PROJECTS
MUSIC & MEMORY
INTRODUCTION
Music & Memory works to improve quality of life for the elderly and infirm, using personalized music made available through new technologies. Projects and plans include:
- Giving individuals access to their favorite music using iPods
- Promoting nursing home use of personalized music
- A national iPod donation program to provide equipment for those unable to afford it
- Creating iPhone telehealth applications for those living at home with conditions like early to mid-stage Alzheimer’s or Parkinson’s Disease
We hope to enlist a cause-related marketing (CRM) partner in order to:
- Secure capacity-building funds to serve both institutionalized and home-bound clients
- Shape and implement a public awareness campaign on the benefits of personalized music
THE NEED
Hundreds of studies have documented music’s beneficial impacts on depression, anxiety, agitation, pain, and sleep. In his recent book, Musicophilia, Dr. Oliver Sacks speaks eloquently of ways that “music can animate people with Parkinson's disease who cannot otherwise move, give words to stroke residents who cannot otherwise speak, and calm and organize people whose memories are ravaged by Alzheimer's or amnesia.”
Too often, however, the elderly and infirm are disconnected from the music they care for most. Reclaiming that music is not easy for them. They may have lost the dexterity to operate a radio or CD player; or they may no longer be able to ask clearly for what they would like to hear.
Individualized music is profoundly beneficial to home-bound and institutionalized elderly and infirm people. Music & Memory strives to reach millions of people in need with the music that new technologies are making more available and affordable.
LARGER AND MORE MUSICAL LIVES AT HOME
In the US alone, seven million people receive home health care, and many millions more are partially incapacitated, dependent on family members or neighbors to get through each day. Most of these people need help in gaining access to the music that they once enjoyed. A system is needed whereby caretakers, most of them family members, can download particular pieces of music and program them on easily usable portable music players.
Music & Memory is assisting the Institute of Music and Neurologic Function (IMNF) in creating a web site with information about how to set up a loved one with his or her favorite music. Recommendations of music will be provided that are appropriate for those with Parkinson’s or Alzheimer’s. For a modest fee, this program will set up iPods for individuals and offer music therapist consulting.
Making the most of quickly developing technologies argues for devoting resources as soon as possible to the development of iPhone/Touch applications that are specific to Alzheimer’s and Parkinson’s. Longer-term plans include working with the Education & Assistance Corporation (EAC) on the integration of personalized music with other tele-health services being provided at home to complement the ‘aging in place’ movement.
PERSONALIZED MUSIC FOR THOSE IN NURSING HOMES
In the USA, 16,000 nursing homes accommodate 1.6 million elderly and infirm individuals. Nursing homes face extraordinary challenges in their efforts to address the social, psychological and emotional needs of their residents. No matter how resident-centered and forward-thinking they are, most residents are idle most of their time (as many as 90% of their waking hours). Individualized music is increasingly recognized as a cost-effective way to address this situation.
Music in nursing homes – typically age-appropriate but not person-appropriate – is usually available only during scheduled activities. Familiar and loved music is especially effective in offering both joy and solace. It can easily be made available at any time to residents in most nursing homes. Why should we delay any longer in providing it?
We have shown in a year-long demonstration project that individualized music generates a range of highly positive outcomes and that it can be made available cheaply and efficiently to nursing home residents. We stand ready to duplicate our success in nursing homes across America.
In the immediate future, the Educational and Assistance Corporation (EAC) plans to work with us to bring the iPod program to Long Island nursing homes, while the IMNF web site will offer inexpensive advice and technical support for facilities beginning their own iPod programs.
OTHER LIKELY INSTITUTIONAL VENUES FOR MUSIC AND MEMORY
The strong therapeutic potential of personalized music argues for expanding our programs to include rehabilitation and assisted living facilities, VA hospitals, and dialysis centers.
One dialysis patient’s comment is revealing: “My previous experience, I would doze off. When I woke up, my hand would be in pain... I’m always in pain. These two times I did my whole dialysis awake. I didn’t doze off at all… I held onto it till the last second when they had me at the door. I love it. I love it.”
In the near future, collaborative efforts also hold promise for our work. We plan on joining forces this year with like-minded advocates to convince the US Government’s Institute of Medicine (IOM) to include personalized music and other non-pharmacological treatment approaches. We also hope to lead a national iPod donation program effort, offering nursing homes those iPods once they are certified as ready.
APPENDIX: RESULTS FROM OUR 2008 DEMONSTRATION PROJECT
With funding from The Shelley & Donald Rubin Foundation, MM supplied 200 iPods to four New York metropolitan area nursing homes to learn: 1) the degree to which resident quality of life would improve; and 2) how to manage a facility-wide installation of this type.
Each facility chose which residents received the iPods. Those able to manage for themselves had ready access to their iPods and music. Nurses and therapeutic recreation staff members helped the others use their iPods and allowed them to choose times they most enjoyed for listening.
Success came readily from re-connecting people with “their own” music. We found that sometimes research with family members or trial-and-error was needed for individuals unable to articulate music preferences, but more often the results were immediate. Shortly after a playlist had been prepared for a resident and programmed for his iPod, a call came: “Come up here right away!” An end-stage Alzheimer’s patient who barely moved and had not said a word in months was waving his hands in the air to the music, saying, “beautiful, beautiful.” Everyone on the ward stopped in amazement.
Impact: Personalizing music is a game changer for all involved. Residents report feeling better and staff note positive changes in behavior. Listening to music in advance “warms up” residents, making those residents ordinarily reluctant more amenable to group participation. Music reduces agitation and increases cooperation and attention, enabling staff to accomplish more with groups.
Time per patient: It takes from 5-20 minutes to select the music to set up an iPod, and subsequent changes can take less than a minute. Activities staff report that it “only takes a minute” to set up patients with their headphones and music.
Costs: For an installation with 100 iPods, the cost per resident is $43/year, based on three years of use. This includes iPods with headphones and AC adapters @ $60 each; a laptop computer, $1,000; training and tech support $3,000; and music @ $3,000 per facility. (Music is shareable under iTunes rules by up to four related facilities and can be loaded on an unlimited number of iPods in those facilities.) iPods can be passed on from one resident to another (but with fresh headphones for hygiene).
In addition, each facility committed time for training staff on Apple’s iTunes program so that staff members could set up and update the playlists for their residents.
Consequences in human happiness: Sixty-one iPod users (31%) in these institutions had Alzheimer’s or other form of dementia; fifty (25%) were more than 80 years old. Ages ranged from 22-99. One patient commented, “Everything here is done to us or for us. The iPod program is done with us.” 96% of the patients said that the way they think and feel has improved; 100% of the 33 staff participating said that this music has brought about positive changes in the mood or behavior of the residents.
Sustained success: The four nursing homes in our study continue to provide this service to their residents. Each serves as a strong reference site.
