MPBN visited The Cedars this week to learn more about Music and Memory, a relatively new program at The Cedars. Full audio here.
PORTLAND, Maine – Of the 1.3 million people living in Maine, about 37,000 have dementia. Over the next five years that number is expected to increase to more than 50,000. There is no cure, so treatment focuses on managing symptoms.
One nursing center in Portland recently employed a new strategy. The Cedars is the first in the state to use the “Music and Memory” program, which advocates say can tap deeply into dementia patients’ memories to help connect them to the present.
Inside The Cedars nursing home is a bright orange toolbox. It’s a sort of treasure chest of memories – music memories, all contained in iPod Shuffles that hold some of the residents’ personalized playlists.
“So I’ll get the iShuffles out for two of our residents,” says Nick Viti, reaching into the toolbox. Viti is an occupational therapist and manager of what’s known as “Life Enrichment” at The Cedars. After grabbing the iPod Shuffles and some headphones, he walks down a hallway to a resident named Loraine, who’s sitting in a chair.
“Loraine, would you like to listen to some music?” he asks her.
“Oh I’d love to,” she says. “I love music.”
Viti says Loraine has been a “do-er” for most of her life, always looking for the next task. Now that she can’t stand on her own anymore, she needs things to engage her as she sits in her chair. Listening to big band music on her iPod Shuffle seems to do the trick.
She closes her eyes and sways her head back and forth. “You can see she’s really getting into it,” Viti says.
Loraine is one of about six residents here who’ve been listening to their favorite songs for about three weeks now. It’s part of a national program called Music and Memory that distributes iPods to nursing facilities across the U.S. to help residents with dementia cope with the disease. Brain function diminishes as the disease progresses, but Viti says the centers of the brain that hold emotional and deep memories remain fairly intact.
“We know that music is strongly tied to our emotions, and we have that emotional connection when we hear a particularly moving piece of music,” Viti says. “So the Music and Memory program accesses those centers of the brain that are still quite active in our residents with dementia, and they have a really profound response when they hear music that they recognize.”
“You know, it doesn’t cure it, but I think it can help people cope with the disease better,” says Dr. Heidi Wierman. Wierman is division director of geriatrics at Maine Medical Center. She says, often, what’s most challenging about dementia are the aggressive or disturbing behaviors that can go along with it.
“Helping families and caregivers manage those behaviors is really, probably, the most challenging aspect, in that it’s often so individualized what the triggers are, and then also the responses that are going to be appropriate and successful,” Wierman says.
Nick Viti says the beauty of these playlists is that they’re tailored to each individual. Residents and their families are given a questionnaire to determine what music might make the strongest connection. Residents can ask for their iPods. Staff also hand out iPods when someone seems to be getting agitated or lonely, or when someone’s calling out for a loved one.
“There’s a resident whose father had a deep baritone singing voice. And she has music sung by a man with a similar voice,” Viti says. “So we can change her calling out for this loved one who has passed away to a positive reminiscence through the music. ‘My Daddy used to sing like that.’ ‘Well, tell me more about your Daddy.’ And those positive conversations replace that worried calling out.”
Viti says some of the restrictions that accompany life in a nursing home mean residents can’t rely on coping strategies like many of us do when we’re feeling out of sorts. They can’t jump in the car and go for a drive, or crank up the music on a stereo. But these iPods do give them the option to use music as a source of comfort.
“Would you like to listen to a little music? I think this is something you’ll really enjoy,” Viti says, offering an iPod to a resident named Carmelita.
“Oh yeah,” she says.
As she listens to the music, she says it makes her want to get up and dance. Viti taps into that memory. “Carmie, did you used to dance a lot?”
“All the time,” she says.
“Where did you used to dance, Carmie?”
“Oh my God, any place there was a dance hall, or any place there were dances, we all went.”
Viti says Carmelita used to get weepy in the afternoons. Now they give her an iPod to prevent her from feeling sad. There’s not much evidence yet about the long-term effects of music therapy. Most studies seem to show it has potential.
But Carmelita doesn’t need any convincing. “Music is good for people. I think it’s good for people. Older or younger, it doesn’t make any difference. It’s good. It really is.”
A film about the Music and Memory program, called “Alive Inside,” will air Wednesday evening at Space Gallery in Portland as part of the Camden International Film Festival’s Aging in Maine tour.
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