Some nurses at Sea View Hospital Rehabilitation Center and Home on Staten Island were skeptical when they first heard about a therapy for patients with Alzheimer’s disease or dementia that was delivered via iPod.
After all, it seemed so simple, accessible and inexpensive. The Music & Memory pilot program involves creating a playlist on an iPod of the patient’s favorite songs — chosen with help from the family — and asking the patient to listen through a headset for two to three one-hour sessions per week. Research from sources such as the American Pain Society and Drexel University, Philadelphia, has shown that music can trigger emotions and boost memory in patients who have withdrawn, and it can help decrease anxiety and depression.
Sea View RNs Jane Fode and Lauren Pegues have seen the effects firsthand in some of their patients at the dementia center.
Fode said one Spanish-speaking patient whose speech was very erratic was combative with nurses during bathing or grooming, putting both himself and the caregivers at risk.
Nurses consulted his family to put together a playlist and found that during listening sessions he was humming along calmly to some of his favorite Spanish tunes.
“After the sessions he is calmer, he’s smiling more and is easier to handle,” Fode said.
Soothed by Sinatra
Pegues said she noticed changes in another patient with moderate dementia who typically wanted to stay in bed and had to be pushed to interact socially. When he listens to his playlist of Tony Bennett, Frank Sinatra and Dean Martin he has “smiling eyes,” Pegues said, and he initiates conversation.
“While they’re listening to the music, those moments — those people are really, really happy. They’re at peace,” she said.
One patient, who is nearly 100 years old with severe dementia, didn’t speak beyond mumbles and moans, Pegues said. “If you look into her eyes sometimes, she looks as though she’s looking past you. At best you get a nod from her.”
The woman’s family worked with the nurses to fill her playlist with favorite artists, including Willie Nelson, Dolly Parton, Nat King Cole and Rosemary Clooney.
Then one morning, Pegues’ morning greeting was met with a response that took her by surprise. “She said, ‘Good morning, how are you?’ I hadn’t heard her speak in years.”
Pegues attributes that success to the music program because she said it is the only real change in her treatment.
Families reconnect as well
Sessions that once involved only one-way communication from family members have become more interactive and meaningful, the nurses said.
Sometimes the families also see benefits simply by discovering their loved one’s music preferences and the memories the songs help revive. They get to experience a connection they may not have felt since the onset of their loved one’s dementia.
The pilot includes 15 patients and is geared toward those with moderate to severe dementia who typically isolate themselves, said Jeanne Policastro, a Sea View spokeswoman.
Music & Memory is a non-profit program developed in 2006 by Dan Cohen, MSW, a former consultant for the U.S. Department of Education. At that time, none of the 16,000 nursing homes in the U.S. used iPods for their residents, according to the company’s website. Since then, the company has incorporated the iPod playlists into 60 long-term care facilities.
Not all patients have responded significantly to the music intervention, Sea View nurses said. Nurses record observations and medication amounts and enter them into the care plan. Progress is discussed at interdisciplinary team meetings.
Eyes on expanding program
One major goal is that the therapy will help reduce anti-psychotic and anti-anxiety medication dosages by calming patients with music instead.
Patients who do respond to the music react differently from each other, Pegues said. Some are moved to tears. Some become more conversational. Progress may not carry over from session to session, nurses said, because short-term memory often is debilitated in patients with dementia.
During the pilot program, the time allowed for the music is limited, but the hope is to expand the listening time and the number of patients, Pegues said.
Policastro said Sea View hopes the therapy can be expanded to patients in the evening hours, especially to help soothe patients who “sundown” — or become agitated or confused at night.