Tony Bennett, the master pop vocalist whose professional career spanned eight decades, died on July 21, 2023, at the age of 96 following a 2016 Alzheimer’s disease diagnosis.
Despite his diagnosis, Bennett’s desire to help others connect through music remained the center of his life and continued to have renewed importance in his journey with the disease. He performed for sold-out audiences, released a No. 1 album at age 85, and continued to record new hit songs through 2021.
In an exclusive interview with the Today Show, the late Bennett’s wife and son opened up about his life after his Alzheimer’s diagnosis, sharing that “the music never left him,” and he was able to remember the songs he performed throughout his legendary career.
What does this tell us about music and dementia?
Music can uniquely touch the lives of people living with dementia, and using it therapeutically can have a significant and positive impact on their day-to-day lives.
“The brain’s response to music is complex, and even in advanced stages of dementia, people may still retain the ability to respond to and connect with music,” says Alexis Baker, MT-BC, CDP, a music therapist at Bridgetown Music Therapy based in Oregon.
Music provides a whole list of benefits, especially for those living with any form of dementia: it encourages cognitive stimulation to various areas of the brain, promotes mood regulation such as decreasing agitation, provides a medium for verbal and non-verbal communication, and it enhances overall well-being by providing meaningful engagement and connection.
“By addressing various physical, cognitive, social, emotional, and spiritual dimensions of being, music therapy can support the overall quality of life,” says Baker.
While formal music therapy is defined as “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional,” many music-based activities can be therapeutically beneficial within dementia care.
You may be surprised to learn how music can help your loved one remain connected and engaged despite the progression of their dementia. Here are four things caregivers and family members should know about music as a therapeutic intervention for Alzheimer’s disease:
Music positively impacts the brain and triggers the release of chemicals
Music has powerful effects on the brain because it releases the chemicals that make us feel good. It triggers emotions, which may promote the creation of new neurons in the brain and help improve memory and mood in people with dementia.
When music enters the brain, it also triggers the “pleasure centers” in our brain that release dopamine, a neurotransmitter that makes us feel happy and may even help reduce age-related cognitive and motor function decline.
Harry Kappen, a musician, composer, and music therapist from the Netherlands, explains that music impacts the same area of the brain affected by dementia.
“Alzheimer’s and vascular dementia mainly affect the frontal lobe of the brain and the more central area where sensory information is received. Those are also the areas where music plays a major role, which is why music stimulation has a direct positive effect on those areas,” he says.
“Dopamine radiates over the entire cerebral cortex, and the recognition of music causes the release of oxytocin (the cuddle hormone) and endorphins that help with pain reduction and gives you that feeling of happiness,” says Kappen.
Music can help improve communication, connection, and memory as dementia progresses.
Music is a powerful tool in supporting communication and connection throughout the different stages of dementia. It can help people with dementia engage with their loved ones when it previously may have been a challenge.
Baker explains that, because of how music affects the brain, it can often lead to “moments of lucidity,” where the person with dementia experiences clarity, such as suddenly remembering who their loved one is.
“In my work as a music therapist serving those living with dementia, I’ve witnessed all kinds of responses to music,” Baker says. “My favorite is seeing the joy and laughter music can bring.”
Shelby Figueroa, a board-certified music therapist (MT-BC) with Harmonic Changes Therapy Services, facilitates weekly virtual group sessions three days a week as part of a collaboration with Music Mends Minds, a nonprofit that creates musical support groups for people with neurocognitive disorders.
She explains that someone with dementia can show a response to music therapy through verbal and non-verbal cues:
“Verbal cues could be singing along with the words, humming or vocalizations (utterances or sounds but not words), or verbally expressing what they notice about the music — they may say, ‘I remember this song,’ or, ‘I love this.’” she says.
“However, these are not the only expressions we notice during music therapy. Non-verbal cues signaling their engagement could be body movement and gestures, like tapping feet, swaying, or clapping, a change in facial expressions, eye contact, or even notable relaxation, like dropping shoulders or yawning.”
The way your loved one responds to music may change as their dementia progresses. Due to the degenerative nature of dementia, when a person is in the later stages, their body functions begin to shut down. They may be unable to participate in music interventions actively, but they most likely can still receptively engage in music therapy.
“In end-of-life care, it’s generally understood that the last sense to go is hearing, so music can be effective to calm and comfort, as well as provide an opportunity for connection with loved ones,” says Baker. She offers some additional ways music therapy is beneficial in the later stages of dementia:
- Non-verbal communication: “Even in the late stages of dementia, some musical memories may remain intact. Familiar songs from the individual’s past can trigger memories and associations, providing a sense of comfort and familiarity.”
- Memory and recognition: “As dementia progresses, verbal communication becomes increasingly challenging. Music, however, transcends language barriers and relies heavily on non-verbal communication, making it accessible and engaging for people with limited verbal abilities.”
- Emotional connection: “Music has a unique ability to evoke strong emotional responses and memories in individuals, even in the advanced stages of dementia. It can reach parts of the brain that remain relatively intact, facilitating emotional connections and reducing feelings of isolation and agitation commonly experienced by those with late-stage dementia.”
Working with a certified music therapist offers extra benefits.
Board-certified music therapists go through extensive training and can therefore offer a unique level of expertise. They have the ability to tailor music interventions depending on your loved one’s goals, strengths, or needs. They also evaluate the progress and implement current research into their work.
“Music therapy program coursework covers not only the field of music but also psychology and behavioral studies, as well as the theory and practice of therapy,” Baker points out.
Music therapists complete 1,200 clinical hours and then must pass a board certification exam. Recertification occurs every five years and requires 100 continuing music therapy education credits each cycle.
“Music therapy is a very passion-driven field, so a music therapist with board certification most likely got there because of a strong calling to the field,” Baker adds. “Additionally, professional music therapists can often offer ideas and tips to the caregiver or care partner. They are yet another professional on your team to consult with in the caregiving journey.”
Caregivers can — and should — promote music activities as part of a daily routine
Although music therapy can only be provided by a music therapist, there are still some great ways that caregivers can promote music activities appropriate for every stage of dementia:
- Sign your loved one up for a community or specialized dementia choir.
- Encourage rhythmic activities, like a percussion ensemble or drumming group.
- Attend concerts or watch videos of performances online.
- Play an instrument, such as a hand drum, harmonica, or shake-able instrument.
- Initiate sing-alongs or musical games like karaoke or “Name That Tune.”
- Listen to music together and reminiscence or have a lyric discussion.
- Make playlists with your loved one’s favorite songs and play them often.
- Use household items to create musical instruments and have a jam session
- Dance together — even limited movement like swaying to the music or facing each other and doing seated movements helps them connect.
Interested in exploring music therapy as an intervention for your loved one’s dementia?
Here are a few resources that can help get you started:
- The Certification Board for Music Therapists and the American Music Therapy Association have a “Find a Therapist” tab that allows you to find services near you.
- Your local caregiver support group or organization may have information about music therapy services available in the community — contact them and inquire.
- Connect with music therapists via social media and explore their websites for valuable music therapy information and resources.
- Check out Music Mends Minds’ free virtual sing-a-longs every Monday, Wednesday, and Friday at 11:30 a.m. PST, facilitated by board-certified music therapists like Figueroa.
“It’s important to note that while music therapy can offer numerous benefits, it is not a cure for dementia,” Baker concludes. “However, it can be a valuable complementary approach to conventional treatments, enriching the lives of those affected by the condition. Specific benefits experienced may vary from person to person, depending on individual preferences and responses to music.”
