Music therapy has industry’s ear

by Jeff Shaw

Seniors housing operators see the physical, emotional and financial benefits of integrating music into the lives of residents

By Eric Taub

Music is a major part of our lives. We hear it everywhere: at home, the ballpark, the supermarket, the gym, and the elevator. It excites, soothes, helps us sleep, and occasionally irritates.

Music permeates assisted living and skilled nursing facilities as well. Enter the lobby and you’re likely to hear pleasant, anodyne music piped into the area. 

Many communities regularly bring in musicians to entertain residents by performing show tunes or popular song standards. 

Yet music can do so much more than just entertain. Many assisted living and skilled nursing facilities are integrating music into residents’ daily lives not only as a diversion, but also as a tool that can radically change an individual’s physical health and mental well-being.


It takes a maestro

Music can improve moods, increase body strength and agility, and even reduce the need for medications. But these benefits don’t come from the guitarist hired once a week to play folk songs. Nor are they a side benefit of the mood music pumped into a community’s hallways.

Instead, these improvements are coming from music therapy and related programs, a recognized practice that requires a degree program and thousands of hours of training to master.

The goal of music therapy is simple: to use music to address non-musical outcomes. For example, stroke victims can learn to walk sooner when their efforts are paired to rhythmic music played at a particular tempo that can help improve one’s gait. 

Music can also help those with brain injuries due to head wounds or a stroke regain their ability to speak, as it “rewires” the brain to understand that skill.


Talent shortage emerges

Music therapy has been available for decades. The problem: there aren’t enough therapists to go around. In the U.S., just 6,500 individuals are board certified music therapists, says Al Bumanis, a spokesman for the Association of Musical Therapists, a professional group. 

In addition, hiring a full-time music therapist can be cost prohibitive for many communities. Depending on the geographical area and level of expertise, music therapists charge from $60 to $100 per hour to work with an individual or group. 

Either the resident or the community pays the costs, according to the 2014 member survey and workforce analysis of the American Music Therapy Association.

Music’s benefits are beginning to be understood by the assisted living industry thanks to a number of new companies that, using the skills of a music therapist, have created programs that can bring music’s benefits to large groups of people.

The results are encouraging. When used properly, communities see reductions in anxiety, hostility and resident non-compliance. Seniors in music programs have become more socially engaged. Bathing, dressing and medication administration meets with less resistance. 

That makes the job of the caretaker easier, resulting in less employee stress, a reduction in medication, and more satisfied residents and family members.


Rekindling memories 

Individuals tend to respond best to music they enjoyed when they were young adults. That is well illustrated in the documentary, Alive Inside: A Story of Music and Memory, which won the Audience Award for U.S. documentaries at the 2014 Sundance Film Festival.

Alive Inside tells the stories of a number of individuals, like Henry and John, who seemingly come “alive” once they listen to music that was popular in their youth. 

John, a former entertainer when he was in his 20s who later in life became a senile elderly person, had become comatose and non-responsive. He began singing and dancing in his wheelchair a few minutes after he heard 1930s music through headphones. 

Henry spent his days staring at the floor. Once he was able to listen to his beloved big band jazz, he opened his eyes, sang to the music and answered questions.

“With music, Henry is being brought to life,” the late writer and psychiatrist Oliver Sacks says in the documentary. “Music has more ability to activate more parts of the brain than any other stimulus.”

The music and the iPods used by Henry and John were supplied by Music and Memory, a New York-based non-profit organization founded by Dan Cohen, a former tech industry executive. 

Through his organization, Cohen supplies the hardware, iTunes gift cards, and training to hundreds of communities throughout North America.

“Skilled nursing homes are trying to be more like home,” says Cohen. “Residents have TVs; now they’ll have music. We’re just restoring what people had.”

One of the biggest Music and Memory installations is taking place in Wisconsin. Thanks to a $400,000 state grant, staffs at 385 nursing homes and student volunteers from 50 high schools have been trained to implement the program. The grant also pays for the iPods given to the over 4,000 participating residents. 

Additionally, this year the Music and Memory program will be extended to a number of assisted living communities throughout the state.


Marching to a different beat

Another provider, Coro Health, eschews the hardware approach. Instead, the company offers a streaming subscription service with a wide set of genres, each designed to improve mental health, socialization, reduce the sundowner effect and entertain. (Sundowning refers to a variety of difficult behaviors in dementia that tend to occur at a regular time each day, usually in the early evening. The behaviors may include increased confusion, disorientation, agitation and aggression.)

The music, which can be accessed via a tablet, computer, smartphone, or Internet-connected speaker system, is categorized according to the specific effect that the community or individual wishes to address.

For example, music can be chosen that is known to help people wake, sleep, become energized or relax. Each program is one to two hours long.

Other categories have been organized to help residents be more sociable at meals, yoga, wine tasting or a manicure. There are also simple music trivia categories that give residents an opportunity to guess the name of a song or its performer.

“For assisted living residents, our program has been proven to reduce anxiety and stress,” says Leanne Flask, chief content officer at Coro Health. “It slows down breathing. Various rhythms and tempos help users relax. And it helps digestion, as digestion is rhythmic.”

Both Coro Health and Music and Memory are passive programs. The user simply listens to music designed to improve mental and physical well-being. 

SingFit, a Los Angeles-based company, believes that even greater outcomes can be achieved through an active program that encourages users to become involved not only by listening, but also by joining in.

The company has developed a sing-along program with music that’s been designed to appeal to their tastes. The point is not to turn out good vocalists, but to awaken an individual to a state that they were in years earlier.

The turnkey product provides a community with a smartphone app that includes 12 playlists updated quarterly. Each playlist includes 10 songs and runs for 50 minutes. All staff members are individually trained by SingFit to use the program.

“Singing is a whole-brain workout,” said SingFit co-founder Andy Tubman, himself a trained music therapist. “It improves people’s timing, memory and physical condition.”

Each song includes four distinct tracks: the first speaks the words quickly before the user sings them; the others include the sung track, background music and the ability to record the song without the original singer.


Finding their voice

Preliminary results of a study being conducted in conjunction with Tufts University show that non-dementia SingFit users enjoy improvements in spatial sense and short-term memory. 

Tubman also points out that singing improves respiratory control, increases heart rate, and that tapping and crossing one’s feet to the music add an exercise element to the work.

Video clips show dramatic results. One user, a former opera singer now suffering from dementia and wheelchair-bound, hadn’t sung in 10 years. She tentatively begins to sing as soon as she hears the music. Within a few sessions, she’s singing in full-throated, operatic mode.

“She used to sleep a lot,” says Tubman. “Once she started singing, she stopped taking afternoon naps and her appetite has come back.”

Assisted living communities that offer music therapy and music programs will be putting themselves “ahead of the game,” says Anne Lipe, a music therapist based Damascus, Md. 

“Music can help keep people calm, refocus and redirect their energies,” she says. In one nursing home, Lipe successfully organized a choir that sang in various local churches. “The whole environment needs to be full of choice, not regimentation.”

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