Listening to music or sharing art can be soothing. Relatedly, creativity is a powerful capacity that all humans share. Unfortunately, for those suffering from cognitive impairments, the utilization of this capacity can be frustrated. However, with a healthy dose of – you guessed it! – creativity, caretakers can enable Alzheimer’s patients (even ones who are far advanced in their declines) to use the arts to express themselves and to realize some of the benefits previously noted. My dad’s case afforded me a glimpse into this fascinating and emotionally salubrious process.

For a bit more detail, you can read about my father, Jim, HERE. Suffice it to say that music and art were two of his many interests. He liked to listen to music and sketch people from the covers of TV Guides. Later, as his disease progressed, but while he was still residing at home, he became unable to plan and execute his own projects. Still, he used to sit with my mom as she made cards. Jim was able to help by brushing color on a background papers or performing rudimentary “stamping” operations with a sponge. As his disease worsened, he started a “music therapy” program in his nursing home. The overseers developed a play list of his favorite songs and fed it into an iPod. It was bittersweet to see him smiling and sometimes even humming along. But a key takeaway is that this therapy also helped to calm him.

In addition to the in-house efforts, the nursing home hired a musician to come about once a month to the main visiting area. Residents were encouraged to clap or sing along. Jim seemed to enjoy listening to the oldies. As he was fond of saying, during happier times in his life, they are “oldies, but goodies.”

Music and movement (like dancing) seems to make people with Alzheimer’s feel happier and more like socializing, thus creating a calmer environment. This could result in a decrease in anxiety and depression levels which, in turn, could possibly reduce the reliance on certain medications.

But being in a new area and seeing others respond to the music also helped to stimulate responses in him.

Art Has Effects That Go Beyond Mere Pacification

According to Generations Healthcare: “[I]n 2013 there were neurological studies done that revealed that artists with dementia could still draw familiar people, places and objects from memory.”[1] Art is also surmised to help build feelings of accomplishment and purpose.

Moreover, there is good reason to suppose that the arts might be able to reduce feelings of loneliness. In an article by the Chicago Bridge on Building Community Through the Arts, the author notes that older adults experience social isolation for a variety of reasons. Some experience it due to diminishing physical capabilities, such as loss of hearing. Similarly, others may find that their own voices become too weak for most people to hear without above-average concentration. Still others develop mental problems, like “aphasia” (i.e., comprehension or language impairment), a common difficulty arising with various forms of dementia.

Language abilities are a complex tapestry of mental powers. For instance, many discrete cognitive faculties contribute to, and constitute, the ability to keep up with a conversation’s flow and to initiate a response. Alzheimer’s sufferers become deficient in many of these relevant processes and can only follow a normal discussion with great effort (if at all).

However, the arts in general, and perhaps music in particular, has the unique ability to touch human beings in a direct and intuitive way that is almost, dare I say, magical.[2] Thus, the creative outlets just sketched give Alzheimer’s-afflicted persons a way to connect even when communication is difficult (or practically impossible).

Dr. Natalie Rogers, an art therapist, described this creative connection quasi-poetically as “a process in which one art form stimulates and fosters creativity in another art form, linking all of the arts to our essential nature. Using the arts in sequence evokes inner truths which are often revealed with new depth and meaning.”[3] This “art connection” arguably supports a total integration of a person’s mind and body, fosters deeper relationships with others, and may even facilitate greater awareness of oneself. Or, where the requisite understanding is lacking, as it is in Alzheimer’s Disease, if not self-awareness, at least a certain self-acceptance or personal peace.

How Do the Arts Help?

Art, dance, and music engage regions of the so-called “non-verbal” parts of the brain. People who have trouble with verbal communication can still connect with others through the kinds of creative activities that, in a way, bypass the neurological roadblocks that are erected by dementia.[4] (For an overview of the literal “plaques” and “tangles” plaguing the brains of Alzheimer’s sufferers, see HERE.)

Alzheimer’s makes it hard for people to handle too much sensory input. Music, somewhat counterintuitively, seems to be able to help patients process sensory stimuli better.[5] Specifically, art appears to have a “strengthening” effect on memory, supporting the brain’s ability to recall associations that have been made with certain sounds and sights.

Investigators theorize that art and music are able to activate areas of the brain that Alzheimer’s has “turned off.” Music is especially potent because it is supposed to be processed in many different areas of the brain.[6] Further, musical memories are believed, so to say, to be more “deeply entrenched” in the brain than even language. Musical recollection sets the limbic system in motion because of the tie between melodies and emotions.

Neurologist Oliver Sacks has gone so far as to opine that human beings listen to music “with our muscles.” Although this is a somewhat cryptic comment, he seems to have in mind the fact that sound processing starts in the primal brainstem and then registers in the root structures called the “basal ganglia” – which, along with the thalamus, control voluntary motor movements and routine behaviors.

Thus, we see that Sacks’s statement highlights the importance of movement. Muscle movement, locomotion, and the like stimulate circulation – specifically, blood flow to the brain.[7]

Tips for Your Own Caregiving Environment

All of this theory is well and good. But how can you implement general art, dance and music in your own caregiving environment – whether at home or in an assisted-living facility or nursing home?

Art

• Begin with simple projects – maybe abstract watercolor painting. But note well that, although projects should be simple, they should not be childish.
• Build conversation into whatever activity you select. Talk about what they are doing.
• Don’t rush anything. Let the person take his or her time.
• Recognize that you might have to help the person get started (for example, by moving the brush) to show them what to do.

Movement

• Again, don’t place arbitrary or unnecessary time limitations on the activity. Let them take the time they need – or desire.
• Play music (for more on which, see below).
• As before, you might need to jumpstart your loved one’s motions (in this case, by clapping with or for them, or tapping his or her feet, etc.)
• Of course, movement can be rudimentary and still be benefit. This could range from dancing or just swaying, to pacing or walking, or even exercising. Hey, if it gets them moving, call it a win.

Music

• Play music that is familiar to, or a favorite of, your loved one.
• Tranquil music can calm, while a faster beat can boost the spirits. Mix it up.
• Don’t play it too loud. Loud noise might cause agitation. On the other hand, remember that aging adults or dementia sufferers might have auditory difficulties on top of whatever other cognitive problems they have. So, be ready with the volume knob or remote in order to regulate the volume as needed.
• Try to get commercial-free music in your play list. Commercials might confuse them. Additionally, commercials just break the mood and will tend to undercut the sustained effects that you are trying to achieve.
• Encourage clapping, dancing, humming, or singing along.

Final Thoughts

Art therapy covers a lot of areas – dance/movement, drawing, improvisation, music appreciating, painting, sculpting, singing, and even (for those still higher functioning) writing. A common undercurrent is their engagement of the senses. For someone whose faculties are failing, these activities become rich avenues of information gathering. If a person’s vision and hearing are not as sharp as they once were, they may now rely on touch, taste and smell. So, don’t be afraid to add such pastimes as tasting or smelling different foods, looking at pictures, listening to rain, massage or aromatherapy.

Elaine Perry is a professor of Neurochemical Pathology at the Institute for Aging and Health – Newcastle University that is currently working on a study of aromatherapy for people suffering with Alzheimer’s and agitation. In one of her papers, she cites specific research that shows that certain essential oils are useful for elevating mood and calming agitation.[9] In several clinical tests using lavender and lemon balm as a natural treatment for residents having advanced dementia, it was found that there was a decrease in negative behavior. Geranium, rosemary and peppermint oils have also been tried with some success. Interestingly enough, the best delivery was in a lotion that was applied to the skin. The physiological effect is alleged to be present even if the person has lost their ability to smell (on which, see HERE).

For Further Research

• Kate Gfeller and Natalie Hanson, Music therapy for Alzheimer’s and Dementia Individuals, Iowa City, Iowa: Univ. of Iowa, School of Music, 1995.

Notes:

[1] See the article titled “The Amazing Effect of Art and Music Therapy on Alzheimer’s,”

[2] Maybe the more apt word would be Orphic.

[3] Natalie Rogers, The Creative Connection: Expressive Arts as Healing, Palo Alto, Cal.: Science and Behavior Books, 1993.

[4] This has given way to the suggestion that cognitive skills may not be inextricably intertwined with the memory, as is presently the dominant view.

[5] It’s counterintuitive in the sense that music itself seems to be a kind of “sensory input.” Then why is it that music doesn’t seem to add to the feelings of overwhelm experienced by the Alzheimer’s sufferer? Perhaps the answer is something like this: the rhythm of the music may provide a kind of structure or “beat” to the afflicted person’s otherwise increasingly chaotic and unstructured thoughts. But this is just sheer speculation on my part.

[6] This is because the various elements involved in music – like pitch, rhythm and melody – are all processed by subtly different brain components.

[7] Oliver Sacks, Musicophilia, New York: Vintage Books, 2008. Sacks wrote: that there is “no single music center in the human brain, but the involvement of a dozen scattered networks throughout the brain.” He also credits the 19th-century German philosopher Friedrich Nietzsche with the thought that “Listening to music is not just auditory and emotional, it is motoric as well …[W]e listen to music with our muscles.”

Blood flow is one of the important factors in brain health according to Dr. Daniel Amen and his BRIGHT MINDS protocol. Exercise was also stressed by Dr. Jacob Teitelbaum’s program that highlights five areas for energy and brain health called SHINE. For more information on these matters, see HERE.

[9] Elaine Perry, “Aromatherapy for the Treatment of Alzheimer’s Disease,” Journal of Quality Research in Dementia, No. 3, n.d., (cached HERE).