As some of you know, my father, Jerry Atkins, at the age of 74, died after living with Alzheimer’s Disease for 13 years. A passionate music lover with an extensive record collection, he sang, danced, played the drums, and always had a song in his heart and on his lips. He has been gone for nearly a quarter of a century. When he was alive, there was little known (and precious scant research) in the field of Alzheimer’s. It was up to us to figure out ways to keep him socially, emotionally, and mentally engaged with the world in a dignified, purposeful, and fun way. Music was always an integral part of our times together.
The tunes my dad loved as a kid and a young man were the songs he sang and danced to with us as kids. As he became ill, we played those songs to keep him moving and strong. The music he enjoyed in jazz clubs, Broadway theatres, or concert halls served as his own personal soundtrack. Music was what we used to soothe, to comfort, to cheer, to motivate, you name it. And it nearly always worked. For these precious moments, this familiar music helped my father to, once again, become the man he was before he became ill. We enjoyed one another as we all sang together. Among his favorites were:
“When the Red, Red Robin comes bob-bob bobbin’ along. There’ll be no more sobbin’ when he starts throbbin’ his old sweet song…”
“I’ve been working on the railroad all the live-long day. I’ve been working on the railroad just to pass the time away…”
“She’ll be coming ‘round the mountain when she comes (yee haw). She’ll be comin’ ‘round the mountain when she comes (yee haw)”
“Blue skies smilin’ at me. Nothin’ but blue skies do I see. Bluebirds singin’ a song. Nothin’ but blue skies from now on.”
“Grab your coat. Don’t forget your hat. But leave your worries. Leave ‘em on the doorstep. Just direct your feet to the sunny side of the street…”
And any Ragtime, Dixieland or Big Band song.
After my dad became more silent, as soon as we began to sing, he joined in, often with a smile or a tear. At the end of our duets or songfests, he would often talk about the song or a memory associated it. We were amazed at how detailed he could be with those music-inspired recollections. Clearly, the music activated his brain in a unique way. And when we sang prayers together, he sang in full voice with an intensity I had not seen or heard in years. With the “Shema” prayer, in particular, there were tears streaming down his cheeks. We sang this particular prayer over and over and over and over. The “Shema” is a prayer of affirmation of Judaism and a declaration of faith in one God. The words of the prayer are: Shema Yisrael Adonai Elohaynu Adonei Ehad. At the time when we were praying and singing together, I was unfamiliar with the neuroscience behind the power of the memories and emotions that are evoked by music. But I saw my father with a light in his eyes. I imagine he may have recalled the special moments he spent in the sanctuary in various synagogues. Perhaps he remembered sitting next to his father as a young boy, or attending a makeshift Sabbath service before piloting his plane in the South Pacific during WW2, or enjoying sitting in a pew on a high holiday with his wife and daughters, surrounded by friends from the community.
Scientific studies can now confirm and help explain why the “right” music for a given individual can have a beneficial effect in moderating the experience of pain, calming them emotionally, or lifting their spirits. Much of the research has been performed with people who have Alzheimer’s Disease or other forms of dementia. Opening these pathways in the brain helps the person to be stimulated and connected. Putting on earphones with their favorite pieces of music that have been curated as their own music playlist and entered into an iPod can bring a person to life right before our eyes. Personalized music wakes up our inner lives. Even when so much of the brain is gone, music can bring much of it back to life.
Given these benefits, it would be useful to have a playlist of the music we personally find calming or energizing. It also makes sense to consider how a person in our lives with Alzheimer’s may relate to music given their age, culture, and musical taste. If we do not know the particulars, take this opportunity to ask:
“Is there a particular song or songs that always makes you smile and feel more energetic?”
“Is there music that soothes you when you are agitated?”
“What are your favorite types of music, singers, composers, bands, etc.?”
When we think about the power music on the brain, it makes sense to think about what YOUR personal soundtrack would sound like. Our songs are deeply personal which is why each person needs their own personal playlist. And, even if we are not dealing with Alzheimer’s, it would be good to share with our family or friends the type of music that we would find helpful if we ever had to be in the hospital for a few days and couldn’t talk.
Since my dad’s diagnosis and subsequent death in 1994, I have spent much of my career in the Alzheimer’s space. In 2011, I attended a conference at which numerous experts discussed The Brain with Alzheimers. I asked several presenters, in a variety of ways, about the intentional inclusion of personally tailored music for people with Alzheimer’s as a way to impact their mood as well as their cognitive function and sense of self. Regrettably, my inquiries were not taken seriously despite multiple positive experiences incorporating music with my father and subsequently, with patients and their families with whom I worked. It was, however, right after that conference that I found the neurologist, Dr. Oliver Sacks’, brilliant book, Musicophilia, about the impact of music and the brain. Since the publication of that book, there has been more focus by musicologists, neurologists, psychologists, and movement therapists in the study of the multiple ways that music helps those with Alzheimer’s (and other brain disorders).
Music is more potent than words in evoking memories. It arouses most of the brain. Emotion and memory are intertwined as music activates memories and emotions simultaneously. Songs can initiate emotional responses as well as motor responses. What is unique about music is that it is embedded nearly everywhere in the brain including emotional centers, memory centers and movement centers. This explains why even when much of the brain is gone, music can wake it up. According to psychologist, Dr. Bill Thompson, music is a super stimulus. He asserts that “because so much of the brain is involved there is more opportunity for the effects of music to be preserved in the face of damage.” Dr. Amee Baird, whose focus is people who have severe brain injuries, notes that “music is hardwired to make us move, to make us feel, and that music is a powerful evoker of memories.” Her studies demonstrate how music, which becomes deeply ingrained in our mind, can help a person recall their past even when they have severe brain injury.
How music touches our essence, particularly the heart and soul of those who have Alzheimer’s is stunningly illustrated in the documentary, Alive Inside, by Michael Rossato-Bennet. Dr. Oliver Sacks, who is interviewed in the film, commented that “music has more ability to activate more parts of the brain than any other stimulus.”” He suggests that by engaging people with music that is meaningful to them, you can help them… “to animate, organize, and bring a sense of identity back to people who are ‘out of it’ otherwise. Music can bring them back ‘into it’; into their own personhood; their own memories…”
Today, music and memory programs are becoming more common. It is quite simple to make personalized music playlists accessible to people who have Alzheimer’s who are in health care environments. Among the many studies examining the positive effects of personalized playlists, the results of a Stanford University study showed that prescribed music can reduce agitation in people who have Alzheimer’s. It helps them feel relaxed and calm. The right playlist can get through to even the person who is quite demented. Music does something to our brain that no other stimulus can do. Dr. Maggie Haertschag refers to what she observes in her patients who have Alzheimer’s as seeing them come “alive for that moment” because we enter through “a side door of the brain.”” She thinks of music as a human right and reminds us that music predates language and is, in fact, primal. We are hard wired to respond to music.
As we grow up, music is very much a part of our lives. Yet when we begin to lose our memories, we are largely disconnected from that music (and over time, as people who have Alzheimer’s become withdrawn, from people and life). For those who have Alzheimer’s, listening to music that has meaning to them serves as a connection to who they were. It reinstates their identity.
Music is the one thing that can help us the most to stay connected. We do not need language to feel emotion. Music carries messages of emotion. Instead of people drawing into themselves, when they listen to “their” music they come out and reconnect with themselves and with their family members. Surprisingly, after listening to a favorite piece of music, some people who have Alzheimer’s (who before hearing the music, could not speak a coherent sentence) not only sing the lyrics but, immediately after listening to the music, are able to engage someone in a conversation.
Music is about bonding and connection. I believe an incredibly kind gift to offer someone who has Alzheimer’s is to create a personal playlist and listen along with them.
Many people that we admire have at least ONE habit that they practice each day. It may be waking up and going to sleep at the same time each day, reading for pleasure, walking in nature, exercising, asking yourself the same “pivotal” question every day, writing in a journal, listening to music, meditating or something else.
What’s the point?
Why bother with a daily habit?
Well, some of us believe that human beings are “creatures of habit.” Most of us feel comfortable (and safe) when we know what lies ahead. With the exception of leaving room for surprises, we generally feel content with the familiar. During COVID-19, some of us worked hard to develop and maintain healthy daily habits. This helped us to feel some control in a situation where there was much that was out of our control. For others of us, we abandoned those habits which may have removed a needed structure and sense of security. As a result, we may have experienced increased anxiety and stress.
So again, why the daily habits?
They provide structure.
They give us a sense of purpose.
They give us a sense of accomplishment.
They help us to focus on a cause or a goal.
They help us to “keep our finger on the pulse” by noting how we are doing in the larger scheme of things.
They help us to prioritize what is important in our daily lives, particularly as things change. Some things we did for years may need to stay as part of our routine while others may require revision or retirement!
Each of us can develop a daily routine that consists of individual habits. Over time, these habits help us to eliminate distractions and keep us focused on whatever our objective is.
With so much hate and posturing and that which was unacceptable becoming acceptable (and often lauded), each of us has a responsibility to reach out to someone and try to understand their experience. To listen to their story without creating our own response while they are talking. To experience deep listening. Each of us wants someone to listen to us. Deeply, without judgement. To pay attention to how and why we are who we are and believe what we believe. Each of us wants to be treated with dignity. How do we do it? It is easy when someone is like us. Harder when they are not.
Once, many years ago, in the mid-1970s, I decided to write a book about listening. As part of my teacher training in a Master’s program for teaching children with hearing loss, I was trained to teach children to use their residual hearing to “listen” well (augmented with hearing aids and later, cochlear implants). Listening was a “teachable” skill for those whose hearing was diminished.
What I learned in the process was that that listening was so much more than hearing. It was about paying attention to another person’s words, body language, total affect, and most important, their story. I felt a book brewing inside. This was in the days before we had personal computers. It was just my yellow legal pad and me.
I was about to embark on a multiple-city speaking tour in Canada. With so many long flights and waiting time in airports, I thought why not get started on the book? Writing this book became my solace. Until it wasn’t. Sadly, at the end of the trip, I hurt my back and could not lift anything. My small purse felt like a workout barbell. I put my camera, and everything I possibly could (including 12 completely filled legal pads) into my suitcase to ship through to the States. But it never arrived. All these years later I wonder where my suitcase went.
I never resurrected the book and, since then, there have been many excellent books written about listening. But lately, I see we all need reminders about how and why we need to listen to one another not so much from our heads but from our hearts. In my view, one of the kindest things we can do for another person is to listen to them.
When we put ourselves in another person’s shoes, we can get a bit closer to what they experience. We cannot do it exactly or perfectly, but we can attempt to see the world (their world), or a situation, from their perspective. To do this effectively, we need to put aside our own experience for a time. When we do this, we are becoming more empathetic, deepening and enhancing our relationship with them.
When we listen, we listen with our whole self, our whole body. We pay attention to the other person’s body language so that we are open to what they are communicating verbally and nonverbally. We may or may not be correct but we can try to ascribe meaning to what we see and hear and then we can ask questions about our perception. In order to do this, we can attempt to clear our mind and be present in this moment. We are essentially listening for what the person means not just what they say. We listen with our head and our heart.
We may be predisposed to compare or judge someone as we listen to them and be aware of that inclination. We can pause and recognize what we are doing. Judging someone while we are listening to them is a great way to shut down communication. If we are focused on the person speaking, with a desire to hear what they are saying and what their message is, we have a greater chance of understanding them and building a deep relationship.
Many of us feel that our role as a listener is to respond, so as we are listening, we are creating our response in the process. Rather than responding, we can try to say back to the person what we understand they said. We may be right or wrong. By doing this we can give them a chance to hear what we heard as well as process what they have said.