Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's

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Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 2

Substantive Overview of Goals Set over Two Weeks

Music therapy is commonly used to accomplish individualized goals such as reducing

stress, self-expression, and improving mood (Kelly, 2018). Patients with dementia can benefit

from music therapy because it brings reminiscence, which helps them anchor themselves to

positive memories that can improve the quality of their lives. Nostalgic music therapy is

therefore an important tool for social workers to help older adults to find the meaning of their

lives by visiting their favorite memories through auditory therapy (Liu et al., 2021). The research

shows popular TV snippets and programming from the 1970s and 1960s that connected with

specific past experiences and emotions of the participants. The test population includes 10-12

participants, including both men and women. The objective of the two weeks was to trigger the

participants' memory using visualization imagery, old TV shows and audio recordings to evoke

feelings and anchor a positive moment or place among participants. This paper demonstrates

how the use of music, visualization imagery and anchoring positive memories can help patients

with dementia revisit their positive memories despite their functional limitations.

Overview of Week's Goals and Accomplishments

As discussed above, the main goal was to examine how to cope with depression and

anxiety by using guided imagery and integrating methods to deal with stress relief using

nostalgic therapy (Burns et al., 2018). The use of receptive imagery and visualization imagery

such as popular TV shows and programming from the 1960s and 1970s was one of the

approaches by which we engaged the participants (GoodTherapy, 2018). The use of mental

imagery helps individuals with Alzheimer’s to improve their recognition of visually presented

words. The participants were able to perform basic visual imagery although their semantic

memory faced limitations from their functional deficits (Klever, 2013).

Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 3

This process combines music therapy and reminiscence in a complementary and

structured manner to achieve positive outcomes for people with Dementia (Elder Care Alliance.,

2020). However, with the awareness that music could provoke bad memories, we prepared

relaxation techniques such as meditation, breathing exercises, and anchoring a pleasant time and

place for a person or situation. Breathing exercises help reduce the anxiety levels that could

potentially occur to people whose bad memories could be triggered by music (Kelly, 2018).

Anchoring a positive memory relates to associating a song with a positive memory to make it

possible to visit certain emotions on purpose (Kelly, 2018). Breathing exercises help people relax

by lowering theirs heart rates thus helping maintain focus. The participants were able to cling to

one memory that made them happy and connected them to their social life (GoodTherapy, 2018).

Through guided meditation and guided imagery, participants were able to navigate any traumatic

memories and maintain their attention in the therapy sessions. Meditation can increase cognitive

skills, overall mental health and avert stress and chronic pain thus making it a crucial practice

among older people (Woods et al., 2018).

Anticipated and Unanticipated Challenges in Implementing the Project

One of the challenges of implementing musical therapy is overstimulation and guiding

people with cognitive impairments (Burns et al., 2018). The acoustics in sound and music alter

the physiological states of people, such as heartbeat, movement, respiratory rate and blood flow

and it could cause negative or positive effects (GoodTherapy, 2018). For instance,

overstimulation can be harmful and cause discomfort and neurological stress (Woods et al.,

2018). Therefore, as much as music triggers memory, it has limitations that can compromise its

efficiency in achieving the therapeutic aims of the process. Subsequently, music therapy is
Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 4

limited to people without auditory impairments thus making it inefficient as an approach for all

dementia patients.

The second challenge in music therapy would be to redirect the attention of participants

to focus during sessions. The attention span of people with dementia can be unpredictable thus

making it difficult to determine how to communicate effectively and maintain controlled therapy

sessions (Burns et al., 2018). Therefore, music therapy requires professionals to understand the

participants and inform them regarding the protocol involved to avoid triggering harmful

memories that participants would rather avoid (Moore, 2014). To navigate the problems with the

participants’ attention spans, we implemented participative leadership to maximize engagement.

The third anticipated challenge in using musical therapy for people with Dementia is

anxiety, which may result from the participants remembering unpleasant memories that they

would rather forget. Not all music resonates similarly with everyone and that makes music

therapy unpredictable because some participants may encounter their fears when a particular

song is used. Using the wrong music can cause or increase anxiety for Alzheimer's patients

(Klever, 2013). Lyrics have a significant impact on the mental state of a person who a therapist is

treating. For instance, when a particular song's lyrics increase the overall sadness of a patient,

their negative mindset is a significant drawback, especially for patients suffering from depression

(Liu et al., 2021).

Strategies used to Overcome Barriers and Challenges.

The primary strategy to overcome the barriers and challenges of using music is to identify

whether music therapy is the right fit for a particular sample population (Incadence., 2022).

Music can grab your attention and distract a person from certain stimuli that can lead to negative
Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 5

behavioral reaction (Elder Care Alliance., 2020). The primary strategy employed to overcome

the challenges associated with music therapy is to personalize and modify the music used to suit

the needs of individual participants. Reminiscence therapy can produce inconsistent results that

differ between different people (Kelly, 2018). Another strategy we employed was to teach deep

breathing and guided relaxation exercises to help people deal with any possible traumatic

memories. We anticipated by every means possible all the potential barriers and challenges to

avoid causing more harm than good in our activities.

Utilization of Coaching or Mentoring

The plan for this capstone project was to teach participants meditation techniques used

audio guided imagery. To prepare sufficiently for these exercises, we also guided each other with

my classmate, professor and preceptor on the site to achieve a convenient plan. I worked with my

classmate to mentor each other, following our professor's insight on various potential activities to

integrate. Using music as our primary approach to trigger memory was convenient because we

had anticipated all the barriers and challenges that were likely to come up. Using Question and

Answer trivia games also led us to our third activity, storytelling. By allowing the audience to

share their stories about what a song reminded them, we implemented participative leadership

and used music to trigger memory and cause a therapeutic reminiscence.

Capstone Project Plan Progress

The project is progressing according to plan and timeline and the participants are equally

receptive. It is amazing that every participant has a favorite song that roots them to a certain

period that represents memories that they cherish.

Leadership Lessons Learnt

Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 6

I implemented participative leadership since the activities required good communication

skills, generosity to share power and an inclusive mindset. I did not implement any other form of

leadership because the participative leadership style was the only approach that was best suited

for this process. I learned that dementia patients need an anchor to their favorite memories to

provoke positive thoughts and cultivate good outcomes.

Outcomes Achieved

The process helped us understand the participants and know what triggered their

physiological states. The second outcome was that musical therapy helped improve the quality of

life among the patients by reducing their pain, depression, fatigue, and anxiety, which improved

their overall functionality. The third outcome was that every participant found an anchor to their

happiest memories to help maintain a positive attitude amid despite their health condition.

Concisely, music therapy for older adults with Dementia can help trigger memories,

especially when the exercise involves reminiscence. However, to avoid the adverse effects of

music therapy, our guided relaxation activities and deep breathing exercises insured our process

against any negative impacts such as overstimulation or the triggering of unwanted memories

that may have come up.

Nostalgic/Reminiscent Music Therapy for Older Adults with dementia/Alzheimer's 7

References

Alistair Burns et al. (2018). NHS England » music and dementia: A powerful

connector. https://www.england.nhs.uk/blog/music-and-dementia-a-powerful-connector/

Bob Woods et al. (2018). Reminiscence therapy for dementia. PubMed Central

(PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494367/

Elder Care Alliance. (2020, December 16). Benefits of reminiscence

therapy. https://eldercarealliance.org/blog/benefits-reminiscence-therapy/

GoodTherapy. (2018, April 26). Reminiscence therapy. GoodTherapy - Find the Right

Therapist. https://www.goodtherapy.org/learn-about-therapy/types/reminiscence-therapy

Incadence. (2022, April 27). Outcomes, benefits, and drawbacks of music therapy. Incadence -

Telehealth Music Therapy. https://www.incadence.org/post/outcomes-benefits-and-

drawbacks-of-music-therapy

Kimberly Sena Moore. (2014, August 15). 5 problems music can create. Psychology

Today. https://www.psychologytoday.com/us/blog/your-musical-self/201408/5-

problems-music-can-create

Klever, S. (2013). Reminiscence therapy: Finding meaning in memories : Nursing2022.

LWW. https://journals.lww.com/nursing/fulltext/2013/04000/reminiscence_therapy__fin

ding_meaning_in_memories.11.aspx

Lisa Kelly. (2018). Reminiscence-Focused Music Therapy to Promote Positive Mood and

Engagement and Shared Interaction for People Living With Dementia.

https://voices.no/index.php/voices/article/view/3139/3263
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Zhuo Liu, Fan Yang, Yifan Lou, Wei Zhou, & Feng Tong. (2021). The effectiveness of

reminiscence therapy on alleviating depressive symptoms in older adults: A systematic

review. Frontiers. https://www.frontiersin.org/articles/10.3389/fpsyg.2021.709853/full