By Robert McCoppin
Chicago Tribune
An audience of patients with Alzheimer’s disease listens in rapt attention as a young woman sings the French song “Beau Soir.” Despite his failing mind, one of the men in the crowd, Les Dean, translates the words into English for a friend.
“See how the setting sun paints a river with roses,” he whispers. “Tremulous vision floats over fields of grain.”
And when the audience joins in a sing-along on another tune, Dean’s voice rumbles in a resonant baritone, “Take my hand, I’m a stranger in paradise. All lost in a wonderland, a stranger in paradise.”
Dean, 76, once taught high school music in Chicago, invented and sold his own music education system and sang with the Chicago Symphony Chorus. Now, like many patients with Alzheimer’s, he is to some extent lost in the past, a stranger to the present. He asks a visitor, “How are the children?” Five minutes later, he asks again, and then again, unable to recall the question or the answer. But when the music plays, he smiles and is transported to a place of beauty, where everything still makes sense.
In recent years, music therapy has grown in popularity for its seeming ability to help calm people with dementia and reconnect them with their memories. Now a Northwestern University researcher is testing whether music played for residents of a suburban nursing home can be therapeutic, whether it can improve cognition, conversation and relationships.
As the number of dementia patients grows — nearly one in three seniors by the time of death — advocates hope to get insurance and Medicare to extend music therapy to everyone who could benefit from it.
In the process, caregivers whose parents or partners have grown distant, confused and agitated are finding new ways to share meaningful moments with the ones they love.
A person with dementia can recede so far that he or she is no longer responsive, suggesting personality and consciousness have been lost. But in his book “Musicophilia: Tales of Music and the Brain,” the renowned late neurologist Dr. Oliver Sacks wrote that he’d seen such patients shiver or weep while listening to music.
“Once one has seen such responses,” he wrote, “one knows that there is still a self to be called upon, even if music, and only music, can do the calling.”
Research has suggested benefits from music therapy for people with autism, depression, schizophrenia, brain injuries and cancer. Newborns in intensive care have been found to gain weight faster when exposed to music.
For people recovering from a stroke, the rhythm of music can help them regain their gait. Those with aphasia, who’ve lost the ability to speak, sometimes can sing familiar songs, and some can eventually be taught to transition from singing to talking.
Such therapy, known as melodic intonation treatment, was used to help Arizona Congresswoman Gabrielle Giffords recover her speech after she was shot in the head.
Researchers suspect this may be particularly useful for patients with damage to the left side of the brain, because music emphasizes use of the right side of the brain, providing a potential alternate route to develop new nerve pathways.
For some people with dementia, music therapy has been shown to enhance attention and cognition, to improve behavior while reducing the use of psychoactive drugs, and to reduce anxiety and depression. Singing songs can help prompt specific memories that otherwise might have been forgotten completely, experts say.
And because music is also processed in part in a core part of the brain called the cerebellum, doctors say patients can retain the ability to dance and sing long after ability to talk has diminished.
Some patients get very agitated by being disoriented, and might throw things or lash out at others. But when they hear music from their youth, it can put them in a familiar environment and help them feel more at ease.
On the other end of the spectrum, some patients are so nonresponsive, or so heavily medicated, they may need music to wake them up and get them moving.
Intrigued by the potential benefits, Dr. Borna Bonakdarpour, a neurologist with Northwestern University’s Feinberg School of Medicine, put together a music therapy study this spring at Silverado Orchard Park Memory Care Community in Morton Grove, Illinois.
For 12 weeks, the nonprofit Institute for Therapy Through the Arts held weekly concerts for 10 Silverado residents. The musicians are specially trained to apply their skills to therapy, often by interacting with patients during performances, and getting them to beat on drums, sing, and dance. The $84,000 program is funded by an anonymous donor.
“Music therapy is gaining more confidence now as an intervention, so this is a very exciting time,” Bonakdarpour said. “We thought when people get Alzheimer’s, they’re done, because there’s no medicine to cure it. But there’s so much we can do to have an impact and improve their quality of life.”
At Silverado, before the concert began, some of the residents were subdued, showing little emotion, not saying much. The ensemble — a pianist, cellist, singer and percussionist — began to play. There were some classic instrumentals, like a piano-cello duet of “The Swan,” and some crowd-pleasing singalongs, like “Get Happy.” The group previously played “Over the Rainbow,” but found that was too emotional for some of the residents.
Many in the audience followed the tempo with tambourines, small drums or hand claps. Some got up and danced. At least one still looked down, showing no reaction.
Not all of the nursing home residents have Alzheimer’s. Doug Brown, the youngest member of the music therapy group at 57, has a brain tumor called glioblastoma, the same type Sen. John McCain has.
Originally from Mississippi, Brown played in an Irish folk band in the 1980s, his girlfriend Cris Noll said. He moved into the nursing home last year, where he remains seemingly content, though Noll called his disease “heartbreaking.” He doesn’t know what day it is, or when it was his birthday recently.
But when it comes to music, Noll said, “He loves watching the musicians play. He sang the songs. Even in his condition, it’s funny how music will spark a memory.”
After some of the sessions, Brown borrowed a musician’s guitar and found he could still play the Eagles’ “Peaceful Easy Feeling.”
After the concerts at the nursing home, the residents broke into smaller groups to share their thoughts. When asked what he did for a living, Dean didn’t answer that he was a retired music teacher, but simply said, “I’m a music teacher.”
He still occasionally plays piano, and sings for his own enjoyment. He recently went to his friend Lisabeth Weiner’s home for Passover and chanted prayers in Hebrew that he learned as a child.
“As a musician, he goes to that zone and it all comes back to him,” Weiner said. “Those are very deep memories. He can still reach in and find them and still do it beautifully.
“The thing you learn about Alzheimer’s is, you have to help the patient enjoy life in the moment,” she said. “It provides a lot of enjoyment for him in the moment.”
Silverado Memory Care resident Les Dean performs a solo during a concert for residents with dementia and Alzheimer’s, with assistance from music therapist Amanda Ziemba. (Chris Sweda | Chicago Tribune)
