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Providing a Precious Moment of Clarity:  
Alzheimer’s Disease and the ‘Well-Tuned’ iPod
By Dr. Concetta M. Tomaino, D.A., MT-BC, LCAT
Senior vice president for music therapy at Beth Abraham Family of HealthServices

Frontline caregivers working with people with Alzheimer’s disease know perhaps better
than anyone just how devastating this affliction is.

It is after all, the long-term caregiver that daily bears witness to the loss of one’s
memories, one’s sense of self and ultimately, one’s ability to function on any self
sufficient level.

All too familiar with the disease’s destructive nature, degenerative pace and effect on
the patient and their family, it is the caregiver that fields a loved one’s tentative inquiry,
“How is it today?”, or shares a patient’s wail of frustration as yet another thought eludes
them.

Indeed, even as science and researchers strive for greater understanding of the
causes of Alzheimer’s disease, and a possible cure, we are the people who are turned
to for answers, for treatment and for hope.

Today, that hope comes by way of an unlikely piece of everyday technology: the iPod.

An important role

At the Institute for Music and Neurologic Function (IMNF), the iPod is playing an
important role in helping people with Alzheimer’s disease reconnect to their memories
and their loved ones, if only for immediate periods of time.

We call it our “Well-Tuned: Music Players for Health” program, and its impact has been
extraordinary.

The iPod is loaded with music that is emotionally significant to the individual with
Alzheimer’s disease.  This customized play list necessarily changes from person to
person, and is based on individual experiences, cultural background, and frame of
reference.

Involve family and friends

In circumstances where the person afflicted with Alzheimer’s disease is non-verbal or
can no longer communicate which music comprises the ‘soundtrack of their life’, family
members and friends are engaged in the “Well-Tuned” process and help assemble
their loved one’s autobiographical play list.

The music may spur memories thought long gone or stimulate recognition of a loved
one that moments earlier was no more than a blank face. As with lovers who grow
sentimental when “their song” is played on the radio, the right music stimulates the
personal associations that it is connected with, sparking memory and renewed
“presence.”

It may also help a person with Alzheimer’s disease function and transition throughout
the day, from energizing their waking hours to winding down as bedtime approaches.
The “Well-Tuned” musical selections also enhance the therapeutic value of other
treatments. One musical menu might create stimuli to make it easier to participate in
an exercise program, while another more “transitional” selection of songs is designed
to keep the patient mobile over the course of the day. Still another program works to
relax patients whose medications might make them hyperactive or agitated.

Can something as simple as the right selection of music and an iPod provide precious
moments of clarity to a person with Alzheimer’s disease and precious moments of
connection for their loved ones?

The short answer is yes.

Emotional connection

The more clinical answer as to why this type of therapeutic music works to restore
some memory and recognition of loved ones, relates to the emotional connection we
make to music throughout our life.

It also has to do with areas of the brain involved in emotion, association and long-term
memory processes that are stimulated by personally
important music.

These areas include the limbic system (the amygdala and hypothalamus) and the
medial prefrontal cortex. In people with Alzheimer’s disease and dementia, these areas
and the neural networks that link them can still be stimulated through the auditory
pathways.

For this reason, key musical selections that are linked to emotional and personal
memories can unlock memories and associations that had seemed lost forever.

The presence of a “Well-Tuned” program, whether at long-term residential facilities,
adult day care centers, in-home care programs or in assisted living environments, may
well be a motivating factor when families are deciding whom to entrust with their loved
one’s care.

Modest costs

At the IMNF, we welcome the opportunity to share the methods, mechanics and aspects
of building “Well-Tuned” programs at other facilities.  The costs involved are modest
and can be customized to meet most budgets.

Professional training can take place at the IMNF headquarters in New York, or on-site at
your local facility.

The reality of Alzheimer’s disease is not so distant from any of us. Certainly, those of us
who work every day in its presence know well that the care requirement is long term
and the prognosis is not yet positive.

Forecasters tell us that the number of people afflicted with Alzheimer’s disease will
increase exponentially in the coming years, with some estimates topping ten-million
among the aging U.S. baby boomer population
alone.

Is Alzheimer’s disease caused by environmental factors, genetic predispositions or a
combination thereof?  Science and scientists will no doubt sort out those questions in
the years to come.  In the meantime, we as caregivers (and perhaps one day as
potential care recipients) must do all that we can to give people with
Alzheimer’s disease every opportunity to reconnect with a parent, spouse, sibling or
friend.

The IMNF works with rehabilitation centers, training caregivers in state-of-the-art,
effective music therapy techniques.  We strongly recommend that long-term care
facilities integrate a trained music therapist in their core of healthcare practitioners.

In addition to providing patient care, these music therapy professionals can also
counsel staff about using music therapeutically in other aspects of care, such as pain
management and relaxation. The following is a sampling of music therapy tips that can
help organize a program and maximize the benefits for people with Alzheimer’s
disease and other dementias.

To learn more about “Well-Tuned” and other IMNF programs, I encourage you to contact
us by email at
info@bethabe.org
or by phone at (718) 519-5840 or 1-
888-792-2247.

• Select music that is familiar, enjoyable and meaningful to the individual with Alzheimer’
s disease.
• Choose music that matches the mood you are trying to create (e.g. play quiet music at
bed
time, and upbeat music to provide stimulation during the day).
• Integrate/schedule a loved-one’s visit with a music therapy session to help stimulate
memory recollection, recognition and personal reconnection.
• When individuals with Alzheimer’s disease are participating in the “Well Tuned”
program,  minimize distractions and extraneous noise by closing doors, turning off the
television, etc.  Encourage individuals with Alzheimer’s disease to interact with the
music by clapping, singing along or even playing an instrument.
• Supplement the music with meaningful photos of family, friends and experiences, and
talk about past memories and events.
• Select older model iPods. They are slightly larger in size with the controls on the unit
and
not on the ear bud cord, making it easier for older, less nimble hands to operate them.
• Long-term care facilities can run “Recycle Your iPod” drives to more easily and
affordably
obtain older model iPods as people trade up for newer models. Facilities can partner
with local schools; civic/fraternal organizations; retailers, and news media outlets.

About the author

Dr. Concetta M. Tomaino, D.A., MT-BC, LCAT, is a pioneer in the field of music therapy
for individuals suffering the effects of
stroke and other brain trauma or are afflicted with such degenerative neurological
diseases as Parkinson’s or Alzheimer’s.
Dr. Tomaino is the executive director and co-founder of the Institute for Music and
Neurologic Function (IMNF) and the senior vice president for music therapy at Beth
Abraham Family of Health Services.  Email:
info@bethabe.org
-END