Experts look to music as way to uncover past buried by dementia

One had to look closely, but the white sneaker definitely tapped the floor. Slightly, softly, steadily. Like a heartbeat.

"What does the music remind you of, Marsha?" the caregiver at Villa Ventura in south Kansas City asked loud enough to be heard above the headphones.

The woman looked up, a bit puzzled at first, then: "Being alive."

Medical researchers haven't seemed to do a lot for Alzheimer's patients.

Maybe Perry Como can help. Or Patsy Cline. Or even Mozart.

Institutions across the country increasingly are using music to try to tap into areas of the brain buried by dementia. Alzheimer's is degenerative. But some experts think old songs can slow the progress by stirring up lost memories and possibly even restore some cognitive function.

Concetta Tomaino, executive director of the Institute for Music and Neurologic Function at New York's Beth Abraham Family of Health Services, said patients with mid- or late-term dementia scored higher on cognitive-function tests after 10 months of music therapy.

It has long been known that even after patients no longer recognize names and faces, they can sing along to a favorite tune.

"Auditory processing seems to be the last skill to go," said Tomaino, who has worked in the field for 32 years.

And people, knowingly or not, associate songs to events, sort of like life's soundtrack.

So in this era of wondrous medical technology, a song such as "Ain't She Sweet" might be the best tool to rouse memories of love, family, a snowy day or coming home.

Villa Ventura recently started its iPod music program. Sarah Miller, assisted living director, can't speak to any cognitive-function benefit, but she can tell what caregivers everywhere strive for with dementia patients: a moment of joy.

In the late afternoon period of confusion known as "sundowning," a resident can pace and feel anxious and lost. But put on iPod headphones and song list provided by her family, and she calms.

Miller said, "She might not remember what she had for breakfast, but she can remember every word to 'Let Me Call You Sweetheart.' "

Researchers have long known that feelings, emotions and memories sleep in the minds -- like forgotten boxes in the attic -- of dementia patients.

Accessing those has proven to be a challenge.

"Now, we're learning more and more about how music can lead to increased function, which can further wake up the mind," said Michelle Niedens, education and policy director of the Heart of America chapter of the Alzheimer's Association, based in Prairie Village.

Not so with a face or photo.

"The mind can't break down the visual," Tomaino said. "Music is more enriched neurologically."

The reason being that music's rhythm, melody and volume make it a complex stimulus not processed by a single area of the brain.

Tomaino told of a patient who seldom spoke and seemingly had no recollection of anything he'd ever done in his life. But after taking part in a music program, the man told about going years earlier to see Frank Sinatra at the Paramount Theatre.

Patients have also been known to begin feeding themselves again.

Another benefit is that the calming effect of familiar music can lessen the need to medicate agitated patients.

The research caught the eye -- ear -- of officials at Senior Star Living, the Tulsa-based corporate ownership of Villa Ventura.

The company's music program is under way at all of its facilities. Staffs work with families to create unique play lists for patients.

Studies have not yet nailed down the effect music has on Alzheimer's disease, said Letitia Jackson, the company's director of health services.

"But we were hearing about regeneration of brain cells, cognitive improvement and mood enhancement. So we had to seize upon this."

Marsha Snyder, 66, swayed on the Villa Ventura couch to Harry Connick Jr.'s "I Only Have Eyes For You."

"He's singing to me," the former nurse said with a big smile.

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Then she noticed the man beside her. He snapped his fingers. Both hands. Head bobbing.

They both wore headphones. She nudged him.

"What are you listening to," she asked.

He answered in song. "My Momma done tol' me ... "

"Blues in the Night." He even imitated a muted trumpet.

Bob Ryan is 88 and suffers no dementia. He just likes music. He sang until a worker wheeled a food cart past.

"Gonna have to charge you a cover," Ryan told the man.

It was pushing 4 p.m. at Villa Ventura. As in nursing and assisted living facilities everywhere, that's when activities tend to end and pacing begins. Part of the confusion and anxiety is tied to shift change for staff. Part of it to coming darkness outside.

Break out the iPods.

Marlene likes the Beatles. They remind her of when her children were young.

"We're after that moment of joy -- whether its five minutes or five seconds," Miller said as she watched.

Typically, residents want to hear Sinatra, big band from Glenn Miller, swing from Benny Goodman and pop standards. That will change over time.

Someday, those requests are likely to include the Rolling Stones and Michael Jackson.

(c) 2010, The Kansas City Star.
Distributed by McClatchy-Tribune Information Services.