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Music has many social and cognitive benefits and has long been credited with providing a distraction from physical and emotional pain among Australia’s senior population. But researchers are now discovering it can also prove a powerful communication tool among dementia patients.

Greek philosopher Plato once noted that music “gives a soul to the universe, wings to the mind, flight to the imagination and life to anything”.

Had he been alive today, researchers in Australia might very well have insisted Plato add “and a voice to the silent” given recent discoveries of the impact vocal and instrumental sound has among those aged 65-plus.

Numerous studies have already shown music therapy in seniors has the ability to increase memory function, relax the body, reduce muscle tension and boost productivity with many aged care residents reaping the benefits of music integration – such as group singing, musical performance, personalised music programs and silent discos – into their everyday activities.

However researchers are only now discovering its benefits as a tool of communication both for those with dementia as well as those charged with caring for them.

Music has many social and cognitive benefits and has long been credited with providing a distraction from physical and emotional pain among Australia’s senior population. But researchers are now discovering it can also prove a powerful communication tool among dementia patients.

A study on the impact of musical therapy for dementia patients was carried out in 2015 by the Anglia Ruskin University in Cambridge. The study examined the impact of music therapy on dementia patients and found that music therapy not only improved participants’ dementia symptoms and general sense of wellbeing, but also led to a decline in behavioural issues towards caregivers.

Dr Imogen Clark, a specialist in music therapy for older adults, and a post-doctoral research fellow and lecturer at the University of Melbourne, says it is well known the act of singing or engaging in music has both conscious and unconscious consequences.

Dr Clark says music therapy plays an important part in assisting in achieving the health goals and wellbeing of older Australians – particularly the one in 10 Australians aged over 65 who are living with dementia – by helping to switch on pathways in the brain that aren’t otherwise accessible.

Past studies have shown that when done correctly music therapy not only evokes responses, such as singing and movement, in dementia patients but can also encourage moments of reconnection – however brief – with their loved ones.

In addition, it is credited with assisting in the management of negative symptoms of dementia including depression, agitation, anxiety and apathy.

Dr Clark says while music comes in many different styles and can be presented in an array of different ways, most people assume that when they see a music therapist singing with a patient, they are just enjoying a sing-a-long. The truth, she says, is far more strategic.

Only too aware that older people tend to have the best connection with music from their late teens and early 20s, one of the easiest ways for music therapists to find common ground with those they are working with is through music selection where therapists try to work out what their patient’s musical preferences were at that time – and use those as a starting point. The music will often stimulate memories and alongside it, dialogue around the patient’s life and connection to the music.

Another tool used by music therapists in working with older patients both with and without dementia involves matching the recipient’s projections – whether vocal or physical – and integrating that into the music, Dr Clark says.

“By doing that, especially with someone who has dementia, we’re able to actually think unconsciously into their brain. For example, the music therapist will be very conscious of how loudly that person is singing or engaging and will work to mirror that person’s response.”

When music therapy patients are agitated or upset, therapists may use a practice they refer to as entrainment which involves synchronising the music or singing to reflect the patient’s approach. It might be louder, it might be faster than normal to start with but gradually the therapist will drop the tempo and the volume of the music to bring that person to a more relaxed state.

“It might take a long time to do that but you need to actually meet that person in their space in a musical way. That’s why music is a resource for communication for people whose communication skills or capacity is that little bit impaired.”

In her attempt to better understand the part innovative music therapy interventions play in improving relationships while also reducing the burden of age-related healthcare, Dr Clark has undertaken several research projects in this area, the latest of which saw her awarded a prestigious research grant from Dementia Australia’s Research Foundation.

The project, which began late last year, involves exploring the potential of group songwriting as a means for “improving social connection, mental health, wellbeing and quality of life for people with dementia and their family carers”.

Used as a music therapy intervention, the project sees 60 community-based elderly dementia patients and their spouses brought together to brainstorm their experiences, ideas and expressions through the act of songwriting.

It is an extremely carthartic process for all participants as people living with dementia and their caregivers are usually very isolated in their community and not often afforded an opportunity to meet with others living similarly or to express what it’s like for them, she says.

Dr Clark says while she attempted not to have too many expectations around likely outcomes prior to commencing the project, the study has already thrown up some interesting data despite the fact she is only around half way through her investigations.

Song writing is often seen as something that is a little too abstract. When I first wrote the project people thought ‘are you nuts?’ because mostly when we think of music and people with dementia we think that they need to have music that they are familiar with.”

Instead the research team found that participants with dementia have been able to contribute so much in terms of lyrics. Dr Clark says most of the songs that are written [during the research project] are parodies where lyrics are re-written “but they’ve created completely new lyrics that are meaningful for them”. Because they’re all living with the same experience of dementia they’re able to understand each other and they’re in a safe space where they can easily share their experiences, Dr Clark says.

“Putting them in a song is quite a powerful way of communicating those experiences hopefully to their own families but also to the public in general. It’s quite astounding the way quite a few of the parties that are living with dementia were so careful about the lyrics and how those words meant so much to them.”

It is anticipated the songs written during the project will be performed and recorded to increase public awareness and understanding about what it is like to live with dementia while helping to alleviate misconceptions others held about the illness, she says.

In addition to this work, Dr Clark is also involved in a second research project, called MIDDELL (Music Interventions for Dementia and Depression in Elderly Care), which is an international study to determine the effectiveness of group music therapy and recreational choir singing in reducing depression symptoms in people with dementia.

The largest trial of music interventions to date, and the first to compare different music-based interventions, it is hosted by The Grieg Academy Music Therapy Research Centre and involves around 1000 participants across 100 aged care homes in Australia, Denmark, Germany, Italy, Netherlands, Norway, Poland and the United Kingdom.

Having begun in July 2018, the six year project is expected to conclude in October 2024.

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