and the brain, we do have an opportunity to improve the quality of life of individuals living with dementia, through the use of music.
When we listen to music we love, the memory centres of our brain are stimulated. If a song you hear has ever transported you through time to re-create a certain memory, it is because the music triggered memory recall within your limbic system. This system is responsible for encoding our deepest and most primal memories. Playing familiar songs that are known to have positive associations can be a great way to engage individuals with dementia through memory recall, and subsequent discussions about that memory.
Music can also be used in dementia care to re-direct attention. For example, a care partner can easily hum or sing a familiar tune while bathing, feeding, or simply being present with an individual with dementia. Music activates the frontal lobe of the brain, which is responsible for attention. Familiar music can re-focus a person’s attention leading to a sense of relief.
Music has both biological and psychosocial effects. Sally benefits from the music used by her nurses, PSWs, and family members. When music is shared with Sally, she in turn shares it with other residents and care providers. It is this ripple effect, where music connects people within a space, which will change the culture of care in the long-term care setting. Music is free, and accessible to all, and has profound impacts on quality of life.
*Name has been changed
Chelsea Mackinnon, BHSc, MA, is Room 217’s research lead. She teaches two interdisciplinary undergraduate courses at McMaster University, and is the founder of the Hamilton Intergenerational Music Program.