The Quality Monitoring Program began a journey with Music &Memory in 2015 with the intent of offering nursing home providers a non-pharmacological alternative to caring for people with Alzheimer's disease or other forms of dementia and with funding provided from Civil Money Penalties certified, 432 nursing facilities. The primary goal of the M&M program is to reduce the use of antipsychotic medications in this population.
M&M staff train care professionals on how to set up personalized music playlists, delivered on iPods and other digital devices, for those in their care. The musical favorites tap deep memories not lost to dementia and can bring participants back to life, enabling them to feel like themselves again, to converse, socialize and stay present. Dr. Bill Thomas, creator of the The Green House Project, states in the documentary film, Alive Inside, which chronicles the birth of the Music & Memory program, "We've never really been able to touch the heart and soul of the patient", and that is a secondary goal of the program.
State agencies in Texas and around the country have seen challenges in implementing a study of the M&M program, because of the variables out of the researcher's control. However, the anecdotal evidence seen since 2015 is hard to ignore. The results we see are nothing less than miraculous.
"Music imprints itself on the brain deeper than any other human experience. Music evokes emotion and emotion can bring with it memory." - Oliver Sacks
M&M provides a way to change the culture of care for people with AD, with person-centeredness at the program's core. The process of obtaining a playlist filled with a resident's individual music preferences offers staff a way to build a new relationship with the people they serve. Empathy forms when staff have a way to find the music that makes the resident happy. No longer is the focus on the institutional flow, but on the search for songs that stimulate memory and human connection.
Touching the Hearts of Our Patients
Measuring reduction in the use of antipsychotic medications is the easy part; but how do you measure joy? How to do you measure a son or daughter's experience when a parent recognizes their child again? The answer is in the reports below submitted from participating facility staff, residents and family members, and documentation entered on music logs over the past two and a half years.
As you will see, Music & Memory has made it possible for us "to touch the heart and soul of the patient."
Ms. B's husband and son have been so impressed with how Ms. B has responded to the music on her iPod that they bought her one for home visits. Mr. B doesn't know how much she "gets" from watching television because she just stares at it, but when she has on her iPod there is a noticeable change in her countenance that comes through her eyes. Ms. B. bops her head back and forth and her mouth turns upwards into a smile. If you see her in the hallways, in therapy or any time, she has a flat affect, so the joy the music has brought her and her family is amazing. Thank you so much!
One resident who used to be the lead singer in his church choir is now bedfast and non-verbal. Recently he and his wife had their 50th wedding anniversary and his family played some of his favorite church songs for him. He sang along and his wife was thrilled to hear his beautiful voice again! The family was amazed at his response to the program.
A young man in the facility who did not speak except to say the word "no" or mumble for the last two and half years is now singing the Eagles song "Take it to the Limit" word for word. The representative at Gardner Villa says that he was the one who convinced her of the benefit of this project. She reported the program is helping with residents wanting to leave, pacing and yelling. They plan to expand the program to individuals who are bedridden next.
Ussery Roan Texas State Veterans Home
Our program is going very well. We have seen it help with behaviors such as decreased wandering, decreased agitation, increase communication, increase fine/gross movements (dancing), entrainment to the music, increase in interpersonal relationship with team members, mask noise during procedures (podiatrist), increased reality orientation and provide reminiscence opportunities.
The Plaza at Richardson
One resident was wheeling down the hall, agitated and repeatedly calling out for her son. She began yelling and cursing about Linda, a CNA who had just given her a shower. Our Wellness Specialist asked if she would like listen to Frank Sinatra and the resident agreed. They came into the Wellness Room and she put on the iPod with her favorite music, then took out a picture book and talked though several photos. The resident became calm and chatty, no longer asking for her son. After five minutes, the resident finally could state she was unhappy that her hair was still damp from her shower and she was uncomfortable. Our Wellness Specialist told her she was going to go with her to dry it and the resident said, "Thank you. I love you!" Wonderful!
SC Regency House
I wanted to share my first success story with you. Mr. F. does not speak clearly mumbles most of his words, and he is at high risk for falls as he shuffles his feet when he walks. The M&M program has been helping him to talk a little more and be more alert. Today the two CNAs on his hall came running in my office to let me know that he was sitting in his recliner listening to his iPod, reminiscing to himself, the girls were getting him ready for supper and he started talking to them about country music as clear as they have ever heard him speak. One of the girls asked him if he two-stepped and he said," that's the only dancing I know how to do!" When he stood up, he started two stepping with all the girls and he was a very smooth dancer (no feet shuffling) while the other aide stood behind him just in case. Mr. F. was full of smiles and laughter and the aides were so excited that they got to witness this and I wanted to share it with all of you. Thank you for the program!
Ms. M. is not a "problem" resident, though at times she has some tearfulness. In general, she is usually very quiet and/or sleeping. Last week when I saw her this way in the living area, I took some time to try and wake her and engage her. She was not very interested at that time. I then went and got her iPod that we had set up for her with personalized music. The difference in her demeanor and attitude was almost instant.
Royce City Health and Rehabilitation
I wanted to share my first I-pod set up and start up with Ms. S. On her way to dialysis was our first day for us both trying it. She was very happy when she started hearing the music. I am so happy and can't wait to do more. I wanted to share how happy this made her.
Additional anecdotal Reports
- Residents and staff report M&M reduces pain for residents. Residents have requested the music "to help with my pain."
- Our residents have improved gait, reduction in falls and potentially reduced hospitalizations.
- Residents are less resistant to care when listening to favorite music.
- Assists people receiving hospice care transition in a more peaceful state of mind. Many facilities have reported residents passing while listening to their favorite songs.
- Psychiatrists and other facility staff have commented on the positive results of reducing behaviors in people with psychiatric conditions with the program.