Musicoterapia e Alzheimer

The Songs They Can’t Forget

"Tom was a wanderer. When his wife, Elsie, came to visit him at a care unit for patients with dementia, he would give her a perfunctory kiss, then wander off through the rooms and stare out the window. Elsie tried to walk with him and hold hands, but he would shake her off, leaving her heartsick.

A music therapist at the facility, Alicia Clair, was searching for ways to help couples like Elsie and Tom connect. Ms. Clair asked Elsie if she’d like to try dancing with Tom, then put on some music from the ’40s — Frank Sinatra singing “Time after Time.” Ms. Clair said recently, “I knew Tom was a World War II vet, and vets did a lot of ballroom dancing.”

As Sinatra began singing, Elsie opened her arms, beckoning. Tom stared a moment, then walked over and began leading her in the foxtrot. “They danced for thirty minutes!” Ms. Clair said. When they were finished, Elsie broke down and sobbed. “I haven’t been held by my husband in three years,” she told Ms. Clair. “Thank you for bringing him back.”

Ms. Clair, a professor of music therapy at the University of Kansas, tells this story to show how music can reach people with Alzheimer’s disease. Music has the power to bypass the mind and wash through us, triggering strong feelings and cueing the body to synchronize with its rhythm.

Researchers and clinicians are finding that when all other means of communication have shut down, people remember and respond to music. Familiar songs can help people with dementia relate to others, move more easily and experience joy. Tom had forgotten his name and couldn’t utter one word, but hearing Sinatra prompted him to dance.

Music memory is preserved better than verbal memory, according to Ms. Clair, because music, unlike language, is not seated in a specific area of the brain but processed across many parts. “You can’t rub out music unless the brain is completely gone.”

Ms. Clair noted, too, that Alzheimer’s is retrograde: “Things fall off in the opposite order from the way they were acquired.” So if someone sang to you as a baby, before you even knew words, you’ll respond to music after words are gone.

The discipline of music therapy (MT) was established in 1950, and last year close to a million people received MT services in hospitals, care facilities, hospices and schools. MT is not merely playing music for people, although that’s beneficial. Practitioners are skilled musicians who play instruments and sing, then are trained and certified to use music for therapeutic purposes.

Patients with a wide range of ailments — from children with disabilities to burn victims to people with Parkinson’s disease and stroke — have experienced the ability of MT to speed healing, improve mood and increase mobility. In a study published by the American Society of Neurorehabilitation, music therapy and conventional physical therapy were given to two groups of stroke victims who could barely walk. The group who received music therapy showed greater improvement in walking in a shorter period of time than those getting physical therapy.

My daughter, Rachel Strauss, who’s studying for a master’s degree in MT, said, “It works faster to relax people than any drug. It’s cost effective and has no side effects.”

There’s been a burst of interest in MT for people with Alzheimer’s. Kate Gfeller, who directs the graduate MT program at the University of Iowa, published a study in the Journal of Music Therapy finding that activities like moving to music, playing rhythm instruments and singing led to more group involvement and less wandering and disruptive behavior among 51 patients with dementia in five nursing facilities.

Other studies demonstrate that MT can slow the progress of Alzheimer’s, relieve pain and create emotional intimacy. The goal, Ms. Gfeller said, is to keep people functioning at their present level as long as possible: “We can’t reverse the disease, but we can make the quality of each day as good as it can be.”

Not just any music will do, though. The trick is finding out what music was popular when the patient was a teen and young adult. Ms. Gfeller said those years are such a powerful time in developing autonomy — a time of first love, learning to drive, getting the first home of one’s own — that people will play the music they heard during those years all their lives, and recall it the longest.

I remember visiting my grandfather, Louie Wass, when he was hospitalized with dementia, lying in bed, unable to talk. I started singing a Hungarian song he’d learned as a youth and later taught to me, “Territch-ka.” I sang the verse and when I stopped, he opened his mouth and sang the chorus: “Yoy, Territch-ka!” Right on key.

My daughter has asked me to send her books of music from the ’60s because, she said, “Boomers will be the next generation in the nursing facilities.” That was cheering. With the generation currently in these facilities, she uses songs like “A Bicycle Built for Two.” She likes those songs but said, “Your generation will be awesome — we’ll get to play the Beatles.”

Sara Davidson can be reached at saradavidson.com.

Fonte: The New York Times Company

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