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.
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.
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.
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.
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.
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.
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.