At the Institute of Applied Social Sciences at THWS, the IFAS, scientists are researching music therapeutic concepts in elderly care. Music therapy can for example be used to treat geriatric depression. Techniques can be provided to help people with dementia and their caring relatives in dealing with the illness in a better way.
Published on 27 March 2024
Music releases emotions. It wakes memories, makes us follow the beat with our fingers or tap our feet, or makes us dance. "Music activates a network in the brain," summarises Professor Dr. Thomas Wosch, Professor of Music Therapy at the Faculty of Applied Social Sciences at the Technical University of Applied Sciences Würzburg-Schweinfurt (THWS). Music can thus help people with dementia to deal better with their illness.
According to recent estimates, about 1.8 million people in Germany have dementia. By 2025, the number of dementia patients could increase to 2.8 million according to the German Alzheimer Association. Music therapy may not heal the causes of dementia, however, it can ease the symptoms of the illness and help master day-to-day situation with certain techniques. While from certain stages onwards, language can no longer be understood and consciously produced by the brain, music, whether made or experienced, targets areas in the brain that are still available, says Professor Dr. Wosch. Especially music that is emotionally moving, that might also involve movement, activated many areas in the brain and is processed and stored in a multi-sensory way that involve multiple perception channels.
Due to this reason, people with advanced dementia can still access these resources, explains Professor Dr. Wosch. "When the old accordion is brought from the attic, the patient struggling to finish sentences might be able to play beautiful folk songs without difficulty and while adding harmonic details." It was impressive to observe the skills music brought forward.
At the Faculty of Applied Social Sciences and the Campus for Professional Development at THWS, at which the professor teaches and conducts his research, the master’s programme "Music Therapy for Empowerment and Inclusion" is offered. The special focus here was placed on application in care for the elderly and handicapped, Wosch explains: "This is unique in the European region." For many projects, the researchers are cooperating with the University of Melbourne. The master’s programme at the Australian university was not specialised but their research in the field of dementia was nonetheless substantiated, the professor emphasises.
Integrating music therapy into the patient's day-to-day
One of these cooperative projects is MUSE-CARE – "Music Empowerment of Caregivers – skill sharing in dementia care". One special characteristic was that not only the patients themselves but also their social environment was included in the studies, Wosch explains: "We want caring relatives and professional caregivers to benefit from elements of music therapy in their day-to-day life." Within the MUSE-CARE project, techniques of music therapy were developed or adapted with a focus on suitability for daily use. One example is the so-called situational song that caregivers use to give instructions through singing. A day-to-day activity like getting up is set to music. If the patient is familiar with the melody, and if the melody supports the process of getting up by its rhythm and beat, brain areas can be activated that are not activated by verbal utterances alone. "Here we have this multi-sensory element again. You have to engage with the communication modus of the person with dementia in order to be understood," Wosch says.
Recalling therapy successes again and again by self-composed songs
Dementia, however, was not the only illness covered as a music-therapeutical field of application within the scope of the MUSE-CARE project One part of the project focused on music therapy for geriatric depression. Jasmin Eickholt, who completed her master's in Music Therapy at THWS, is currently a doctoral student at the University of Melbourne. Within the framework of her dissertation, she has developed an application concept of therapeutic songwriting for people suffering from geriatric depression. The scientist and freelance music therapist now applies the concept in her professional practice: "Therapeutic songwriting uses music to express and work out our most personal topics. The music helps to intensify these topics." By setting the topics to music, they can be kept and accessed again and again. These topics may include individual experiences or specific experiences from the previous therapy, for example from traditional conversational therapy. "We can play the self-composed songs again and again or sing them ourselves. That way, the clients are reminded of their progress in therapy or what they have already achieved in their lives," Eickholt says.
The special characteristic about Eickholt's application concept is that she has integrated findings of positive psychology. Positive psychology was not only happy thinking, says Eickholt: "Positive psychology also acknowledges hardship but tries to focus on the things that are positive about my current life, positive emotions, good relationships, gratitude, achievements, in order to increase my well-being again." She often made the initial suggestions for the song texts, the music therapist explains. For this, she summed up the first sessions she had experienced with her clients. Gradually, more and more suggestions came from the clients themselves. "I try to stick to their own words as closely as possible."
While Eickholt's doctoral studies focussed on geriatric depression, therapeutic songwriting was also useful for dementia: "The difference is that the therapist writes songs for the patients more often, so the patient is not the songwriter." One form of therapeutic songwriting is the situational song, which can help with daily activities. Especially in the first stages of dementia, songwriting could be a helpful tool, but also for geriatric depression, Eickholt adds.
This is also shown in the subsequent project that she is planning with her Australian colleague Zara Thompson: "We want to motivate people with dementia and their caring relatives to write songs together so that they can work out what positive experiences they share and work out the strengths of their relationship." The idea to include both groups stems from Thompson’s doctoral thesis. She based her research on a choir project, in which dementia patients and their caring relatives visited and sung in a choir. It is about relationship work and about experiencing and enjoying music together. Several studies show that patients would experience the joy of music with music therapeutic measures, Eickholt explains. Also Thompson and herself were able to prove this effect in their dissertations. This would be another advantage of therapeutic songwriting but also of music therapy in general, the scientist remarks. Patients could be more easily motivated to participate in a therapy session: "At the beginning, we focus on the positive by experiencing music together."
