Music Therapy in Geriatric Care

Music Heals

For the geriatric client, music therapy can be an effective and enjoyable medium for the maintenance and improvement of cognitive, physical and socio-emotional functioning. Music therapy sessions are individually designed to meet the specific needs of the elderly client Typical musical experiences can include singing, music listening, sharing and discussion of songs, learning to play instruments, song writing, moving to music, and participation in music activities designed to promote social interaction and self-esteem.

Music is one of life’s earliest experiences and in late adulthood musical memories remain as some of the most deep-rooted. A person’s musical history is an important component of the music therapy assessment and treatment plan. Providing music that is related to an individual’s cultural and/or religious backgrounds, or providing opportunities to rediscover musical skills gives a personalized approach and is especially valuable when working with persons with dementia.

Music therapy can stimulate cognitive functioning through providing opportunities to learn new skills as well as through utilizing previously acquired knowledge. Both long and short term recall can be stimulated through such experiences as musical associations, singing familiar songs, and sequenced activities utilizing rhythm instruments, songs and/or movement. Music therapy can also provide a non-threatening source of reality orientation. By providing music related to seasons, holidays, ‘or special events or through incorporating musical associations into the process of life review, reality may be realized in a manner that is affirmative of and empathic to the person’s needs and capabilities.

Music is often used to provide motivation for physical activation in the elderly. Playing instruments can increase range of motion, develop muscle strength and tolerance, and enhance both fine and gross motor functioning. Singing can improve oral-motor skills and enhance respiratory functioning. The use of a technique called Melodic Intonation Therapy has been successful in restoring functional speech for some persons who have suffered cerebrovascular accidents. Music can also facilitate states of relaxation thereby promoting sleep and decreasing pain and anxiety.

Song writing, instrumental improvisation, discussion of lyrics, and directed music listening can help promote verbal and non-verbal communication. Music can be used to validate feelings of grief, loneliness and depression and assist in promoting feelings of well being and satisfaction.

Music therapy offers an alternative and positive approach for reinforcing quality of life for the elderly.

In Geriatric Care, Music Therapy can:

Provide motivation for physical activity, and distraction from associated pain

The use of music to accompany physical activity can enhance repetitive exercise and provide diversion from pain. The qualities of rhythm stimulate physical activation and may promote increased steadiness and smoothness in physical functioning. Frequently used musical experiences include movement to music, dance, and instrumental manipulation. Live music is most often used so that tempi may be altered to meet the capabilities of the client and ensure flexibility and adaptability within the music/exercise session.

Improve circulation and improve muscle strength and tolerance

Improved circulation and increased muscle strength and tolerance may be benefits of music therapy programming. Movement to music and the use of varying sizes and weights of instruments may be incorporated to improve physical functioning vital to the maintenance of independence. Strategic placement of instruments can encourage the rehabilitation and/or maintenance of range of motion and fine and gross motor skills.

Improve oral-motor functioning and restore functional speech

Singing techniques may enhance oral-motor functioning essential for attaining improved speech and communication skills. Often, when a person has lost speech capabilities due to a cerebrovascular accident, the ability to sing may remain intact. For these persons, the use of Melodic Intonation Therapy (M.I.T.) may be successful in restoring functional speech.

Facilitate reality orientation and stimulate short and long term recall

Music therapy sessions can provide a pleasurable and non-threatening environment where musical cues, rather than direct, formal questioning, can stimulate and encourage reality orientation. Long-term recall can be facilitated through musical association with childhood and adult experiences. The use of themes, melodies and/or lyrics can prompt short-term recall, important for maintaining independence and assisting in activities of daily living.

Facilitate the acquisition and/or maintenance, of cognitive skills

The opportunity provided by music therapy to exercise old skills or to learn new skills facilitates important and necessary sensory and intellectual stimulation. Instrument manipulation, song writing, discussion of song lyrics and themes, and music listening all require the individual to exercise such cognitive skills as concentration, attention and critical thought. The music therapy session can be specifically designed to meet the individual at his or her level, thereby minimizing frustration and fostering successful experiences.

Establish and/or maintain social awareness and interaction

Music has universal appeal and the power to draw people together. People feel a sense of community when singing in groups and the use of familiar song material can often be the impetus for establishing social awareness and interaction. Song writing, instrumental ensembles and interactive song tasks can all encourage cooperative participation in a non-threatening and pleasurable manner. In this respect, music therapy can successfully draw out and bring together those individuals prone to social isolation, loneliness and depression.

Facilitate reminiscence, life review and validation of life experiences

Reminiscence and life review may be facilitated through musical associations from a person’s past. This may be particularly important for persons with dementia who may not be able to reminisce independently. Music therapy can provide a sense of self-identity through eliciting memories of past accomplishments, significant others and significant life events. Validation of life experiences and emotions associated with them may help to resolve old conflicts and alleviate feelings of anxiety and depression. Validation may occur through such musical experiences as song writing, discussion of song lyrics, and instrumental or vocal improvisation.

Reduce aggressive behaviours and wandering

As a direct appeal to the emotions, music can often be highly effective in altering clients’ affective states and in relieving anxiety. Carefully selected music, often improvisatory, can be used to reflect, validate and redirect aggressive impulses, thus decreasing agitation. Instrumental improvisation may also allow appropriate expression of feelings when words no longer have meaning. The structure inherent in music and in a music therapy session can help to provide a positive and pleasurable external control for the aggressive or wandering elder. The use of music may also encourage attentiveness, thereby assisting in maintaining participation in tasks.

Provide opportunities for self-expression

Music therapy provides opportunities for verbal and non-verbal self-expression. Song-writing, discussion of song lyrics or instrumental improvisation may be used to- facilitate this process. Music therapy may serve as a catalyst to break down barriers inhibiting self-expression through the presentation of carefully chosen music. Music therapy also provides a non-threatening atmosphere, which fosters open communication and creativity.

Increase self-esteem

Opportunities for successful experiences within music therapy programming can increase self-esteem. Experiences designed to acknowledge individual preferences emphasize the positive and unique qualities of the individual, providing needed support and enhancing feelings of self-worth and well-being. Music provides a sense of normality and enjoyment within the therapeutic process.