The Brain & Music
Just how the brain and body process music remains mysterious. Dr. Concetta Tomaino, Director of the Institute for Music and Neurologic Function at Beth Abraham Family of Health Services in New York, says we at least know music is processed on many levels at once.
"Why it's so positive is that we process music with almost every part of our brain," she says. "Music that has personal significance to someone or is connected with historical events is a strong stimulus to engage responses in people, even in late stages of dementia. Even if they're not necessarily able to tell you what the song is, they are able to be moved and feel the associations."
Tomaino and other researchers have found a strong connection between the human brain's auditory cortex and its limbic system, where emotions are processed. "This biological link makes it possible for sound to be processed almost immediately by the areas of the brain that are associated with long-term memory and the emotions," she says.
Sound of Music. Typically, “stimulative music” activates, while “sedative music” quiets. Stimulative music, with percussive sounds and fairly quick tempos, tends to naturally promote movement, such as toe taps. Look to dance tunes of any era for examples. Slightly stimulative music can assist with activities of daily living: for example, at mealtime to rouse individuals who tend to fall asleep at the table or during bathing to facilitate movement from one room to another.
On the other hand, the characteristics of sedative music—ballads and lullabies—include unaccented beats, no syncopation, slow tempos, and little percussive sound. This is the best choice when preparing for bed or any change in routine that might cause agitation.
Responses that are opposite of those expected can occur and are likely due to a person’s specific associations with the piece or style of music.
Agitation Management. Non-verbal individuals in late dementia often become agitated out of frustration and sensory overload from the inability to process environmental stimuli. Engaging them in singing, rhythm playing, dancing, physical exercise, and other structured music activities can diffuse this behavior and redirect their attention.
For best outcomes, carefully observe an individual’s patterns in order to use music therapies just prior to the time of day when disruptive behaviors usually occur.
Emotional Closeness. As dementia progresses, individuals typically lose the ability to share thoughts and gestures of affection with their loved ones. However, they retain their ability to move with the beat until very late in the disease process.
Ambulatory individuals can be easily directed to couple dance, which may evoke hugs, kisses or caresses; those who are no longer walking can follow cues to rhythmically swing their arms. They often allow gentle rocking or patting in beat to the music and may reciprocate with affection.
An alternative to moving or touching is singing, which is associated with safety and security from early life. Any reciprocal engagement provides an opportunity for caregivers and care receivers to connect with one another, even when the disease has deprived them of traditional forms of closeness.
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