Treatment of Dementia Through Cultural Arts

Abstract

Editor's Note. This article was published originally in the Journal of Long Term Home Health Care, Volume 11, Number 3, 1992. We are running it again now upon refl ection on a passage in Musicophilia: Tales of Music and the Brain, by Oliver Sacks, Alfred A. Knopf, 2007. Sacks writes: the response to music is preserved, even when dementia is very advanced. . . . The aim of music therapy in people with dementia . . . seeks to address the emotions, cognitive powers, thoughts, and memories, the surviving self of the patient, to stimulate these and bring them to the fore. It aims to enrich and enlarge existence, to give freedom, stability, organization, and focus. (pp. 336-337) On any given day at the Sunshine Terrace Adult Day Center in Logan, Utah, you might hear a quartet beautifully harmonizing, a fi ddler playing toe-tappin' music, the recitation of a poem that evokes tears from the listeners, a fi ne Irish tenor singing Wild Irish Rose, a company of actors presenting a melodrama, a choir of bells, or the sound of rich violin tones playing a lovely ballad. The performances would be enjoyable to any audience, but the performers are even more impressive. Most have Alzheimer's disease and are well over 80 years of age. Many have been appreciated only for their life work in the distant past, but now tears are streaming, people are clapping, laughing, and enjoying accomplishments of today. This generation of elderly comes from a past of doing and giving. Yet now the ravages of disease and aging-and society's lack of expectations for them-have forced them to become spectators, watching the world go by. This inert life often results in a loss of self-esteem, depression, and a decrease in mental, physical, and social functioning. In the name of love, professional and family caregivers act for elderly persons when, instead, they might still be able to help themselves. BACKGROUND My conversion to the idea that the abilities of impaired elderly persons can be grossly underestimated came when I visited my mother after the doctor had diagnosed probable Alzheimer's and predicted she would die within six months. Dad explained that she spent all day on the couch sleeping, rose only with assistance, and spoke little. I sat beside her and fi nally got her to open her eyes and focus on me briefl y, and to say yes or no to a couple of questions. This once-strong mother looked hopelessly frail, and I felt helpless. I thought of the many things I had learned from her, especially the songs we sang together. I began to sing one of our old favorites. To my amazement, Mother turned toward me, opened her eyes wide, and with raised eyebrows began to sing the old familiar harmony. We sang two more songs, and she sat up. Soon she was talking, laughing, making sense, and sharing real feelings. Music was the spark that could produce fire out of the ashes of her life. THE ENVIRONMENT A year later, while serving as a social worker in the nursing home operated by the Sunshine Terrace Foundation, I was given a chance to develop a program designed to offer others the same opportunities that had promoted an increase in functional capacity and a sense of belonging and joy for my mother. I was asked to design and implement an adult day care program, to be located in a new addition on the lower level of the nursing home. The board of directors supported the idea and advanced the necessary funds to decorate and purchase needed supplies. A priority was to develop an environment that felt and looked like home. The setting was important in encouraging feelings of self-worth that could help clients rise above the limitations of disease, to uncover or discover talents and skills buried beneath pain, depression, memory loss, and discouragement. Every effort was made to develop a comfort zone by tapping into long-term memories of fl owered wallpaper, pretty chairs and sofas, birds in cages, and a huge fi sh tank. …