Webinar: Music Engagement for People Living with Dementia
Dementia Australia webinars are free videos where subject experts discuss topics relating to dementia for a general audience.
In this webinar, music therapist Geena Cheung discusses music therapy and how to use music for health and wellbeing, with a focus on engaging people living with dementia.
You will learn about:
- music interventions to support health and wellbeing at home
- therapeutic outcomes of music therapy interventions
- how to access music therapy.
Transcript
[Beginning of recorded material]
[Title card: Dementia Australia]
[Title card: Music engagement for people living with dementia]
Geena: Hello, and welcome to today's presentation on music engagement for people living with dementia, where we'll be exploring how you can use music for health and wellbeing at home. I am Geena Cheung, a registered music therapist based here in Sydney. I'd like to start off with an acknowledgement of country. I acknowledge the traditional custodians of country throughout Australia and recognise a continuing connection to land, waters, and community. I pay my respects to them and their cultures, to Elders both past and present, and extend that respect to all Aboriginal and Torres Strait Islander peoples viewing this video today.
So, what is music therapy? Music therapy is intentional use of music by university trained therapist who is registered with the Australian Music Therapy Association, also known as the AMTA. Music Therapists draw upon evidence-based interventions that aim to improve quality of life. And it differs from music education and music entertainment because the focus is on health and wellbeing.
I'd like to start off with a short introduction on music, the brain, and everyday life, and how that all relates to one another. So receptive and active music participation stimulates the whole brain as depicted by this little image in the corner. It's an integration of motor, cognitive, emotional and sensory processes, and because it engages all those things simultaneously, it has the ability to induce neuroplasticity. That is the brain's ability to regenerate in the face of deterioration and damage.
Now, music can also alter our emotional and arousal states because it triggers the release of different chemicals in our brain, and can also affect the way we breathe, and the rate that our heart beats. And lastly, music is associated with time, place, people and events because we often use music in daily life to accompany activities, or for social bonding and et cetera.
Well, today we'll be looking at a bunch of activities as well as their outcomes. The activities that we're looking at include music listening, singing, rhythm-based activities, songwriting, and music and relaxation. We'll be exploring how you can use these activities at home and I'll be providing some tips, as well.
Starting with music listening. Music listening is a meaningful way to pass time. As we saw earlier on, as it does stimulate the whole brain, it makes it a great activity to engage in passively but also containing therapeutic benefits. If you're sharing a music listening session with someone, you can use music as a starting point for conversation, which leads to social bonding. You may also like to use music to accompany activities of daily living, such as personal hygiene activities, mealtimes, or even movement to music.
When I say movement to music, I refer to general exercise that you may enjoy doing, such as going for walks, or else it could be physiotherapy exercises that are quite repetitive. And if you're someone that enjoys dancing and having a bit of fun and expressing yourself, that's also something you can do to music. When we perform movement to music, we naturally sync up with the ongoing beats of the music. And this is the process of entrainment, where entrainment is a timed structure of two or more systems that become synchronised. And this naturally happens because as I mentioned earlier on, music can affect the brain, and therefore, can affect the rate at which the neurons are firing and leads to our motor actions becoming synced up with the music.
Listening to music can increase connectivity in the brain, as I mentioned earlier on, it's also a positive shared experience that supports social bonding, if you do it to other people. It can enhance the experience of activities of daily living if you select the right kinds of music to support the activities. And lastly, it improves psychological wellbeing by enhancing mood, inducing relaxation, inspiring reminiscence, and maintaining self-identity if you're listening to music that you've always enjoyed in your whole life. And some tips on using music listening at home. Therapeutic benefits are augmented if you use the music that is familiar and meaningful to the person. And, again, if you select music that matches the energy levels and mood of the personal activity, that again, increases the therapeutic benefits of music. You’ve got to be careful about music that changes erratically as this can cause agitation at some times, so be really careful with the radio. Finally, music can provoke negative feelings and memories so always monitor the emotional response of the person listening to music.
If you require more resources on how to create your playlist for therapeutic music listening, or else you just want to learn more about the benefits of music listening on health and wellbeing, you can head over to playlistforlife.org.uk, where there will be a tab called “Make a Playlist”, and many free resources that you can download such as this little template prompt that will prompt you to think of songs that are attached to memories.
The equipment you may require for music listening include your personal CD or records collection, or else you can create playlists on streaming platforms such as YouTube, Spotify, and Apple Music, and so on. Or else you can create playlists and pop them onto an MP3 player like this one. The benefits of creating a playlist is that you can tailor them to particular activities. You may end up with a playlist for your active exercises, and another playlist for cleaning, or another playlist for going to bed, and so on.
The next activity we'll be exploring together is singing. This is highly accessible because you can do it anytime, anywhere, and you don't require any equipment at all, if you don't have any. It includes singing familiar songs with and without music accompaniment, or you can improvise, and make it up on the spot, and express yourself. If you are doing singing together with someone, you can encourage participation by leaving out the final words at the end of the phrases. For example, "You are my sun, my only sun, you make me ... When skies are ..." Just like that. When you couple singing with active movements such as clapping, you're exercising dual tasking, which once again, lends to that neuroplasticity in our brains. It also helps ground singing when we're singing without accompaniment. For example, "You are my sunshine, my only sunshine, you make me happy ..." I think the clapping leads to fervour and motion, and also, it just really helps give it a time reference on rhythm.
The benefits of singing include the maintenance of executive function such as attention, regulation, adaptive thinking. If you are sharing this activity with another person, it's social interactivity. It can help you maintain speech and language ability as well because when we sing, we often use words as well. And it improves psychological wellbeing because it enables emotional release, enhances your mood, and because you're expressing yourself through using your voice, it's self-expression, which helps maintain or else increase self-confidence.
Our next activity is rhythm-based. So, we have four activities listed here. The first one is free drumming which is kind of self-explanatory. You just pop on your favourite music that really gets you going, and you just drum away however you want. Our second activity listed here is maintaining a basic beat. Again, very self-explanatory. Pop on your favourite music and just follow the beat. You'd be surprised even such a simple action requires a lot of planning – we're listening to the music, we're processing the beat and what's going on, and then we're organising and coordinating our motor and auditory systems to create an action that is also relevant to the ongoing stimulus. And if you want to take it up the next level, you may like to try some patterns.
There are two ways of making patterns. The first way is making rhythmic patterns, like this. And you can try this activity by taking turns with a partner. The second way of making patterns is making sequential patterns and this is just a series of different actions, or you may like to explore different ways of playing a drum such as tapping your fingers, knocking off your fist, smoothing with the palm and rumbling, and using that to make a sequence. You can also make sequences by varying left and right hand. And as I did earlier on, I incorporated my body parts. The benefits of rhythm-based activities are very similar to therapeutic singing, mostly because they're both activities that are active music making.
So, here, we have improved cognition with the addition of benefits to memory and planning, especially if you are using patterns. Once again, if you're doing it with someone, then you're engaging in social interactivity, and it improves psychological wellbeing much like singing. Some tips, you may have already heard me mention it a few times but it's quite fun to do it with a partner, and enabling turn taking where possible is a great way to just interact. You may also like to include concept as fast and slow, or loud and quiet, to exercise cognitive flexibility and regulation. So you may go, “Okay, fast, or else slow”. And we can use body language to communicate this such as fast, slow, loud, and quiet. Those are my ways of using body language, you have your own, I'm sure. The equipment you may need for rhythm-based activities include anything that makes a sound at home – you can use your body, body percussion is a thing. Just make sure you don't hit yourself too hard, otherwise you’ll go a bit red. Or else you can purchase small instruments from your local music shop. These little drums come for about $90 and they're very small. Or else you can get a little tambourine with a drumhead on it, and these range between $10 and $20. And the benefits of a tambourine for a drumhead is you can shake it, and you can also hit it.
Our second last activity we're exploring today is songwriting. A lot of people feel a bit nervous about approaching songwriting but it doesn't have to be anxiety inducing. If we simply change the lyrics to existing songs, it makes it quite accessible activity for anyone to try. And you can engage in lyrics substitution in songwriting by reflecting on the main message or theme of the lyrics, and then creating your own lyrics that fit the melody and the theme. Let's try an example. I'm sure we're very familiar with this song made Famous by Louie Armstrong. It goes, "I see trees of green, red roses, too. I see them bloom for me and you. And I think to myself what a wonderful world." And this can lead you to reflect on what you think is wonderful about the world, and you may like to make a list, and then construct sentences that fit into that melody.
Use visual prompts were appropriate. Photographs are great way to really help you record those memories, or prompt your thoughts, and you can create songs to help learn and remember important information, as well. For example, if you keep forgetting someone's phone number, just turn it into a song, and it's a great way to learn because our brains naturally encode that information easier.
The benefits of songwriting include improved psychological wellbeing. If you're participating in this activity with someone else, it leads to social bonding through a discussion and sharing memories, thoughts, and feelings. It inspires reminiscence and this is the reflection on lived experience. It allows you to express your thoughts and feelings, and because you've completed something creative, it leads to a sense of accomplishment.
The final activity we'll explore is music and relaxation. When we use music for relaxation, it helps set up a space for us to really downturn our nervous system. It also helps create timeframes for us to time these relaxation activities. For example, if we're doing mindfulness to music, it might be a good way to think of it as, "I'm going to do this mindfulness activity until this song ends." I've suggested two mindfulness activities here, but I'm sure you can find more or you have ones of your own that you're already practising. So, great mindfulness activity to do through music is simply belly breathing which requires no equipment and can be done anywhere, any place. You just pop on your music, close your eyes if you feel safe, and just allow your breath to flow in and out as you listen to the music. If you're looking for a more engaging breathwork exercise, you may like to try box breathing or the 4, 4, 4, 4 exercise where you breathe in for four, hold for four, out for four and hold for four. Once again, because of entrainment, we'll naturally start breathing in time with the music and holding our breath in time with the music.
Finally, a mindfulness activity that you may like to try. People usually like to do this one before bed, especially if they have trouble sleeping. It's a body scan. It's simply where you scan your body from head to toe, one part at a time, and relaxing them or the other way around, toe to head. Some people prefer guided body scans, and this, you can access through CDs that you may find at the library, or else online.
A more active way to relax if you're an active relaxer like I am, is art expression to music. This may include drawing or painting to music. Drawing can simply mean putting a pen to page and following the music wherever it may flow, or else, listening to the music and seeing what comes to mind, what images are inspired or memories, as well. Painting can include splashing colour on a page in time with the music, or else similarly, painting what images are inspired by the music, and using colours that are inspired by the music. Art expression can also be buying colouring books from your local bookshop or newsagency, and engaging in colouring.
Music for relaxation is generally slow because that has an effect on our nervous system, and slow music helps slow our nervous systems down. You may even like to use nature sounds, or the sounds of your environment to facilitate relaxation. This leads to awareness. And finally, everyone relaxes to different music, so choose your own adventure, pop on the music that you relax to. Doesn't necessarily have to be classical music, as many assume.
Relaxation is as important as physical exercise, just because it's important for us to help prevent stress and anxiety that we may experience in our daily life. Therefore, doing relaxation to music helps improve physical wellbeing by slowing down the heart rate and lowering blood pressure, as examples. It also helps improve concentration and mood if you allow your brain to have a break. It can help improve sleep quality, because I'm sure we've all experienced at some point when we're particularly stressed or anxious, just makes it so hard to sleep at night.
I'd like to also inform you on how to access music therapy if you'd actually like to see a registered music therapist. You can head on to the AMTA site by following this link that is provided in the resources area, and then you go to public resources tab on top where you'll find “find an RMT”, and this will lead you to a page of the directory, where you can include your suburb and your postcode in Australia, and then you can click on more filters and select specifically what kind of service you would like to acquire. Music therapy sessions can be funded by yourself, it can be funded by NDIS funding and your home care packages, if you have them. Thank you so much for watching my presentation today. I hope you got something out of it.
[Title card: Together we can reshape the impact of dementia]
[Title card: Dementia Australia. 1800 100 500. Dementia.org.au]
[END of recorded material]
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