Personalized Music and the Mind

The research is clear: music is powerful for people living with dementia

We encourage everyone to make a Keepsake Soundtrack that’s a personal playlist of songs that are the most loved and meaningful to you! Dementia Program Director Maribeth Gallagher and music therapist Amanda Marcum sat down for a conversation about why even people with healthy brains should start one.

Q: When we talk about the benefits of music and dementia, one key concept that comes up is personalized music. What does this mean exactly and why is it so powerful to think about the individual?

MG: I think the quickest answer is what we all know. One person's musical heaven is another person's musical hell! So, consequently, it's so important that it is customized to the individual.
AM: When we're looking at personalized music, we want to look at the music that has been meaningful to that person in key moments in their life. And we know the more emotional the moments, the stickier those thoughts are.
MB: Including the cultural environment that we grew up in. Music is associated with so many moments in our lives that, whether we are aware of it or not, it's got impact. I think for those of us who grew up in the church, spiritual songs are huge. When I hear the song “Ave Maria” I can almost feel it in my cells, because it's a song that's probably been playing since I was one month old in my household.

Q: What kind of reactions have you both seen with people using personalized music?

AM: I would say the primary reaction I see is a greater sense of presence. Somebody might have increased eye contact. Somebody might have access to singing words when verbalization isn't always at their access.
MB: Yeah, that’s a beautiful way of describing it. And as dementia progresses through the brain over time, we notice that people’s facial expressions start to become more blunted or even flat. We observe that their reaction times slow down, sometimes so slowly we don’t even notice any reaction at all. But when we start playing their personalized music, suddenly, we do see some sort of awakening or response. In a person whose eyes are closed, they'll spontaneously open. Or maybe we’ll notice their body starts to relax, tap to the beat and even reposition themselves in the direction of the music. AND, in addition to these nonverbal responses, we’ll see somebody who hasn't spoken suddenly singing lyrics. It’s really fun to witness, isn't it?
AM: Yeah, there’s something so powerful when caregivers realize mom can't say my name, but she knows every word to “How Great Thou Art.”

Q: What about music's effect on more mild or mid-level dementia?

AM: That need for self-expression is there from the day we're born to the day we die. And with mild dementia, especially, there may be this awareness of the disease progression, but sometimes limited verbal access. So sometimes music is a great avenue to prompt an emotional expression and release.
MB: If I'm aware that I am starting to have brain changes, I'm starting to become aware of the things that I CAN’T do, and that really brings me down. It frightens me. But if you put on a song that I know and love, by the time I get to the chorus, I am singing with song. The music shows me what I can do, and who I am.

Q: Can you tell us about the neuroscience, why does music work like this for dementia?

AM: Music activates all over the brain. All the different elements of music are going to be processed throughout. Therefore, when we have brain change, and when we have areas that aren't working the way that they use to, music finds a work around.
MB: Yes and again, music is tied into our deeply embedded memories and associations. So, most people with brain changes still have access to that, right? The soundtrack of their lives, so to speak. Everybody who's listened to music had a moment where they heard the first couple of notes and their eyes filled with tears, or they got full body chills. Music can launch a profound neurochemical cascade that caused these feelings to happen in milliseconds, quicker than IV push medication takes effect. That's how quick it is.

Q: So, each of us could make a playlist of our most meaningful songs as a way to care for “future me”?

MB: Yes! It’s a tool. I would invite everybody to play around with this concept. No matter how old you are and no matter how healthy you are. As you start to draft this Keepsake Soundtrack, you're going to be adding more and more songs to the list. It will change over time, but you will always have it.
AM: We prepare for so many things in our life. We make sure that we have proper insurance and so on. Why not take 20 minutes, and some joyful self-reflection to prepare and know what songs would be meaningful for yourself in the future and also right now!

Q: Will each of you share 3 songs that are in your Keepsake Soundtrack playlist to give us an idea of how to start?

MB: Van Morrison’s “Into the Mystic”—it was during my tender years with my friends who were like my family. “Ave Maria” brings such a level of stillness and connection with the sacred. And I think, the real mark of a singer is to be able to stand still, inhale, and on the exhalation, just deliver the song in a way that offers transcendence by stirring my heart and soul . So Roberta Flack’s “The First Time Ever I saw Your Face.”
AM: “Love Story” by Taylor Swift is definitely on mine. I remember first listening to this song on my little purple boom box in my tiny bedroom. “Closer” by the Chainsmokers. It's a pop song that came out in 2016 when I went into college. My third is “Wildflowers” by Tom Petty. I was working at a summer camp; I decided that that was like the anthem of my life. And the lyrics absolutely speak to me.

For Tips on creating your own Keepsake Soundtrack, click here.