Although musical memory processes are not universally immune to dementia, people living with the disease often retain the ability to sing familiar songs, remembering not only the melodic details and lyrics of the song, but also the embedded memories associated with the preferred song or piece of music. In my work as a music therapist, I have seen people at the later stages of their journey with dementia, who although cannot verbally communicate can still engage in music. This remaining ability to engage in music can be a meaningful communication tool to connect the person with dementia when everyday conversations and activities become difficult.

There is a vast array of music readily available at our fingertips thanks to streaming platforms such as YouTube, Spotify and iTunes. There are custom-created playlists designed for people living with dementia and their caregivers, with music from earlier decades including multiple genres such as blues, country, folk, jazz and swing. While a popular and useful resource, these can be harmful rather than helpful unless used appropriately, with the person’s musical preferences taken into consideration. With support and guidance from expertly trained music therapists, family and informal caregivers can choose appropriate music at specific times to support the person with dementia in their care. For example, music might be used to reduce agitation in the evening or carefully selected to support the person during meal times.

Music therapy

Music therapy is an evidence-based clinical profession. Music therapists use music-based methods such as singing, improvisation, instrument play and song writing to promote positive health and well-being. Its application in dementia care is becoming increasingly popular and research in the field has established that it can reduce agitation, encourage reminiscence, promote self-expression, provide cognitive stimulation and promote improved quality of life (Matthews, 2015). Music therapists work in a person-centred way and focus on being with the person in the present moment, matching their level of awareness at the various stages of the dementia trajectory.

Music therapists facilitate individual and group music therapy sessions with people living with dementia and their families. Music therapists are expertly trained to provide meaningful musical experiences while being mindful of the participants needs.

The impact of Covid-19

The Covid-19 pandemic necessitated a move to technology to stay connected with one another while safely staying apart. People with dementia and their family or informal caregivers have been radically affected by the strict social distancing measures that have been put in place across Europe and as a result are at an increased risk of social isolation. Dementia community support services, recreational activities and psychosocial services such as music therapy were required to move online due to the pandemic. Even before Covid-19, people living in remote rural areas were unlikely to be able to benefit from music therapy. Here in Ireland, music therapy is predominantly only available in large urban areas.

Online dementia cafés have become commonplace over the past year as Covid-19 restrictions remain in place and has highlighted the advantages of using online platforms. The introduction, and hopefully continuation, of these online services ensures that people at the later stages of the disease can attend or ‘be involved’ in activities from the comfort of their own home while also diminishing barriers of geographical location, mobility issues and regular transportation.  Potentially, online music therapy offers an equity of access that may have been previously limited.

Lero, The Science Foundation Ireland Research Centre for Software recently funded a documentary ‘Music, Technology & Dementia’, which provides a snapshot into how people living with dementia and their caregivers use music and technology in the home. Arts and health practitioners share their experiences of working with people living with dementia and their caregivers online, their future recommendations and the importance of choosing appropriate software and communications platforms.