Music is a powerful tool. A single song can evoke emotions, change moods and conjure up memories. Most of us will have songs that lift our spirits or a soundtrack that we play to relax to and many of us will have songs that we associate with profound or meaningful moments in our lives. It is only natural then that music is used as a form of therapy and more commonly is being used in the treatment of patients living with dementia.

We spoke to Daniel Thomas, managing director of Chroma Therapies, to find out his thoughts on the use of music therapy in the treatment of dementia.

What is music therapy?
Music therapy is the therapeutic application of music to cognitive, affective, sensory, language and motor dysfunctions due to disease or injury to the human nervous system. As a profession, it is called an Allied Health Profession and is regulated by the Health and Care Professions Council. Chroma is the UK’s only national provider of music therapy, art psychotherapy, dramatherapy and Neurologic Music Therapy, which is especially helpful for people living with dementia.How do you introduce this as a treatment?
Neurologic music therapy is introduced as a treatment as part of MDT discussions. This may be because a patient is not responding well to OT, PT or SLT due to lack of motivation, cognitive deficit or damage, or as a way to include family members in the treatment. There are no specific music goals for patients; the neurologic music therapy works towards the shared goals of the MDT.What setting is best for introducing music therapy?
Neurologic music therapy can be introduced in many settings successfully. These include hospital, care/nursing homes, day centres and private homes. It’s more important to understand what the goals for treatment are and how the context of the setting influences a patient’s engagement with the treatment.How do you believe it helps patients with dementia?
Neurologic music therapy can be very helpful for people living with dementia in many ways. As an approach based on music neuroscience research neurologic music therapy has a number of certified techniques that are considered helpful. For issues with gait, unsteady balance or to reduce the risk of falls, Rhythmic Auditory Stimulation (RAS) would be recommended. RAS uses the physiological effects of auditory rhythm on the motor system to improve the control of movement in rehabilitation of functional, stable and adaptive gait patterns in patients with significant gait deficits due to neurological impairment. RAS can be used in two different ways: as an immediate entrainment stimulus providing rhythmic cues during movement, and as a facilitating stimulus for training in order to achieve more functional gait patterns (Thaut 2005). In addition, Associative Mood and Memory Training (AMMT) involves musical mood induction techniques to instate a mood congruent mood state to facilitate memory recall, or to access associative mood and memory function through inducing a positive emotional state in the learning and recall process (Bower 1981; Dolan 2002). To assist people where swallowing and motor control of the mouth impacts eating and talking, Oral Motor and Respiratory Exercises (OMREX) involves the use of musical materials and exercises, mainly through sound vocalisation and wind instrument playing, to enhance articulatory control and respiratory strength and function of the speech apparatus. This technique would be used with such populations as developmental disorders, dysarthria, and muscular dystrophy (Hass and Distenfield 1986).

What can be done to increase the awareness and use of music therapy for patients living with dementia?
OT practices and groups can contact organisations such as Chroma to request presentations and training days about the use of neurologic music therapy. Research studies can be highlighted – Chroma is taking part in a research study looking at music therapy and palliative care in the last week of life – does music therapy help with the dying process and the grief process? This is set to start in 2018.

Why do you believe it is not being used enough?
There is a lack of awareness about music therapy in general and neurologic music therapy in particular. As music therapy is one of the Allied Health Professions, OTs can be confident to commission services when working with organisations such as Chroma. The lack of awareness is a problem of education and not efficacy.

If you would like to know more about music therapy and other arts therapies please contact Chroma UK on 0330 440 1838 or visit wearechroma.com.

Playlist for Life
Playlist for Life is a charity founded by writer and broadcaster Sally Magnusson in memory of her mother, Mamie who had dementia. Sally discovered that personally meaningful music helped improve her mother’s life with the disease more than anything else.

The website helps people set up a personal playlist for their family member, friend or patient living with dementia. It even has advice on how to be a ‘music detective’ to find out which songs or music genres could hit the right note, bring back memories and enhance daily life for those who are living with dementia.

playlistforlife.org.uk