Of the many gifts the arts bestow on those who love them, perhaps the most important is a feeling of transcendence ”“ what music therapist Concetta Tomaino calls “the sense of being connected to something greater than themselves.”
That connection is vital in Alzheimer”™s and other forms of dementia, where the patient”™s relationships ”“ to others, to the mind, to his very identity ”“ erode daily and are ultimately destroyed.
So it comes as no surprise that arts therapy, particularly music therapy, is a growing part not only of caring for dementia sufferers but helping their caregivers cope as well.
“As the population ages, there is an increasing need for it,” says performer/musicologist Peter Muir. The director of the Institute for Music and Health in Verbank. Muir says he does a lot of programs like the one on early-20th century American song that he”™ll be offering to dementia patients and their caregivers on Nov. 21 at Chappaqua Library in Chappaqua.
Perhaps the biggest growth in arts therapy, however, has taken place in nursing homes.
Schnurmacher Center for Rehabilitation and Nursing in White Plains. plans to have music therapy four days a week instead of the usual three, says Marlon Sobol, manager of Schnurmacher”™s Institute for Music and Neurologic Function.
And at Greenwich Woods Rehabilitation and Health Care Center in Greenwich, Conn., the arts have become an integral part of a holistic approach to dementia care in its Redwood unit.
“We have learned to make the last days count the most,” says Shipe Hajdari, director of staff development at Greenwich Woods.
But why should the arts matter so much at the end when dwindling attendance and financial support tell us that they count for increasingly less during most of life? The answer lies in the way the brain works. When cognitive skills fall away ”“ which they inevitably do in dementia ”“ what remains is the ability to respond in some way to sensation ”“ be it the rhythm of music and poetry or evocative imagery.
“Music is deeper than language. It”™s deep within us,” says Muir, who has worked closely for 20 years with Dr. John Diamond, a pioneer in the fields of music for wellness and holistic medicine. “It”™s a wonderful way of communicating.”
So are the visual arts, says social worker Alice Feintuch, care consultant for the Alzheimer”™s Association ”“ Hudson Valley/Rockland/Westchester, NY Chapter:
“People who have trouble expressing themselves, when they look at a painting, they”™re able to say what it reminds them of. ”¦ Both art and music stimulate people”™s memories in different ways. They make a connection that people with dementia can”™t always make, and that”™s a beautiful thing to me.”
Greenwich Woods”™ Hajdari remembers a patient encountering a portrait of Queen Elizabeth II as part of Neu Experiences in Art, the Neuberger Museum of Art”™s program of free, monthly guided tours for dementia patients and their caregivers. The woman had spent her early life in England. When she saw the portrait, she began weeping in recognition.
So crucial is art in memory that Greenwich Woods encourages the patients in its Redwood unit to become curators of their own lives and select the meaningful photographs that grace the halls and gently cue them to the current season.
“They spark memories and can start conversations,” says Cheryl Doeberl, director of recreation at Greenwich Woods.
She describes the music-therapy group there as “a fun-loving crowd” that enjoys karaoke and playing “Name That Tune.”
“The process of music is rooted deeply in the emotions,” says Concetta Tomaino, executive director of Schnurmacher”™s Institute for Music and Neurologic Function. “Long-term memory is stimulated when you hear a piece of music in your past. Every aspect of the moment is preserved in the music.”
At Schnurmacher, Sobol says he uses the repetition that is characteristic of music to work on short-term memory as well, creating a sing-along out of a relatively easy, familiar song like “Home on the Range” or “By the Light of the Silvery Moon,” and then asking the group alone to supply part of the lyric on the repeat.
Using a keyboard, ukulele and percussion, Sobol also encourages even the wheelchair-bound patients to move as rhythmically as possible. To that end, he has produced a CD called “Keep On Moving: Music for Therapeutic Rhythmic Activities,” which spices the American songbook with a Caribbean beat.
“Rhythm gives structure to time,” Sobol says. And structured time is important in dementia care. Music therapy takes place before lunch ”“ a structured activity ”“ or between 3 and 5 p.m., when “sundowning” occurs, often leading to increased disorientation and agitation on the part of the patients.
Sobol places his music “students” in a circle: “Just by putting people in a circle, you”™re allowing them visually to see each other and acknowledge the reality of each person in the group.”
The arts, then, are a way into socialization. And not just for the patients.
The holistic approach to dementia ”“ to which the arts are so integral ”“ is getting families and friends into the act, says Greenwich Woods”™ Doeberl.
Adds colleague Hajdari: “Caring for an individual with Alzheimer”™s is that ”˜It Takes A Village”™ phenomenon. Everyone has to be involved.”
With the likes of Mozart and Van Gogh in support, patients, therapists and caregivers are recognizing that they”™re not alone.
