What I continually found was that as soon as I played octaves on the piano (see film on Piano Music for Alzheimer’s), the patients would:
- Stop or slow down the madness
- Pivot to see (and feel) where the sound was coming from
- Sit, listen and “normalize” for the 45 to 60 minutes of piano playing
- Respond, converse, joke and interact with one another after the music stopped.
One day when I came in to play at the center, there was a lady seated in a wheelchair in the far corner of the room, screaming repeatedly “FOUR! FOUR! FOUR!” She stabbed her right arm across her chest, over her left shoulder and above her head every time she yelled “FOUR.”
All of the dementia patients there were in various stages of mental, physical and emotional chaos so I simply began my music program. All of the patients, except the “FOUR” lady, sat down as usual and gave me their rapt attention.
At this point, the caregivers were going to wheel her away to another room in the building so as not to disturb the other patients who were settled and already listening. I asked them to bring her right beside the piano with me instead. I tried to keep playing the planned program (to get her closer to the sound) but realized I had to play something else entirely different and prescriptive for her.
I tried a couple of classical piano pieces in the book I had with me to redirect her with music. I finally “got in” her head with Mozart’s Sonata in C, a very familiar piece. I didn’t just play it. Rather, I had to decisively pair a very strong musical rhythm from the piece with her “FOUR” verbal/arm movement and, in essence, take over the rhythm and resonance of her problem.
As soon as her body realized that the music was accompanying her strong (out of control) verbal and physical rhythm, her problem began to stagger, soften, hesitate and then completely dissolve—all within a short 2 to 3 minute period.
This was an intense musical intervention and was incredibly hard work for me—I had to play very hard and loud, in order to pair strongly enough with the intensity of her “FOUR! FOUR! FOUR! FOUR!” and stop it through musical dominance. Once I matched her rhythm I could control it, and I did so through this specific piece.
As this took place, the other dementia listeners seemed completely unbothered, un-phased by her madness. They sat and enjoyed her “FOUR!” music as I worked with her to eliminate it. This worked beautifully. I was able to calm her completely down in minutes and she enjoyed the rest of the program, smiled and thanked me afterward. This is the power of music in chronic, late-stage dementia—but one really has to know how and why it works!
Linda Maguire, MHS, MA, BMus is a Virginia-based neuroscientist, gerontologist and professional musician. She specializes in aging brain health and designs Prescription iPods and vocal music interventions for dementia patients and their caregivers. Visit www.lindamaguireproductions.com