Music Therapy for Adults with Dementia
When thinking of the world of music therapy, it is not uncommon to have music therapy for adults with dementia be one of the first areas to cross one’s mind. Though there is no “cure” for dementia, here has been extensive research and case studies conducted by music therapists to see the effects that music therapy can have on an individual who is dealing with the disease in order to better their quality of life. Music therapy can also be a guide for family members of the client to have a rekindled connection with their loved one through music and therapeutic experiences.
Dementia
What is dementia? In general terms, dementia is a chronic disease that affects the psychic-emotional system and nervous system, and is characterized by memory loss and loss of typical cognitive functioning in an individual that affect the individuals daily life and ability to take part in social and professional activities. (Hamdy et al, 2013). In 2018 in the United States alone, 5.7 million people are diagnosed and living with Alzheimer’s and dementia. (“Facts and Figures,” 2018). That 5.7 million from the United States adds into the whopping 46 million people that are affected worldwide. (Hamdy et al, 2013).
Causes of Dementia
Though the most popular cause of dementia is growing older, having dementia is not a part of the typical aging process. (Hamdy et al, 2013). It is also important to note that dementia is not solely for the older population. Dementia can affect younger people as well, as it can be caused by other factors along with aging. Even though aging is the most popular cause of dementia, it is not the most common cause. Dementia is most commonly caused by Alzheimer’s disease. (Hamdy et al, 2013). Alzheimer’s disease is indicated by memory loss, personality disorders, and much more. (Hamdy et al, 2013). Pick’s disease is another cause of dementia. (Hamdy et al, 2013). Unlike Alzheimer’s disease, Pick’s disease is rare and affects younger people, more specifically younger women. (Hamdy et al, 2013). Pick’s disease is categorized by lack of foresight, changes in personality, etc. (Hamdy et al, 2013). One other major cause of dementia are multiple strokes. (Hamdy et al, 2013). When someone has a stroke it damages the brain, so consequentially when someone has multiple strokes it can damage a large enough portion of their brain to interfere with cognitive functioning, therefore leading to multi-infarct dementia (MID). (Hamdy et al, 2013). Other causes of dementia can be head trauma (blood clotting, etc.) and chronic infections (HIV, AIDs, etc.). (Hamdy et al, 2013). Dementia could also be caused by “damage to the cerebral cortex.” (Hamdy et al, 2013). Vascular dementia is also a cause of dementia in older patients. (Hamdy et al, 2013). Over the years, the amount of cases of vascular dementia have gone down, but there are higher rates in geographical regions that have higher rates of cardiovascular and cerebrovascular diseases. (Hamdy et al, 2013). Dementia is also being recognized as a late manifestation of Parkinson’s disease. (Hamdy et al, 2013). Subdural hematomas, which are collections of blood inside of the brain, are also causes of dementia. (Hamdy et al, 2013). During these traumas the person affected may not even lose consciousness or feel as though they have suffered a brain injury. Headaches are a common side effect of these injuries, and they can show up on a CT scan. (Hamdy et al, 2013).
Symptoms of Dementia
Since dementia is a chronic disease, as it progresses the symptoms affiliated with it will evolve and get worse as time goes on. (Draper, 2013). One of the main symptoms of dementia is permanent memory loss mostly affecting an individual’s recent memory. (Hamdy et al, 2013). Dementia can also begin to interfere with a patients daily life as it can make it hard for those suffering to function normally while partaking in social and professional activities. (Hamdy et al, 2013). Other symptoms of dementia include: “disorientation and confusion, impaired language skills such as the inability to comprehend language, behavioral changes, psychological symptoms (depression, anxiety, etc.), impaired judgement (decision making, insight), intellectual decline, impaired functional capacity, and impaired social function.” (Draper, 2013, p. 65). Along with the mental decline, sufferers of dementia will also have to deal with the physical decline of apraxia, or the inability to perform complex or coordinated movements. (Hamdy et al, 2013). Agnosia, or the inability to recognize or identify common objects could also be a problem for someone with dementia. (Hamdy et al, 2013).
Dementia’s Effect on the Family and Caregivers
As can be imagined, dementia takes a toll on not only the one who is diagnosed, but the family as well. When accepting the diagnosis for a family member, the family is accepting that their loved one is being diagnosed with a chronic illness, and they are also facing the possibility that there could be a genetic risk. (Draper, 2013). It becomes especially hard on the family and caregivers when dementia advances into more severe stages, behavioral and personality changes become more obvious. (Draper, 2013). Even in the early stages of dementia, a patient could be at risk for injury to self or property by simply forgetting to blow out a candle or leaving a boiling pot on the stove. This being said, family intervention and caregivers play an extremely large role when it comes to the lives of dementia patients and keeping them safe to ensure the best life possible. One of the biggest challenges for a family to overcome in the process of dementia is simply accepting the diagnosis. (Draper, 2013). Another considerable challenge for family members and caregivers are faced with the frustration of not being able to have meaningful communication with their loved one as there is a lot of unknown for what their family member will remember and what they will not. (Thompson, Pulsford, 2012). When symptoms progress and dementia moves into the more severe stages, there tends to be problems where some family members and caregivers alike will disconnect who the patient was in the past and who they currently are. This dissociating mindset can lead to people quickly losing patience with and being harsh or short with the individual. (Meyer, 2018). It is highly important for families and caretakers to remember that the person they love is still there, they just take a little bit more effort to reach.
Other Types of Treatments
For treating dementia, different kinds of therapies are commonly used. For those suffering from impaired language, they may be assigned a speech pathologist to work with them on regaining or improving their speech. (Bayles, Tomoeda, 2013). There are also studies that are supporting the use of psychotherapy to help maintain some level of cognitive functioning. (Staubo et al, 2017). Another treatment, though not so commonly used is acupuncture therapy. Aricular acupuncture is “a safe nonpharmaceutical treatment that involves the application of a stainless steel needle or medicinal herb on acupoints in the outer-ear.” (Kwon et al, 2018, p. 2). Over the last few years, other treatments such as antipsychotic drugs have decreased, but “treatment with combinations of psychotropic medications is common.” (Karlsson et al, 2017).
Music Therapy and Older Adults with Dementia
The use of music therapy for the treatment of adults with dementia as it not only helps the one suffering from dementia, but also gives families and caregivers a way to better care. (Matthews, 2015). When someone has dementia, they are no longer able to transfer short-term memory into long-term memory because the transfer process is disturbed. (Rio, 2009). One way to improve transfer from short term to long term memory, is by associations with other things that are important to the client. (Rio, 2009). Music is known to bring up and pull out many emotions that sometimes are not expected. Songs can return memories of lost loved ones, fun days at the park, and even entire eras in one’s life. With this in mind, it is easy to see why music is such a beautiful option to help those with dementia remember past events or even to help them learn new information. (Rio, 2009). Also, music can be used as a way for the family to have meaningful communication again with their family member. The family could be a part of the music therapy session and maybe learn some new ways to interact with their loved one. Music therapy can also enhance the emotional well-being of the individual. Giving a patient the opportunity for some kind of meaningful interaction or movement is worth a lot for their mental wellness. (Solé et al, 2014). Another way music therapy can be used in patients with dementia is to reduce agitation. Live music or even some recorded music can be used to calm patients with dementia who are agitated or frustrated. (Martinelli, 2018). Music therapy has also “awoken” some patients who were suffering from dementia. “Often, after months or even years of not speaking at all, they begin to talk again, become more social and seem more engaged by their surroundings. Some begin to remember names long forgotten.” (Geist, 2015). Music therapy allows for patients with dementia to find a sense of self once again within the music and within the experiences and interactions they have within the music and with the people involved in their group. Music therapy increases participation in clients with dementia and also increases their emotional well-being. (Solé et al, 2014).