My first year of internal medicine residency was spent rotating through every area of medicine, taking call every third or fourth night, learning at such a rapid pace it was hard to imagine my brain could hold more information. It was during this year that I rotated through the Emergency Department. As a hospice and palliative medicine physician, it’s pretty clear that my strengths are not ones that are especially effective in the Emergency Room setting. I was often taking more time than the ER staff would view as appropriate to see patients, assessing all their medications, their home social supports, their functional status. I was always trying to see the patients with cancer as their diagnosis, or geriatric patients, and studiously avoiding traumas.
It was during one of these shifts that I came upon an elderly couple, sitting on one of the overflow gurneys in the hallway. The patient, I’ll call him George, had Alzheimer’s dementia, and had come to the ER after having some gastrointestinal bleeding. They sat there on that bed together, holding hands, his wife looking anxiously at him. Due to his advanced dementia, George could not respond verbally to any questions I asked. He smiled pleasantly, but could not contribute any history, so I relied on his wife. She smiled when she told me “he doesn’t speak, but he sings…” and shortly thereafter she started to lead him in an upbeat version of "You Are My Sunshine." He chimed in immediately, joyfully and clearly singing all of the words. As she looked at him, I saw a love that had existed between them for more than 50 years, tinged with sadness as his wife was watching him slowly slip away.
The connection of music continued to bring them together and allowed her to see that he was still that 25-year-old man she fell in love with. I was struck by how musicality seems to be rooted somewhere deeper in our brains, connecting us to feelings and memories that we thought were lost.
There is building evidence that music may help decrease symptoms of agitation that patients with dementia may experience, decreasing a reliance on mood-altering or sedative medications. There are also studies suggesting that patients with Alzheimer’s may actually be able to learn new information when put in the form of a song. This could have implications for how caregivers can help their loved ones remember to take medications, help remind them how to get dressed or even help them remember phone numbers.
Music also brings us together, decreasing social isolation and reminding us of our shared humanity. I will never forget how George’s face lit up as he began singing with his wife, and the joy that was felt by both of them at a time of uncertainty and worry.
At Transitions LifeCare we are excited to be working toward becoming a Music and Memory Certified facility so we can help utilize the power of music to provide the best care for our patients with dementia.
--Dr. Laura Patel, Medical Director