Human beings are governed by rhythms. They influence our heartbeat, the cadence of our speech, and even when we fall asleep and wake up. Perhaps this is why we are so mesmerized by music.
“From lullabies to funeral songs, music is a part of our lives from the moment we enter the world until the moment we leave it,” says Diane Snyder Cowan, director of The Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.
In her work, she uses a phenomenon called “entrainment,” whereby a person’s biological rhythms become synchronized with the music they are listening to. Entrainment exerts such a powerful force that simply listening to and focusing on soothing music can help a person enter a more relaxed state of physical and mental functioning. Once a person enters this state, they are better able to process things both physically and mentally, from medications to emotions.
As a certified hospice and palliative care administrator and a board certified music therapist, Snyder Cowan is part of a specially trained group of care providers that uses melodies to help patients achieve treatment goals. “This type of therapy is all about the intentional use of music to bring about a particular change, whether that change is therapeutic, emotional or spiritual,” she explains.
The Benefits of Music Therapy for Older Adults
Music therapists work in a variety of different settings, from hospitals to halfway houses. In the elder care context, they can be found in residential long-term care communities, senior rehabilitation centers, and hospice and palliative care settings. Music can be used to help aging adults manage everything from chronic pain to symptoms of Alzheimer’s disease.
“I’ve seen the power of music so many times in older adults,” Snyder Cowan recalls. “It’s such a powerful tool and can be accessed so easily.” One well-known application of music therapy is helping people with advanced dementia communicate and engage with their surroundings.
Music is particularly beneficial for people struggling with cognitive decline because it is easier for them to access the memory of a cherished melody than to recall a person’s name or a past event. “The memory of the song stays with them much longer than regular memories,” notes Snyder Cowan.
In some cases, music may be even more powerful than traditional medical interventions, such as prescription medications and physical therapy exercises.
A study conducted by researchers at the University of Helsinki found that a group of Finnish stroke survivors who listened to music daily while recovering enjoyed improvements in auditory and verbal memory, focused attention, and mood. When compared to stroke patients who listened to audiobooks or nothing at all, those that listened to music for a few hours a day regained their verbal skills much faster. The music listeners were also less likely to be depressed and confused—two common post-stroke side effects.
German researchers discovered that patients recovering from open-heart surgery had lower levels of the stress hormone cortisol in their blood after only 30 minutes of listening to classical music while on bedrest when compared to patients who did not listen to music. They also found that relaxing music was more calming for patients pre-surgery than midazolam, a sedative commonly administered before medical procedures to cause sleepiness and relieve anxiety.
Music Therapy at the End of Life
Music therapists also work with hospice care providers to assist terminally ill patients and their family members as they navigate the end-of-life and grieving processes.
Depending on the unique needs and wishes of the elder and their family, a music therapist can help create a compilation CD of songs that have special meaning to the dying person to give as a legacy gift after they have passed. Therapists can also compose a song about the person’s life and select and play melodies meant to ease their physical and emotional pain throughout the dying process.
A type of music therapy that is used specifically in palliative care is called music-thanatology. Specialists in this field closely observe their patients’ vital signs and tailor their music to the situation to ease symptoms like pain, labored breathing and sleeplessness. A music-thanatologist typically uses a harp and their voice to provide prescriptive music. One study of music-thanatology found that patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil.
Does Insurance Cover Music Therapy?
Professional music therapy services may be covered by government programs such as Medicare and Medicaid if certain requirements are met.
Music therapy is considered a form of “activity therapy” under Medicare guidelines and must be formally prescribed by a physician to meet a specific health care goal. A personalized treatment plan must be drawn up and improvement must be proven after a certain amount of time. If all these requirements are met, medically necessary music therapy falls under outpatient mental health care and is covered under Medicare Part B as long as the provider accepts assignment. Some Medicare Advantage Plans (Part C) may offer additional coverage for mental health services like music therapy.
Guidelines for Medicaid coverage vary by state and may or may not be covered for seniors.
According to the American Music Therapy Association, an estimated 20 percent of music therapists receive third party reimbursement for their services. Private insurance companies may cover music therapy if a patient seeks pre-approval and the services are deemed medically or behaviorally necessary for reaching their unique treatment goals.
Music Therapy Activities for Seniors
You don’t have to be a musician or music therapist to help your loved one enjoy the holistic benefits of music. While live music offers a richer and more personalized experience for listeners, recorded music can still be of value. Snyder Cowan offers the following suggestions for how caregivers and their loved ones can bond over song from the comfort of home.
Make Music Together
If you or your loved one had a passion for playing an instrument, don’t hesitate to dust off the old six-string and strum out a few chords. “Live music has its own set of special rewards,” says Snyder Cowan. You can also download inexpensive smart phone apps that simulate musical instruments, such as a piano, trombone, percussion pieces and a harmonica. These are great options for making music with a senior that keep noise levels reasonable and don’t involve unwieldy equipment.
Use Music to Travel Back in Time
Music and memory are very closely intertwined. Combine music therapy with reminiscence therapy by playing popular music from a senior’s past. This approach can help memories resurface for older adults with and without dementia. Try playing music that was popular when they were in their twenties and thirties and encourage them to sing along if they can. Recordings of the Lawrence Welk Show and big band music are very popular with older adults.
Play Music to Alter Moods
No one genre of music is more therapeutic than another. According to Snyder Cowan, it’s all about personal preference. Pick songs that you and your loved one enjoy listening to. Keeping the principal of entrainment in mind, try to align the songs with the mood you’re looking to promote. If a senior is feeling agitated or upset, aim for slower, more soothing music rather than quick, energetic selections. Many family caregivers swear by playing a senior’s favorite songs during difficult care tasks (like bathing and administering medications) to keep their spirits up and encourage them through the process.
Bring Musical Hobbies Into the Home
For example, your loved one may not be able to dress up and visit the opera like they used to, but that doesn’t mean they have to forgo their favorite arias. You can help bring the opera to them by purchasing or downloading some of their favorite performances and playing them. The same goes for any genre of music that accompanied hobbies they loved, like dancing or cruising around town in their favorite car.
Sources: Music listening after stroke: beneficial effects and potential neural mechanisms (https://www.ncbi.nlm.nih.gov/pubmed/22524369); The effects of music on the cardiovascular system and cardiovascular health (https://heart.bmj.com/content/96/23/1868.long); Music thanatology: Prescriptive harp music as palliative care for the dying patient (https://journals.sagepub.com/doi/abs/10.1177/104990910602300206); Mental health care (outpatient) (https://www.medicare.gov/coverage/mental-health-care-outpatient); American Music Therapy Association FAQs (https://www.musictherapy.org/faq/#51)