Strong personal connections to songs are more important than the music itself when it comes to using music as therapy.
Research has found that personalised music playlists are likely to be more effective than genre-based collections designed to be calming, motivating or uplifting.
Which explains why Aileen, who has dementia, lights up when her husband Don plays her the country ballads she grew up listening to as a girl.
Being mindful of individual responses to songs allows playlists to be customised for people with cognitive impairment including dementia, mental health issues, and even to promote physical rehabilitation for people with Parkinson’s or following a stroke.
Cherry Hense is a music therapist and researcher at University of Melbourne and said understanding a person’s music preferences and life experiences was vital.
“What we are finding increasingly is that there is no one particular style of music that is good for one particular person or thing or outcome.
“One song may have a particular meaning for me in my life — based on my associations with that song and memories with that song — but it might have a very different meaning for you.”
So how do you go about creating a playlist for yourself or someone close to you?
Young people and mental health
From the early days of rock, parents have despaired over teenage choices in music.
And while listening to Elvis in the 1950s was not a gateway to immoral behaviour, teenagers can be prone to using music in a negative way.
“When people are emotionally vulnerable they may use music to isolate themselves from others and connect more with particular songs that offer them a sense of relatedness and understanding that their peers can’t,” Ms Hense said.
“Or use the same song to churn up those same feelings of angst over and over.”
Instead, a study by the University of Melbourne has found that teenagers should be encouraged to be conscious of the effect music has on their mental health.
“We couldn’t pinpoint that if you listen to particular styles of music you are more likely to be experiencing poor mental health,” Ms Hense said.
She said that once young people started to become conscious of the effect music had on them they could create playlists to improve mental health.
They should progressively help you achieve the emotional state you wish to achieve by starting with a track that reflects your current mood.
“If you’re feeling low and someone says ‘well, just listen to this happy song’, all it does is really highlight how bad you’re feeling and it can make you feel a lot worse,” Ms Hense said.
Singalongs and dementia
Singalongs are a fixture in many nursing homes.
But what if your favourite music when you were younger was country and instead they played old hymns?
That is where a personalised playlist can be much more effective.
An incredible reaction by a dementia resident when he heard his favourite jazz singer Cab Calloway sparked the formation of Music and Memory, a US-based non-profit organisation that creates personalised playlists for people with cognitive impairments and social isolation.
The program was adopted in Australia in 2016 and is now directed by Melanie Karajas.
She said it was being used in more than 100 hospitals and nursing homes for rehabilitation and dementia patients, and that the results showed the importance of personalised music choices.
“Everyone has their own favourite songs. In the car you will turn the radio station over if you don’t like a particular song,” Ms Karajas said.
“Walking into nursing homes and hearing the same CD put on a loop — we hear it from families with no impairments and they think ‘please, turn that music off’.
A pilot Music and Memory program at aged care facility Leigh Place in Sydney was having impressive results.
Its chief executive, Joe Azzi, said staff met with family members of dementia residents to create customised playlists that were played to residents three times a week.
“The responses from residents were really positive. The people who would normally sometimes be aggressive would become passive and relaxed. So the atmosphere changed,” Mr Azzi said.
“On several occasions you could have a normal conversations with residents who were otherwise very quiet.”
The facility plans to reintroduce the program later this year using digital music services to avoid problems with devices such as iPods which had in the past been broken, left uncharged or not updated.
Designing a playlist for someone with dementia required a knowledge of the music they enjoyed listening to when they were in their teenage years and early 20s.
“People’s memory is strongest when they were young, so the most meaningful music you can find for someone with dementia is the music that was relevant to them when they were young,” Ms Hense said.
“Having a knowledge of that person’s youth and what they were listening to and what was relevant and meaningful for them back then is the most powerful form of engaging with music that we can do.
She recommended listening to the playlist with them to monitor their reactions in case the music churns up uncomfortable memories.
“Better still, make a playlist with them to begin with. But where that’s not possible, listen with them and observe carefully and adapt as you think appropriate,” Ms Hense said.
Physical rehabilitation and Parkinsons
Playing the right music can help with physical rehabilitation, and singing has been shown to help with neurological conditions including Parkinson’s by maintaining speech.
“There wasn’t one particular style (of music) that would encourage physical activity. It was particularly around people’s connection with the lyrics,” she said.
Playlists for someone undergoing physical rehabilitation, such as following a stroke, should be created with consideration for their responses to the lyrics and with a beat that would encourage movement.
Ms Hense said our bodies wanted to connect with an external rhythm, which explained why pop songs are remixed at a faster tempo for gym workouts.
“When we hear a faster rhythm it makes us breathe a little faster, maybe our hearts beat a little more rapidly,” she said.
If you or anyone you know needs assistance contact the National Dementia Helpline on 1800 100 500.