Saint Mary-of-the-Woods College — Alzheimer’s Disease affects more than 4 million Americans, steals short-term memory and some researchers believe that many of the earliest memories remain intact. Music therapy and art therapy can help access those long-term memories and tap into previously unreachable thoughts and feelings.
Sharon Boyle, assistant professor of music therapy at Saint Mary-of-the-Woods College in Saint Mary-of-the-Woods, Ind., has worked as a music therapist with patients diagnosed with Alzheimer’s Disease and other forms of dementia for nearly 10 years.
“One of our unique traits as human beings is the need for self-expression and the ability to create,” Boyle said. “Individuals with Alzheimer’s are able to connect with others through music, expressing thoughts and feelings that may be difficult to convey in normal conversation. People may isolate themselves and become more confused as the disease progresses, but music is a non-threatening medium through which they can actively participate and connect with others.”
Boyle says that research studies have shown that people with Alzheimer’s Disease respond to music at all stages of the disease.
In the early stages, music therapists can help the person use existing music skills to constructively fill leisure time. Music also can be paired with relaxation techniques, or individuals can create live music in the moment to relieve symptoms of depression.
“Active music-making is key to stimulating numerous areas of the brain, so playing instruments, as well as singing familiar songs from a person’s young adult years, can be extremely effective for addressing motor, cognitive, social, and emotional needs of a person,” Boyle said.
During the middle stages of the disease, singing and playing familiar music or moving to music can provide a source of comfort and reassurance. Theme-based music therapy groups can assist in increasing focus and addressing various cognitive skills, encouraging social interaction and improving mood. Even people in the later stages of the disease can respond to rhythm through increased eye contact, changes in facial expressions and vocalizations.
Music therapists are trained to use music to affect the environment and draw out responses that are appropriate, depending upon a person’s needs. A music therapist singing or playing live music, for example, will adapt tempo, dynamics, and other elements as needed to help decrease problem behaviors associated with agitation or aggression. Caregivers are also encouraged to sing with or to a person to assist with completing various tasks and to provide meaningful human contact.
Boyle has presented the results of using of music therapy at the Alzheimer’s Association Wisconsin State Conference. She also has had additional training in music therapy and gerontology and worked in a specialized Alzheimer’s unit within a long-term county facility for five years. There she facilitated both individual and group music therapy sessions with people in all stages of Alzheimer’s Disease and dementia. While working with one particular elderly client, Boyle witnessed the power of music therapy.
“She was no longer able to converse in a lucid manner,” Boyle said. “She did not interact with her daughter, having long forgotten that she had children. When we would sing hymns in music therapy group, songs she had sung since she was a young girl, this woman would begin to sing and smile. She could recall lyrics of numerous hymns and folk songs and it was during this time that she would begin to speak in a more coherent way, laughing and talking to the woman next to her, who was her grown daughter. Her daughter would smile and look at her mother with tears in her eyes, helping her to play instruments and singing along. It was then that I realized that music therapy benefits the families of patients with Alzheimer’s, not just those suffering directly from the disease.”
In addition to working with patients in various stages of the disease, Boyle has also worked with those in the dying process.
“In the end, after working with patients at various points of the disease, I would sometimes have the privilege of providing music therapy for the family and patient, creating a nurturing and supportive environment when family members and patients were anxious or grieving. Often the music ‘spoke’ in place of words,” Boyle said.
Cara Knight, who is pursuing a master’s degree in art therapy at Saint Mary-of-the-Woods College, says that the number of people diagnosed with Alzheimer’s is expected to rise as the nation’s overall population ages. With no cure on the horizon, caregivers are increasingly exploring art as a way to help manage the disease, and they take encouragement from the results with music.
“The use of art therapy with Alzheimer’s patients is based upon the principle that the process of creating something can be healing and assist in working through feelings that may be difficult to express,” Knight said. “Although the use of art therapy can be varied depending upon the context and needs of the individual, it has specific beneficial qualities for those with Alzheimer’s disease.”
Knight, who works at Bloomington Hospitality House, a long-term care facility in Bloomington, Ind., says that those who operating the facility believe that it is important to engage residents in creative ways that foster self-growth and expression.
“During this time of life, it is vital to encourage individuals to continue to develop their skills as well as review the events of their lives thus far,” Knight said. “In addition to recreational therapy interventions, we utilize the method of ‘art as therapy’ along with more traditional art therapy models to enhance the lives of many of our residents.”
Knight says that creating art has been observed as being therapeutic in a number of ways.
First and foremost, it allows the individual an opportunity to contemplate thoughts and feelings on a non-verbal level. In regard to Alzheimer’s, this form of therapy can be valuable as cognition and verbal abilities begin to decline.
“Creating the image allows an individual with Alzheimer’s to still communicate effectively without words, which furthermore allows them the ability to externalize feelings that may otherwise not be communicated,” Knight said.
In addition, creating art allows the individual with Alzheimer’s Disease feel a sense of control in what they are doing and increases self-esteem through the ability to make an image they can be proud of. Art therapy also serves as a source of life review as individuals are able to focus on memories or events that were significant in their lives. Through creating images about their experiences, individuals are able to gain a sense of purpose and also communicate this important process with others.
Art therapy serves those with Alzheimer’s Disease not only as a form of emotional outlet, but also as a way to sustain cognitive and physical abilities. For example, working with materials such as a brush and paint can encourage use of hand/eye coordination as well as gross and fine motor dexterity, thereby fostering continual development of physical aptitude. The tasks of problem solving and organizing when creating an image, along with the processing of it, employ cognitive skills. Encouraging continual use of these abilities through a creative process likely will sustain the levels of cognitive and physical functioning of an individual with Alzheimer’s for a longer period of time compared to no intervention. The colors and textures of materials also can serve as a source of sensory stimulation, which also is important, especially with those in the final stages of Alzheimer’s.
Knight says that during a creative arts session with one of the male residents in the Alzheimer’s care unit, she witnessed the power of the image to transcend verbal barriers. This particular man, though in his 90s always believed that he was 19. Amazingly, he had the energy to go along with it; however, as his physical health began to deteriorate, he showed a rapid decline in mood and almost immediately exhibited signs of depression. Although unable to verbalize his feelings when asked, it seemed as though his mood was affected by his physical state.
“With some encouragement, the man began to paint two lines on a sheet of paper, one of which was dark purple and jagged, the other smooth and bright orange,” Knight said. “The man began to tell a story about these two lines and identified the orange one as being young and alive, and the purple one being old, slow and sad. He also stated that the two were getting to be too close together and the purple one would soon consume the orange.
“When asked which line he identified with, he stated longingly that he desired to be the orange one, but wasn’t sure if he was anymore,” Knight continued. “It became apparent to me that although unable to identify what was going on with his physical body in a verbal way, he was aware of the decline and affected by it negatively for a sense of fear of no longer being the young, ‘orange’ line that he so desired and enjoyed being.”
While music and art certainly do not provide a cure for Alzheimer’s patients, their use as alternative therapies allow caregivers and the family and friends of those afflicted some “small victories” in their battles with the disease.
‘’There’s no intervention that will stop or reverse the disorder,” Boyle said. “But for the individuals with Alzheimer’s disease and for the loved ones who care for them, music and art therapy can provide moments of connection and a means of communication when words may no longer be an option.”
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SMWC faculty, students use music, art therapy to connect with Alzheimer’s patients
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