Music Therapy and Dementia Care:
Older Adults Living with Memory Disorders
DEMENTIA - A TYPE OF MEMORY DISORDER
Memory Disorders typically affecting older adults are diseases that cause progressive damage tothe brain resulting in dementia. According to the Centers for Disease Control, 5 million adults in theUnited States are living with dementia, including Alzheimer’s disease. Of the 5 million adults living withdementia, 80% of those live alone or with others in their communities, while 20% reside in care facilities.
Residents in living communities are often placed due to limitations of living at home or with loved ones,
as individual needs outweigh the abilities of the caregivers. Behaviors and symptoms that impact dailyliving can include agitation, wandering, repetitive questioning, depression and sleep problems.
FACTS ABOUT MUSIC THERAPY AND MEMORY DISORDERS
Clinical music therapy is the use of music within a therapeutic
relationship between a client(s) and a board-certified music therapist.
According to the 2018 AMTA Member Survey and Workforce Analysis,
the work settings with the highest number of music therapists arein geriatric facilities, which include adult day care, assisted living,nursing home, geriatric non-nursing, and geriatric psychiatric units(AMTA, 2018, p. 15). Memory disorders with which board-certified
music therapists (MT-BCs) work include, but are not limited to:
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Alzheimer’s disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia
Dementia caused by injury
Mild cognitive impairment

Music Therapy in Older Adults Living with Dementia is…

Purposes of Music
Therapy
Provide structure andmeaningful engagement
Enhance daily living in an
individual or group setting
Promote communicationand self-expression throughsinging, and active music
making
Improve mood and increaseenergyEncourage physicalmovement through active
music making♦ A holistic approach that relies on individual strengths andneeds, positively impacts mood, behavior, cognition andmobility.
Decrease stress and♦ A multi-modal means of expression, both verbal and nonagitation through predictable,pleasurable experiences
verbal.
♦ Sensory stimulation, personally engaging, validating andcomforting.
♦ A source of meaningful experiences between the caregiverand their loved one.

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Music Therapy and Dementia Care:
Older Adults Living with Memory Disorders

MUSIC THERAPY CLINICAL PROCESS
Prior to providing services, MT-BCs complete an Assessment to determine client(s) needs that can beaddressed through music therapy, as well as strengths that can be activated during the process. Theymay use a variety of assessment tools and ask questions of the older adult and/or caregivers, whenappropriate.
Music therapists may work as a member of a multidisciplinary team or on their own. Based on theinformation gathered from the client(s), clinical staff, family members and caregivers, music therapists
engage in Treatment Planning to design a plan of care to support both long term goals and short-term
objectives. Goals addressing anxiety, interaction, transitions, relaxation, physical activity and otherneeds would be included here.
Implementation of music therapy could include engaging in music making such as singing, songwriting
and improvisation to promote self-expression, or the use of moving to music to facilitate the transitionfrom the client room to the dining room for a meal. Clinical music therapy provides in-person support forclient(s) by matching the live music to the needs of the client.
Important in the process of music therapy is continual Evaluation of the music therapy treatment and its
effect on the client(s). Written documentation as well as appropriate verbal updates to staff/caregivers(per HIPAA guidelines) can provide information on the successful use of music to facilitate desiredchange. Board certified music therapists provide ongoing evaluation of the therapeutic process in order
to best serve the client. Continuation or termination of services are based on a number of factors
including client preference and funding (including third-party sources).
RESEARCH AREAS
How does it work?
Most people have a positive relationship with music, and long term memories of experiences in faithbased and educational settings will still be accessible to the person with memory loss. Because musicalperception is processed throughout the entire brain, music activates all areas of brain tissue during
both receptive and expressive musical behavior. Musical memory, therefore, is stored throughout thebrain which means that it is accessible even in the late stages of memory disorders when only somebrain tissue is still capable of functioning normally. Additionally, music stimulates the use of synaptic
connections between neurons in the many specialized areas of the brain, which may otherwise remain
dormant and lose function due to the characteristic inactivity of dementia and other memory disorders.
Music therapy cannot reverse the loss of cognitive function, but it can maximize the existing function.
Does it work?
While pharmacological remedies for behaviors and psychological symptoms of dementia (BPSD) causeside effects (e.g., nausea, agitation, sleep difficulties), studies have shown that nonpharmacologic
treatments pose fewer side effects and music therapy has been effective in reducing BPSD (2015).
Research on music therapy in the treatment of memory disorders has shown the following benefits:
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Decreased depression & improved mood
Decreased anxiety & agitation
Decreased medication
Increased alertness & orientation
Enhanced cognition & memory recall
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Music Therapy and Dementia Care:
Older Adults Living with Memory Disorders♦ Improved communication & meaningful socialization♦ Improved sleep & appetite♦ Reduced caregiver stress
Considerations and Possible Contraindications of Music Therapy in this Setting
Rather than contraindications, there are considerations that need to be taken into account regarding
the use of music therapy in this setting. When working with individuals with memory loss, use musicthat is preferred and is not associated with any traumatic event; ensure clients are able to adequately
communicate their needs and preferences through music therapy evaluation, provide careful monitoringof non-verbal responses to music interventions, and ensure a manageable volume, while decreasing
any unnecessary noise or visual stimulation. An assessment by a board-certified music therapist canhelp uncover hidden strengths and needs.
References
Alzheimer’s Association https://www.alz.org/alzheimers-dementia/facts-figures
American Music Therapy Association, Inc. (2018). Member survey and workforce analysis. Retrieved on October 10, 2019from https://www.musictherapy.org/assets/1/7/18WorkforceAnalysis.pdf
Belgrave, M., Darrow, A.A., Walworth, D., & Wlodarczyk, N. (2011). Music therapy and geriatric populations: A handbook
for practicing music therapists and healthcare professionals. Silver Spring, MD: American Music Therapy Association.
Clair, A. A., & Memmot, J. (2008). Therapeutic uses of music with older adults (2nd Ed). Silver Spring, MD: American Music
Therapy Association.
Fang, R., Ye, S., Huangfu, J., Calimag, D. (2017). Music therapy is a potential intervention for cognition of Alzheimer’s
disease: a mini review. Translational Neurodegeneration. 6:2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5267457/
Gomez, G. M., Gomez, G. J., (2017). Music therapy and Alzheimer's disease: Cognitive, psychological, and behaviouraleffects. Neurologia. 32(5):300-308. doi: 10.1016/j.nrl.2015.12.003. https://www.ncbi.nlm.nih.gov/pubmed/26896913
National Institute on Aging: What is Dementia? https://www.nia.nih.gov/health/what-dementia-symptoms-types-anddiagnosis
Oliveira, A. M., Radanovic, M., de Mello, P. C., Buchain, P.C., Vizzotto, A.D., Diego L. C., Florindo, S., Piersol, C.V.,
Forlenza, O.V. (2015). Nonpharmalogical interventions to reduce behavioral and psychological symptoms of dementia:
A systematic review. Biomed Research International. doi: 10.1155/2015/218980 Retrieved on November 7, 2019 fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676992/
Ridde, H., Stige, B., Qvale, L, Gold, C. (2013). Individual music therapy for agitation in dementia: an exploratory randomized
controlled trial. Aging and Mental Health. 17(6) 667-668. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685573/
Rio, R. (2009). Connecting through music with people with dementia: A guide for caregivers. Philadelphia, PA: Jessica
Kingsley.
Satoh M, Yuba T, Tabei K, Okubo Y, Kida H, Sakuma H, et al. (2015). Music therapy using singing training improves
psychomotor speed in patients with Alzheimer’s disease: a neuropsychological and fMRI study. Dement Geriatr CognDis Extra. 5:296–308. doi: 10.1159/000436960.

What is AMTA?
The American Music Therapy Association (AMTA) represents 10,000 music therapists, corporate members, andrelated associations worldwide. AMTA is committed to the advancement of education, training, professional
standards, and research in support of the music therapy profession. AMTA establishes criteria for the educationand clinical training of music therapists. Professional members of AMTA adhere to a Code of Ethics and Standardsof Practice in the delivery of music therapy services. AMTA's mission is to advance public knowledge of music
therapy benefits and increase access to quality music therapy services. Learn more at www.musictherapy.org.
© 2021 American Music Therapy Association, Inc. Compiled by: Geiger, J.; et al.
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