A dementia research programme at a residential care home is investigating the power of music and whether it can be used to sustain language in older people. Chelsea Court Place has collaborated with the University of Roehampton to launch the exciting music project, called Beyond Words.
Researchers Prof. Adam Ockelford, Dr Fiona Costa, PhD student Caitlin Shaughnessy and “savant” pianist Derek Paravicini – who is blind and held his first concert at the age of seven – are leading this this innovative project with residents from Chelsea Court Place.
Here, Care & Nursing Essentials magazine speaks with Professor Adam Ockelford about the dementia research …
What does the Beyond Words dementia research programme hope to achieve?
The year-long study aims to investigate the power of music and if it can be used to sustain language in older people with dementia, enabling them to communicate their wishes and needs for a longer period than would be normally be the case in the natural deterioration caused by the disease.
One of the symptoms of dementia in its later stages is a decline in verbal communication. Together with the deterioration of memory, often an early stage of the disease, this can create a major challenge of communication. For many people in the severe stage of dementia, the ability to communicate is completely lost.
There is no cure for dementia. There is no stopping the decline in the ability to communicate and its accompanying frustration. Several health institutions recommend the development of non-pharmacological approaches (NICE, 2016).
There is wide acceptance for the use of music as a therapeutic intervention for dementia patients. In a recent study of their responses to music ‘music was highlighted as one of the few mediums to which most people could still access’. This was particularly true of personal, meaningful music (McDermott et al. 2015). It has also been suggested that musical abilities and memories may not be connected to neurological deterioration relating to speech and language. This raises the possibility of using music as a non-verbal form of communication for people with dementia (Aldridge, 2000; Hubbard et al. 2002).
What happens during the dementia research music sessions at Chelsea Court Place?
The weekly, 45-minute sessions include a repertoire of familiar songs (requested by the audience) and proceed into a series of ‘micro-songs’; short rhythmic melodies associated with key functional language. Such micro-songs have been successfully used with children and young people with complex needs to scaffold or substitute language, but no research has been conducted to understand the extent to which this happens.
Can you explain how music can help to scaffold language?
Melodies provide a simple framework in sound on which words can be ‘hung’ – rather like pegs on a washing line. Research has shown that it is easier to remember the words in songs than it is to try to learn and recall words on their own. This is because music uses simple, repetitive structures that the brain finds easy to process, and in the brain, the words and the music are stored together, and can be recalled at the same time.
Have you seen examples before in the elderly where music has triggered a response?
In our work with elderly people with memory difficulties in the past, we have observed how listening to familiar music heard earlier in life can have a dramatic, positive effect: those who seem to have little or no speech (or an unwillingness to use it) suddenly ‘come alive’ and will sing and even dance! There is emotional engagement too, and often memories can be stirred that have been dormant, perhaps for a long time. There can often be a ‘halo’ effect, whereby once the brain has been ‘kick-started’ into action, language returns, conversations can take place once more, and there is a sense of being together with others, replacing the feeling of isolation that can be so distressing. Music seems to have the ability to reach the parts of the brain that other interventions cannot, and it has a power beyond its notes to rekindle memories, words and a sense of well-being.
If the dementia research findings show an improvement in speech, what could care home providers do to use music effectively? Which types of music might be best to play and for how long?
Based on our work at Chelsea Court, we will make the materials we are developing generally available online to relatives and carers who wish to use them. This resource will take a while to develop, but if any readers would like pre-publication copies of the songs and activities we are developing, then please get in touch with Dr Fi Costa at Fiona.Costa@roehampton.ac.uk