Dementia can be extremely upsetting for both sufferers and their loved ones, but music therapy can have profoundly beneficial effects.
Margaret Torrance often plays the piano for a rapt audience, reeling off one note-perfect tune after another without so much as a glance at a sheet of music.
She also has trouble remembering her daughter’s name, does not know she has grandchildren and struggles to hold a conversation lasting longer than a few minutes.
Margaret is 81, and was diagnosed with vascular dementia four years ago. She has been in a care home since July 2010.
A talented pianist, she regularly plays for other residents on the piano which she and her husband bought in the 1950s and which her daughter, Jan, gave to the home so her mother could continue doing what she loved.
Margaret’s talent is remarkable, but the fact that she remains able to play music despite suffering from advanced dementia is not.
It is well documented that the capacity to remember music – whether it’s the ability to play an instrument or recite the lyrics to our favourite song – remains one of the last to leave us.
Dr Vicky Williamson, a research fellow at Goldsmith’s University in London who specialises in the relationship between music and memory, explains that, in physiological terms, it is unsurprising that the two are so closely linked.
“There are very direct, close connections between the music that we like – which activate these emotion and reward sensors – and your hippocampus, which is where all your emotions are stored,” she says.
She explains that even those in advanced stages of dementia are still likely to remember music learnt as a child or teenager, as memory loss tends to work backwards, eroding the most recent memories first.
As a result of the strong relationship between music and memory, singing, playing an instrument or just hearing a familiar tune can all have a therapeutic effect on dementia sufferers.
For Margaret, music is a way of managing her condition, calming her when she becomes distressed or disoriented.
“There were times when Mum was very anxious to get out of the home,” says her daughter Jan.
“She thinks a lot about her mum and dad and talks about them all the time, and has spells where she’s very unsettled and wants to get out. The piano is a way of diverting her. It really helps.”
With a growing elderly population, dementia is a particular concern in the UK, where a person is diagnosed with dementia every 3.2 minutes. It affects well over a million people: 800,000 sufferers and their 670,000 carers.
The condition also costs the UK billions every year – twice as much as cancer – but spending on dementia is only a fraction of the millions ploughed into cancer research, according to figures released in 2010.
There are two main kinds of dementia: vascular dementia, which is caused by problems with the blood supply to the brain, and Alzheimer’s disease, which is the most common form.
However, ‘dementia’ technically describes a set of symptoms – including memory loss, difficulty communicating and reasoning, and dramatic mood swings – and so can also be part of other neurological conditions such as Huntington’s disease and Parkinson’s disease.
Last year Prime Minister David Cameron launched a campaign to improve public understanding of dementia, as early symptoms are often dismissed as a ‘normal’ part of ageing.
There’s currently no cure and, when dementia is diagnosed, nobody can tell you precisely how things will progress. While one person may be lucid for several years before beginning to deteriorate, another may be in a care home within months.
It can be extremely difficult to live with, and one of the cruellest aspects of the disease is memory loss. Sufferers of late-stage dementia forget the names and faces of their dearest family members and cannot understand where they are or why they are there. Unable to express this frustration, they can become angry and aggressive.
Traditional treatment involves drugs to try to alleviate symptoms and slow down the progression of the disease, but their effects are limited.
Music therapy is increasingly becoming a legitimate way of managing various conditions – including dementia – and there are now 600 registered music therapists in the UK.
“There’s growing convincing evidence which means that people are starting to take notice of music therapy,” says Dr Williamson.
Although many professionals recognise the benefits music can have on sufferers, a recent study by Bupa found that fewer than one in 10 people would consider using music to communicate with a relative who has dementia.
Bupa has been working to raise awareness of dementia, and recently launched its ‘Talking Toolkit’ which gives advice on how to connect with a loved one living with the condition.
In a recent survey, it found that ‘being forgotten’ (45%) and ‘losing personal connections’ (40%) were the biggest concerns in relation to loved ones developing dementia.
Helping rekindle a sense of connection is just one of the many benefits music therapy can hold – making it a comfort for relatives as well as an important therapy for patients.
Bupa is also keen to highlight these benefits, and music therapy sessions are now run in Bupa-run nursing homes across the UK.
One example is Anglesea Heights in Ipswich, where staff ask for information about a resident’s musical tastes when they first arrive.
Music is an integral part of the residents’ lives. A music therapist runs weekly one-hour sessions for all 120 of them. They are encouraged to join in either by playing instruments or singing or even dancing along.
The home introduced the sessions nine years ago, and manager Tina Askew says both residents and their relatives have noticed the beneficial effects, even for patients with the most advanced illnesses.
But music therapy is beginning to spread beyond care homes, and within the last decade a number of organisations have begun to offer musical sessions to dementia sufferers.
In 2003, the charity Alzheimer’s UK launched a nationwide initiative called ‘Singing for the Brain’, running weekly sessions at which dementia sufferers and their carers can sing and socialise.
Lost Chord, a Sheffield-based charity also set up in 2003, employs professional singers and musicians to perform live at care homes nationwide.
Not all dementia sufferers will have access to music therapy or sessions like these, but that doesn’t mean that they can’t benefit from music. Simply listening to a song with emotional significance can have a positive effect and bring back memories.
“The wonderful thing about memory is you can think of it as a line of dominoes, rather than simply a link between two different isolated things,” Dr Williamson explains.
“By triggering off an emotional or a motor-behavioural response that is associated with music, you might collapse the domino chain to other types of memory. Music is a key link in a chain rather than the end point you’re trying to get to.”
For Jan Torrance, music continues to provide her and her family with some comfort, and even moments of humour. She describes a visit to her mother a few months ago, on one of her more lucid days.
“She told me, ‘They’ve got me working hard playing that piano again!’, and she said it with a bit of a smile on her face.”
:: For more information about Bupa’s ‘Talking Toolkit’ visit http://www.bupa.co.uk/individuals/care-homes/understanding-dementi
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