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Alzheimer's patients find music a light in the darkness

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Listening to Hank
Harland Semke, 91, is overjoyed by the music of Hank Williams Jr. as it plays on his iPod at the Hillview Health Care Center, in La Crosse, Wis., Monday, April 7, 2014.
Alex Kolyer / For MPR News

Harland Semke is often anxious, agitated and withdrawn. At 91, his mind and memories are disappearing, casualties of the various forms of dementia he has lived with for the past decade.

But when Brooke Smith approaches the retired farmer and handyman with a set of headphones and a tiny iPod loaded with songs from his youth, he soon comes to life.

"Is that good music?" Smith asks.

"These people are ... nuts," Semke replies, and the two break out in laughter.

Semke, who lives at the Hillview Health Care Center in La Crosse, starts to tap his right foot. He smiles at his son Kevin, who is visiting. In seconds, he begins singing along to the tune he is listening to on the headphones: the Hank Williams classic "Cold, Cold Heart."

"You can tell it's doing something," said Kevin Semke. 

Searching for a long-lost memory can be a frustrating experience for Alzheimer's patients and their families. But research shows music can help reclaim some of those memories and offer temporary lucidity.

At assisted living facilities across the United States and Canada, music is helping patients with advanced Alzheimer's rekindle some of their memories.

"Some days he recognizes you, some days he doesn't," Kevin Semke said of his dad's advanced Alzheimer's disease. "Today we were sitting here and he asked me how my parents were. 'Oh, they're doing fine. Good as can be.' You go with it."

The elder Semke is one of 16 residents in the center's Music and Memory program. It reconnects Alzheimer's patients with the music that they love by personalizing iPod playlists for them. Semke's list includes the old-time polka tunes of the Jolly Swiss Boys, older country-western songs, hymns, and patriotic music.

Placing headphones
Brooke Smith, recreation therapy manager at Hillview Health Care Center, places headphones on Edna Zeuner so she can listen to music Monday, April 7, 2014. Workers at the Hillview Healthcare Center in La Crosse, Wis. are using iPods to help Alzheimer's patients rekindle long-lost memories through the use of music. The Hillview center is one more than 100 across Wisconsin participating in the Music and Memory program that bring personalized music into the lives of the elderly and sick.
Alex Kolyer / For MPR News

There are six elder care facilities using the Music and Memory program in Minnesota and more than 100 in Wisconsin, one in South Dakota and three in North Dakota, according to the program's website.

Smith, the center's recreation and therapy manager, said in the six weeks the program has been in operation, the personalized playlists have calmed patients, improved their mood, and in some cases, reduced the need for anti-anxiety and anti-psychotic medication. 

"They're able to communicate longer," she said. "They're able to stay awake. When staff talk with them, they're talking back to them. They're still smiling. They're mood is still an uplifted mood. So we are seeing that the effects are lasting."

Kevin Semke agreed.

"Anything that you don't have to take out of a [pill] bottle is a lot better for him," he said of his father. "It just seems it quiets him down and he's more peaceful."

For families like Semke's, the music sessions offer moments of magic. For researchers, they help show how the brain works. 

That's because memories are stored in networks of connections in the brain, not just in one part of the brain. 

Music is a complex experience involving everything from rhythm and melody, to lyrics and harmony, affecting many parts of the brain. 

"There's many elements to making the experience of music," said Connie Tomaino, executive director of the New York-based Institute for Music and Neurologic Function. "There's the rhythm of music, the time element of music. There's the melody, the pitch element of the music. There's the harmony, the feeling of whether this is a happy piece of music or a sad melancholy piece of music...All of these elements enrich the experience of that piece of music."

While listening to music won't repair a damaged brain or bring back total memories, it can provide stimulation to pieces of those feelings, said Ron Petersen, director of the Alzheimer's Disease Research Center at Mayo Clinic.

"What music may do is allow you to access those networks and reactivate those networks via a different pathway than say going through that temporal lobe part of the brain to remember my grocery list," he said. "Rather, the memory from music might be evoked from other signals and you can access it."

Dancing
Phyllis Eklund, 86, dances with Brooke Smith, the Recreation Therapy Manager of the Hillview Health Care Center, in La Crosse, Wis., Monday, April 7, 2014.
Alex Kolyer / For MPR News

Petersen said older memories tend to be more resilient than newer ones. That's another reason music tends to be effective at recalling memories.

"In general, when Alzheimer's disease develops in a person, the memories to go first are more recently experienced events," he said. "So going back 30, 40, even 50 years, some of those memories, if you can access them, if you can get into them, might very well be preserved."

At Hillview Health Care Center, 86-year-old Phyllis Eklund was slumped in her wheelchair, almost asleep when Brooke approached her with an iPod.

"Phyllis, I have your music for you. Can you hear that music? Shall we dance to it?"

When listening to Benny Goodman's "Whispering" Eklund can't verbalize her thoughts or feelings. But it's clear she's thinking about something. She reaches for Smith's hands, and for three minutes, the two sway side to side, Eklund with a big smile on her face.