Tag: music therapy

Musical Minds

 

The past which is not recoverable in any other way is embedded, as if in amber, in the music, and people can regain a sense of identity.—Oliver Sacks (1933-2015)

The late afternoon sun slides slowly over the top of the atrium glass, the clouds dancing a slow tango in the periwinkle sky as voices hum in the background. The atrium where we gather to sing, play instruments, and listen to music is enclosed in glass, and the garden view and clouds provide a quiet, peaceful setting for our visits.

As the residents sway, clap, or sing along with their iPods, the golden minutes seem to be extended somehow. Reality is crystalized in brilliant sparks of cognizant personalities that surface and retreat, like waves in an ocean. The sun graciously casts its final shadows on this long day, as the quiet humming and sweet smiles fade until the next Music and Memory class.

Our college music education students and I travel from Oklahoma Baptist University together to visit the Baptist Village Community retirement facility several times a semester. It is one of the first Music and Memory programs in the State of Oklahoma, and we find it exciting to participate in a program that supports music to enhance memory and enrich the lives of the elderly with dementia or Alzheimer’s disease.

My own father-in-law passed away after struggling with this difficult illness, and I have seen firsthand the debilitating and challenging lives these patients lead. The strange thing is that for fleeting moments, all is right with the world—the words come, the thoughts are present. But then, they are gone again. No wonder much frustration and anger accompany these residents whose realities play “hide and seek” with their psyches.

For their own safety, the Memory Center is a secured area. Visitors sign in, check in with the director, and are given the code to enter the patient area. Much like many nursing facilities, patient rooms line long halls with a community cafeteria, a nurse’s station, and an atrium area in the center. Our group always arrives at the dinner hour, and most residents are still eating their meal as we get set up for the group music presentation.

Our university students are mostly music education majors, with some performance majors and music minors. They participate for several reasons, the foremost being their love of music and the opportunity to see the power of music “in action” with the Memory Center residents. The second reason is that as members of our National Association for Music Education collegiate chapter, they are aware of the importance of service learning opportunities like this to their professional development. Service learning is defined as “a methodology that extends classroom learning into real-life situations through participation in service experiences organized by collaborating schools and communities” (U.S. National and Community Service Act,1990). Thirdly, many students are Christians and feel compelled by their faith to share acts of kindness toward their neighbors. These are pretty special students, and their altruism is inspiring.

Music and Memory Team member Andrea Larson talking with one of the residents at the Baptist Village Community retirement facility.

Music and Memory Team member Andrea Larson talking with one of the residents at the Baptist Village Community retirement facility.

The Music and Memory program was founded by Dan Cohen in 2006. It is a non-profit organization that brings personalized music into the lives of the elderly or infirmed through digital music technology. The nursing home staff and family members are trained to create and provide personalized playlists using portable media players that enable residents to connect with the world through music-triggered memories. The Music and Memory program was made famous by a video documentary of the work, Alive Inside: A Story of Music and Memory, and it received the Audience Award at the 2014 Sundance Film Festival. Prior to beginning our university work with the retirement center, our students watched excerpts of this documentary on our campus. It is a powerful story of how music can bring a person with dementia or Alzheimer’s back to life and revitalize their memories.

What I love the most about performing and assisting the Music and Memory program is that there is much about life to learn from these elderly residents. When they are alert, they truly live in the moment. With our busy multitasking lifestyles, we seldom take time to be aware of our circumstances and pay attention to others around us. It is a huge life lesson. When these lovely people look at you and talk with you, it is as if you are the only person in the world. They are very appreciative of your time and conversations. They are also playful. It is cool to see that when it is all said and done, enjoying every moment in life is the most important thing, and somehow music unlocks the key to this joy.

Our students start our group music session in the cafeteria gathered around the piano. Our first selections are usually familiar hymns. We have several residents that are adamant about needing their own hymnal to follow along with. Others have all of the words memorized and just sing out with gusto. Some prefer to play tambourines or hand drums. I accompany on the piano and take turns with our piano students. We then segue to familiar folk songs. Some favorites are “Yankee Doodle,” “She’ll Be Comin’ ‘Round the Mountain,” and “Oh! Susanna.”

As residents sing out, you see their eyes sparkle with remembrance and familiarity. This is a vast contrast to the disengaged and sometimes catatonic personalities that we see upon first arriving. Some residents are very good at keeping a beat to the music on rhythm instruments. Others really find their voice, and it is great to hear their voices blending in harmony with ours.

Music and Memory team member Jennifer Watson talking with one of the residents who is seated in a wheelchair.

Another Music and Memory team member Jennifer Watson with one of the residents.

The group music making time serves as an icebreaker—so that residents become comfortable with us and communicate with us—as well as for social stimulation. After the residents have sung with us for twenty minutes, we move to the atrium and find seating for everyone. The patients each have their own assigned digital audio players and earphones that have been pre-programmed by their family members. Residents listen to customized playlists of their favorite songs from when they were in their twenties. If you can imagine a group of people gathering together to summon the voices of Frank Sinatra, Elvis Presley, Ella Fitzgerald, and many others to recall a place in time that is tangible and lovely, then you have the idea of what the Music and Memory program is like. Tangible because the music reminds them of specific places and special people that have shared this music with them before. The haunting melodies restore them in some ethereal way.

Music reminds them of specific places and special people that have shared this music with them before.

The students are assigned a resident partner, assist them with setting up the media players and earphones, and sit with them while recording their reactions to the music as a part of our action music research project. Students also assist residents in selecting songs and volume for listening. This part of our project lasts from 45 minutes to an hour, depending on the group participation. The documentation of the resident participation is needed for further grant proposals and program needs assessment. In between our visits, the Memory Center director coordinates the listening prior to mealtime and after mealtime.

The responses are varied: some people enjoy shutting their eyes and stepping back in time by recalling melodies of the past. The result is that most often, the music triggers happy periods in their past and brings a feeling of joy. Some residents hum, tap their toes, or clap to the music. These seemingly minimal movements are actually profound for many of the dementia/Alzheimer’s patients. They lose touch with the most basic of emotions and communication skills. These moments of clarity brought on by music are significant. Residents become more communicative and often share their reactions to the music with the university students.

The Music and Memory website shares the latest music research that supports the use of iPods and music listening with memory challenged people. One article is in Psychology Today (“Why Do the Songs from Your Past Evoke Such Vivid Memories?” December 11, 2013) by columnist Christopher Bergland in which he explains music research about “music-evoked autobiographical memories” and why music evokes such strong responses from people with Alzheimer’s disease. A 2015 article on the website of MIT’s McGovern Institute for Brain Research (“Music in the brain” December 16, 2015), Anne Trafton describes how science is just beginning to understand how music is processed in the human brain. According to Sam Norman-Haignere, a McGovern postdoctoral researcher she quotes in the article:

[N]euroscientists at the university have pinpointed the neural ensemble in the human auditory cortex that allows humans to select and identify music apart from other sounds, like human speech or general noise…We think this provides evidence that there’s a hierarchy of processing where there are responses to relatively simple acoustic dimensions in this primary auditory area. That’s followed by a second stage of processing that represents more abstract properties of sound related to speech and music.

As technology becomes more sophisticated and measurement tools more refined, it seems that the case for music as a specific human function is growing stronger. Music is no longer seen as merely a form of entertainment. The brain is designed to process music differently from other sounds. We are musical beings. This data supports a greater understanding of how specific processing of music occurs and may have implications for further study of connections to music and well being.

The brain is designed to process music differently from other sounds.

As I am writing this I am receiving word that my parents, who are in their eighties, have received an Amazon Echo as a Christmas gift from my brother. I can’t think of a better gift! A world of music just for their listening pleasure! Little do they know it may be stimulating their brain’s neural ensemble! With more evidence to support music’s potential benefits for the elderly, we may need to take a closer look at music experiences of our senior citizens.

One of the oldest Memory Center residents, whom I will call June (pseudonymns are used here for resident privacy) is 101 years old. As she listens to jazz standards, she sits up taller, opens her eyes, and she smiles.

One of our most endearing residents is Charlie, a tall balding man with a strong voice. He never misses a Music and Memory session. Charlie loves to sing. In fact, he can be heard singing “Silent Night” morning, noon, and night all over the Memory Center. Even in mid-summer, it is “Silent Night, Holy Night!” You can imagine that some residents become very irritated with Charlie because of his prolific love of “Silent Night.” One of our goals each visit is to redirect Charlie so that he is using his big strong voice to sing other songs as well, and to participate socially in a positive way with the other patients. He has a beautiful voice and you can tell at one time he must have been a great singer. The students love Charlie and named my office Beta fish in his honor.

Dr. Scherler (right) sitting with a Baptist Village Community Retirement Center resident

Dr. Scherler encourages Charlie to sing.

My role as a music educator has always inspired me to envision the future of each of my students—imagining what they may become or what they are capable of accomplishing so that I may encourage them to work toward these goals. However, with the Memory Center residents, the opposite phenomenon occurs. As we begin to know each person more intimately, I envision what they must have been in the prime of their lives, what they accomplished, and what great wisdom they could possibly impart.

As our meetings continue, data collection is gathered from several sources:

1) Reflective observations: written reports and audio recordings

2) Interviews: Memory Center Director and Assistant Director

3) Field notes

To date, documentation showed patterns in behavior related to the Music and Memory listening sessions:

  • Improvement of Resident’s Lived Experiences (implications for increased appetite): Residents who listened to music after supper appeared to be calmer and more relaxed with decreased symptoms of “sundown syndrome,” the agitation and anxiety often experienced by Alzheimer’s patients in the evening. There were implications for better sleep and less depression
  • Improvement of Resident’s Enriched Living: In general, the director stated that she believed the residents experienced more enriched life experience with greater sense of self identity as a result of experiencing and participating in regular music activities and the Music Memory project.
  • Voice and Value of Residents: An important outcome of the study was that the voices of the resident became strong again. Memories validated through music memory brought related memories and increased speaking back to the majority of residents. Increased confidence and self-awareness was observed to be valuable to the residents.
Yoder sitting with a guitar next to one of the retirement center residents.

Collegiate music education student Eric Yoder enjoys singing with the residents and playing his guitar at the Music and Memory class held at the retirement center.

There were other results of this action research, such as increased collaboration between the university and retirement center, strong community engagement from university students, and meaningful relationships developed between university students and residents as they monitored music engagement and progress. As one student put it, “It helped me see the larger purpose of music education, of connections to outside organizations off of our own campus.”

There were surprisingly many different behavioral patterns and results of this research project which were beneficial for the university students: development of communication skills, music leadership, performance opportunities, development of empathy for others, and giving back to the community. We have now completed two semesters of visits to the retirement center. Next semester we will begin to study the protocols of resident engagement and life enrichment through music.

We were sad to find out that several of our resident partners had passed away in between our last visits. On our van drive to the retirement center, I prepared the university students for this possibility. “We will have to remember that our job is to help them participate in music listening and music making so that they will have more beautiful lives while they are here.” So the students bring their guitars, a colleague even brought his saxophone one week, and we continue to “let the music speak to and through the residents of the Memory Center.” Along the way we were taught a few things by the residents:

Life is short. Moments matter. People matter. Participating in music is joyful.

11 members of the Music and Memory Team standing in a row at the Baptist Village Community Retirement Center.

The Music and Memory Team at the Baptist Village Community Retirement Center.

Composing Advocacy: Social Voices

Canticle
birds

Photo courtesty of Flickr

In this week’s essay on new music and advocacy, I’m narrowing my focus to show how composers and performers are looking at the diverse landscapes in which we live, with their complex human histories and changing values, as the grounds to examine the intersection of place and people—past and present. In other words, in addition to advocating for place, new music can advocate for the human and social context of place.

Composing music with political and social themes certainly isn’t new. Ruth Crawford Seeger famously pursued musical activism between the world wars to highlight social injustice in America. The songs of Woody Guthrie were employed to foster enthusiasm for the construction of massive dams to harness the power of the mighty Columbia River. Some people are uncomfortable with the subversive implication of using our artistic skills in this manner. I am not implying that we should all use music as a platform for activism. However, either in response or with intention, musicians are doing so. So are we truly experiencing a resurgence in new music composed to highlight social equity? Is this a manifestation of a larger sense of stewardship toward the places, communities, and cultures in which we live? And if so, why now?

As humans, most of us believe that we possess the power to make positive change in the world. Composer Darrell Grant has said,I believe that we who create art possess an extraordinary power to communicate, inspire, provoke, inform, and to move others to transform society.” Across communities, new music is actively challenging us to pay attention to the issues and the voices in our society.

While many works were composed to express the horror of 9/11, the reality is that we’ve been living with ongoing war, and its partner terrorism, for nearly 15 years. Many composers are grappling with its long-term effects. Composer Ethan Ganse Morse’s moving opera The Canticle of the Black Madonna addresses head-on the crisis level of PTSD in returning soldiers.

Canticle

The pieces being wrought and their means of creation are diverse. Composers are ardently responding to harmful practices affecting our environment. Cellist Kari Juusela composed PBBP Blues, a searing response to the British Petroleum oil spill that devastated the Gulf coast in 2010. Brian Harnetty has examined the human and environmental impacts of the extraction industries of southeastern Ohio, both through his music and in a series for NewMusicBox just last month. These works are sobering reminders of the fragile nature of our ecosystem and the inextricable ways we are tied to our landscape. Others are composing works celebrating our national environmental treasures.

When I compose about place, I consider various points of view that the piece could embody. While we compose as an expression of our human experience, our singular voice, each of our points of view are limited in perspective and can’t convey all facets of the experience. So composers are raising social equity awareness and understanding by telling the story through historical and social narrative. For the Oregon Stories Project, composers Mark Orton, Darrell Grant, and Douglas Detrick have created a fusion of music and dialog to recount the stories of disenfranchised Oregonians who overcame society’s imposed limitations to make a lasting difference in their community. Composer Joan Szymko worked for months with families, patients, and caregivers to share the voices of those with Alzheimer’s disease in her choral work Shadow and Light.

New music is having the greatest social impact at the interactive community level. Composers and ensembles are reaching out—not with the outward Euro-paternalistic focus of the past, but with honest commitment—to understand how musicians can collaboratively work with the community to help solve problems. Composer Daniel Bernard Roumain’s oratorio Meditations on Raising Boys rose out of the Chautauqua Symphony Orchestra’s work with issues affecting boys and young men. The program involved lectures and workshops as well as master classes.

Chautauqua Symphony

Premiere of Meditation on Raising Boys, Chautauqua Symphony

Others ensembles are working in their communities to help refugees manage the transition into a new life in America as they struggle with identity and racial bias. Central Ohio Symphony initiated a drumming circle program for troubled teenagers.

Music also has the power to heal. Research confirming the health benefits of live music is well documented and has spawned music therapy programs across universities. As our population ages, this has inspired music ensembles across the country to work with area hospitals, rehab facilities, and related special needs programs.

New music can advocate for the changes needed in our society by connecting us to issues larger than ourselves. But why now? Perhaps composers and those commissioning new works are seeking to better connect music to our humanity. We all want to write music that is well crafted, that engages the performer, and that may outlast our limited lifespans. By creating works that look to the diverse landscapes in which we live as a foundation, the intersection of place and people expands our musical palette. The resulting pieces may become some of the most compelling works of our time.