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Chelsea Mackinnon • November 22, 2017

The Brain On Music: A Dementia Perspective

Room 217’s research lead, Chelsea Mackinnon, wrote this piece for the November 2017 edition of Home and Long Term Care News.

“This song brings me so many emotions,” said Sally*, a long-term care resident who was listening to one of her all-time favourite pieces. Sally has dementia, and musical moments like this one have become highlights within her day-to-day routine.

I have witnessed Sally, among many other residents, find peace, joy, pain relief, happiness and love within their musical experiences. Music is an invaluable tool in long-term care. It connects people with memories, emotions, and with their loved ones. Out of all of our activities of daily living, music activates the most brain areas, which explains why music can have such powerful and diverse effects.

The effects of music begin in the brain, and from there, they project to all parts of our body and soul. Our ears detect sound waves from the environment, and use an encoding system of neurons that is 100 times more powerful than the one our eyes use to encode colours and shapes. Our auditory system is extremely precise. Once our ear has collected and encoded all the information from the airwaves, the coded information travels into our brain through a bundle of neurons appropriately named the auditory nerve. Once the information reaches our brain, it projects to many different areas, which are responsible for the effects of music.

The brain relies on neurons that connect and communicate with different areas in order to function properly. In dementia, neuronal communication is jeopardized, leading to symptoms such as memory and communication challenges. Interestingly, music is the last type of memory to deteriorate in dementia. Research shows that brains of individuals with dementia are able to respond to musical stimuli to a far greater degree than other brain networks, at the same stage of dementia. For example, an individual with dementia who is not able to recognize their children or spouse, quite often can sing every word to many songs from their youth. In this way, music can provide a moment of peace and familiarity in an otherwise unfamiliar world.

Even though we have not answered all the questions about music and the brain, we do have an opportunity to improve the quality of life of individuals living with dementia, through the use of music.

When we listen to music we love, the memory centres of our brain are stimulated. If a song you hear has ever transported you through time to re-create a certain memory, it is because the music triggered memory recall within your limbic system. This system is responsible for encoding our deepest and most primal memories. Playing familiar songs that are known to have positive associations can be a great way to engage individuals with dementia through memory recall, and subsequent discussions about that memory.

Music can also be used in dementia care to re-direct attention. For example, a care partner can easily hum or sing a familiar tune while bathing, feeding, or simply being present with an individual with dementia. Music activates the frontal lobe of the brain, which is responsible for attention. Familiar music can re-focus a person’s attention leading to a sense of relief.

Music has both biological and psychosocial effects. Sally benefits from the music used by her nurses, PSWs, and family members. When music is shared with Sally, she in turn shares it with other residents and care providers. It is this ripple effect, where music connects people within a space, which will change the culture of care in the long-term care setting. Music is free, and accessible to all, and has profound impacts on quality of life.

*Name has been changed

Chelsea Mackinnon, BHSc, MA, is Room 217’s research lead. She teaches two interdisciplinary undergraduate courses at McMaster University, and is the founder of the Hamilton Intergenerational Music Program.

By Shelley Neal March 8, 2024
I initially trained with MUSIC CARE to work with Seniors in Long Term Care who were experiencing dementia and Alzheimer’s Disease. This is the path I travelled with my mom. My training with Music Care and Room 217 supported capacity building in selecting music that was played on my harp or chosen recorded music. The music centered on the care of the individual and their specific needs. My job was to determine the individual’s specific and select music to address these needs. The music selected helped to build community, support sleep, talk about life experiences, create a background landscape of sound, support connection to decrease isolation and loneliness, as well as coming alongside people dying. My training with Music Care helped me understand how to support people “where they were” physically, emotionally, and spiritually. Through using beat, tempo, melody, and timbre, I could cater the music and desired support required for individuals or small groups. My profession is teaching. I am a special education teacher and use music in my primary teaching as a method for learning, practicing language skills, transmitting information about science studies or math equations, as well as having fun and creating our own songs. My teacher toolkit married exceptionally well with the knowledge and skills provided by the Music Care Certification training. Recently, my work with students has involved individual programming for the medically fragile children and the palliative children. I use music (repeating the chorus several times) to engage and connect with the kiddos. We use music to "talk" about feelings (our communication is through eye gaze, eye blinks, and squeezing hands), and content material. I use music to enjoy our relationship of being together. At times, due to medication for seizures, my little ones can be very sleepy. I increase the tempo, engaging in tapping the beat on her hands and using silly action songs. The giggles and wiggles make it magical. I also use music to tell stories (my students have CVI, cortical vision impairment, so visual perception is difficult). This helps the child to engage in the story arch and adventures. Music is my conduit for reaching out and being with the students. Recently, I had the sacred journey of visiting one of my children in ICU at Sick Kids. I was invited to come to say "goodbye". A dear friend who was an ICU nurse in a different department told me (AKA, insisted) that I bring my harp with me. I wasn't sure if this would be appropriate for the family. However, with the permission of the mom, I bravely packed my harp up and took it to the Unit. It was a beautiful evening of talking with their mom and dad about how special their child was in my life. I played the kiddo's favorite songs and then ended with "The More We Get Together". The little one opened their eyes and stared at me. We hugged, and I left. They passed the next morning. I consider this time to be a sacred gift. Music Care Certification has given me the confidence and toolset to work alongside people and to journey together. It is a time a beautiful, difficult, or sacred time that I have been honoured to participate in.  Thank You
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