Music is a Powerful Tool for Memory!

Has a song ever come on the radio and you’re instantly transported back to a time from your youth?  It’s more than just a memory—it’s so vivid you can practically smell it and taste it and feel it.  In fact, the detail may be sharper than something much more recent.

 

Record player

Why is that?

Music can help to encode memories. The very structure of music—with melody and phrasing—makes it easier to recall later.  When young children are trying to learn the alphabet, we often use a sing-song tune to make it easier to remember and sing along, “now I know my A, B, C,’s…”.  The tune of the music serves as a cue for memory. When your brain struggles to retrieve the information from the hippocampus directly, the cue of the melody and rhythm associated with the information provides an alternate route to access the same information.

 

If you try and memorize a list of words, you’d be using your explicit memory.  Explicit memory is intentional—you concentrate on recalling the past. It’s the type of memory that allows you to answer factual questions like: who, what, where, when and why. 

 

Implicit memory, on the other hand, is less intentional. It happens almost unconsciously as you absorb information through a combination of all of your senses, and thus uses numerous parts of the brain.  Implicit memory is often very powerful and connected to a strong emotional reaction.  Music connects to implicit memory and can often draw out strong emotions.

 

When that song comes on the radio and instantly transports you back to your youth, it is implicit memory that is connecting the music and emotion.  In fact, the emotion you feel may not even match the emotion in the song; a sad song may evoke memories of a happy time, or a happy song could be associated with a sad memory.  You may also notice that the music which triggers the strongest memories typically comes from your youth—your teenage years and your twenties. 

 

This time in life is characterized by gaining independence and having many new experiences, all set to the soundtrack of the era. Often, it will be the pop music of the era, the top 20 or top 50 hits that are being played everywhere you go which further cement the memories and the music as being very specific to that timeframe.

 

Because music connects to implicit memories and strong emotions of the past, it can be a successful tool to help people access memory when their explicit memory system is not retrieving memories as efficiently.  If someone’s explicit memory has been damaged by dementia or Alzheimer’s, or if they’ve suffered a traumatic brain injury such as a stroke, music can create a bridge to implicit memories.

 

a microphone for singing

Music can also affect speech.

While it would seem like singing and speaking are pretty similar functions, our brains perceive them as totally different activities.  Speaking is a left-brain activity whereas singing is a right brain activity.  When someone suffers a stroke to the left side of their brain, speech is typically affected.  They may have expressive aphasia where they know exactly what they want to say, but the words won’t come out.  Fascinatingly though, people with aphasia are often able to sing!  If the left-brain stroke did not affect the right side of the brain, then the ability to sing may remain intact. Once set to a melody, it becomes possible to utter words.

 

Initially, someone may be able to sing the words to a familiar song. Over time, they can train their brain to sing alternate words to the same familiar tune.

 

Beyond the possibilities of speech, music can serve as a form of communication. It is a way to connect with someone who otherwise can’t speak or otherwise communicate. It offers the opportunity to share a moment together where you can be completely present, enjoying the music. By selecting music that matches their youthful era, you can help your elderly loved ones to revisit strong, emotional implicit memories from their youth.  You may be surprised and delighted at the strong emotional reactions that music can create.

 

So break out the old records and cassettes, or create a custom playlist, and crank up the volume!

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Falling is a serious concern for the elderly.  Falling can cause a fracture which leads to a whole series of problematic health outcomes. 

 

What about someone who has dementia? At quick glance, it would seem that dementia and falls are not related.  Yet, the data indicates that those with dementia are at a higher risk of falling.  In fact, according to the Canadian Institute for Health Information, 15% of all Emergency Visits by seniors with dementia are fall-related (compared to only 9% of other seniors).

 

older lady in wheelchair

Why is that?

There are a number of risk factors that are exacerbated for those who have dementia. Here are a few:

 

Medications: some of the medications associated with dementia can have side effects which cause drowsiness, dizziness, or instability.  Antipsychotic medications sometimes have a side effect of orthostatic hypotension, which is a sudden drop in blood pressure when you stand up.

 

Visual Perception Changes: dementia can affect someone’s ability to process what they are seeing. Depth perception, in particular, is affected and impacts fall risk.

 

Spatial Judgement: dementia can impact someone’s spatial awareness and ability to judge distances making it difficult to navigate around hazards or prevent bumping into obstacles

 

Fatigue: many people with dementia are keen to walk incessantly, but sometimes they fail to notice when they are tired and they don’t rest when needed. 

 

Mobility Aids: when a walker is introduced for safety, someone with dementia may have trouble remembering how to use the walker, or remembering to use it at all.


Washroom Needs: the sudden urge to use the washroom may cause someone to rush for the bathroom, especially if help is not on the way quickly enough.

 

Boredom: when feeling bored, lonely, confused, uncertain, or in pain, some people with dementia tend to get up and start pacing, but it may not be safe to do so.

How can you help to prevent a fall?

There are many items to consider for fall prevention, especially among those who have dementia. Here are a few modifications or suggestions you can implement to increase safety for your loved one.

 

ENVIRONMENT

Someone with dementia may not be able to scan the environment and take note of risks or hazards. They may not be able to process something as risky, and they may not be thinking about safety and fall prevention. 

 

Aim to make the environment safer on your loved one’s behalf by:

  • Decluttering
  • Removing floor mats and other tripping hazards
  • Keep frequently used items within arm’s reach

 

VISIBILITY

Since your loved one with dementia may be experiencing perception changes, try to see their environment through their eyes. 

 

Some recommended adjustments:

  • Increase the lighting—people with dementia require brighter lighting to easily see their surroundings
  • Use contrast colours to make items more visible (i.e: a beige door on a beige wall may be hard to see; paint the door a contrast colour for easier way-finding)
  • Clearly mark the edges of steps

SOCIAL NEEDS

Boredom is the cause of many so-called behaviours in dementia, pacing included.  All humans have a desire to be productive and to be doing something meaningful.  Someone with dementia may be confused about what that activity should be, and in the absence of something obvious to do, they may create an activity that can be a fall risk.

 

To prevent this concern:

  • Keep your loved ones busy with an activity that is meaningful to them. If they are content and engaged in an activity, they’ll be less likely to wander away and be at risk of falling
  • Maintain social connections

PHYSICAL ACTIVITY

Someone with dementia may attempt to walk faster than their current physical ability permits, which can increase their risk of falling.  Failing to use mobility aids can add to that risk as well.

 

To help mitigate these risks:

  • Continue strength-based exercises to maintain strength and mobility for as long as possible
  • Constantly remind and demonstrate how to use mobility aids correctly until it becomes a new habit
  • Provide ample opportunities to be up and walking with support when someone is present to assist, reducing the impulse to pace later.

The risk of falling increases as someone ages, but that risk accelerates when dementia is added to the mix. By identifying some of the additional risk factors faced by someone with dementia, a family can aim to mitigate those risks and put preventative safety practices in place. Protect your loved ones by following fall prevention safety guidelines!

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