Every month, prior to COVID, Donna brought her husband Brian to the community center for “drumming and singing,” a music therapy program designed specifically for individuals with dementia, their loved ones, and care partners. Donna and Brian are the youngest members in the group (58 and 62 respectively). Donna is usually vibrant while mingling around the room, making others laugh while moving around the room helping out some of the others. On this day Donna looked unusually tired – and so does Brian.
What is caregiver burnout?
The Cleveland Clinic defines ‘caregiver burnout’ as a state of physical, emotional and mental exhaustion. It may be accompanied by a change in attitude, from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able, physically or financially. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones. Caregivers who are “burned out” may experience fatigue, stress, anxiety and depression.
Since the mid-1950s Certified Music Therapists (MTAs), have facilitated a wide variety of music experiences connected to specific goals including singing, listening to music, counselling questions, songwriting, and instrument exploration.
Music Therapists support individuals living with dementia and their care partners by ensuring everyone in the session has an opportunity to feel heard, connected to others, and experience moments of feeling good. When music therapists use music one can expect to witness repeatable impact from week to week and month to month.
What does music do for our wellness?
It’s long been known that music triggers powerful recollections, but now brain-scan studies show us even more. The part of the brain known as the medial prefrontal cortex sits just behind the forehead and helps us travel down memory lane. “What happens is that a piece of familiar music serves as a soundtrack for a mental movie that starts playing in our head,” suggests Petr Janata, a cognitive neuroscientist at the University of California.
Music has the capacity to meet you where you are at – whether frustrated, unsure, tired or ready to re-enter the world. It can be a sure friend. Delving into your music, like through the curation of a playlist or drumming with friends, will bring you into a deep-seated creative process that will ease your mind and guide you to see your world through a different lens. If you reflect on the past, stay open in the moment, and are willing to embrace the new, your memories, moods, and motivations will continue to grow and change — sometimes a little..and other times a lot.
Back in the music therapy session the music therapist has carefully placed drums and percussion instruments in the middle of a circle of chairs. By 10:00 a.m., ten couples, including Donna and Brian, enter the room and select their seats. Brian looks around uncertain and confused.
Is music always effective?
In the book Wellness, Wellplayed Dr. Laurel Young, a music therapist researcher at Concordia University in Montreal, Canada, reminds us that music is not always positive – and that means we need to pay extra attention.
Young critiques the oversimplified portrayal of music as a nonpharmacological “magic pill” to be “prescribed” to people living with dementia. “Although neuroscience research helps us to understand cognitive processes underlying music, individuals’ musical experiences, cultural backgrounds, and personalities influence how they respond. Music that I perceive as happy or pleasurable may be experienced very differently by others. We also cannot assume the music one wanted to hear yesterday will be the same music you want to hear today. If music becomes irritating or overwhelming, it needs to be turned off or changed immediately. If it evokes strong emotions, whether happy or sad, someone should be there to provide support. Music must always be used with care and a genuine understanding of each listener’s current needs and preferences. When this happens, music may serve as a bridge via which persons living with dementia feel connected to their sense of self, their environment, and others.”
After Donna found two chairs side-by-side, the music therapist walked over to her, pointed to another chair across the circle and said, “Donna, that chair and drum is available. I will sit next to Brian today.”
Although music therapy will not heal Brian of dementia, it can provide moments of clarity, autonomy and relief when music is used intentionally in the right way and at the right time. The music therapist will sit close to some members to provide verbal, non-verbal and musical cues of support. For Donna, the music therapy session will create a space around her worries – even for a brief period of time, allowing her to get as much rest and renewal possible within the hour.
As the session continued, Donna went through a visible transformation. First, Donna closed her eyes and within a few minutes, you could hear her drum above all the others. After 20 minutes, the drumming came to a stop. She leaned back in her chair but kept her eyes closed and her face looked much more relaxed.
Why does music work?
Music is effective and very efficient at fostering positive social interactions by promoting trust and cooperation within even the most diverse gathering of people. Dr. Alan Harvey puts it this way: “In a group context, music-related activities … encourage the formation of bigger social networks, help to define cultural identity, and may represent a ‘safe-haven’ in which individuals can interact and share experiences.” In his research from 2020, he goes on to document the links between music and the hormone oxytocin and the influence they have on physical and mental well-being, the key roles they play in bonding and feelings of attachment, and their positive impact on social recognition and social memory.
As people’s lives and the world becomes even more complex, society continues to seek new ways to feel more connected and feel well. The informed music therapist, and the diverse sessions they provide, help to artfully and skillfully build that bridge of connection and wellness. Each session is designed with several factors in mind, including the client’s physical health, communication abilities, cognitive skills, emotional well-being, and interests. After an initial assessment and after the mutually agreed goals are established, the music therapist will embark on either the creative or receptive process – and in both cases no previous music experience is necessary.
“In the creative process, the music therapist works with the client to actively create or produce the music. This may include composing a song, engaging in music or song improvisation, or drumming. In the receptive process, the therapist offers music listening experiences, such as using music to facilitate a client or group’s relaxation. Clients or groups may then discuss thoughts, feelings, or ideas elicited by that music.” – Dr. Annie Heidersheit, Past President, World Federation of Music Therapy
After the drumming stopped and there was a brief moment of silence, the music therapist picked up the guitar and strummed a few chords leading into a song both Donna and Brian loved. Brian sang every word, frequently looking at me in the eyes with a warm smile of recognition. When the song ended, the music therapist asked Brian, “How did the music make you feel today?” Donna took a deep breath ready to answer for him from across the room when Brian smiled knowingly and said, “music makes me happy.” You could hear Donna’s audible breath of relief.