Singing and Rhythm

As other abilities fade, music remains

Regular readers of our blog will recall that in 2020, we published a blog titled ‘Singing for the Brain’, where we explored the positive effects of singing. We shared how singing releases endorphins and how that release boosts mood and even reduces symptoms associated with anxiety and depression—improving an individual’s overall sense of wellbeing.

Many people with dementia retain their right temporal lobe’s functioning for much longer than the left; this means that they keep their ability to hum, sing, foot-tap, and move to music. Here we provide insight into the significance of rhythm, pitch, tone, volume, and breath.

Meeting the inner or spiritual needs of a person living with dementia is crucial to both how well they engage and how connected they feel during any engagement. The more we can learn through family and friends about our people living with dementia, such as where they came from and what opens their hearts, the more we can connect through music, prayer, hymn, and poetry.

A leading educator on dementia, Teepa Snow, places music at the centre of her many approaches to dementia care—reminding us that ‘as ability fades, music remains’. As people with dementia experience changes in brain function, it is not uncommon for a person living with dementia to feel a sense of everything is falling apart—music remains a powerful tool in helping those living with dementia feel included, connected, and safe.

But how and when should we use music to support people living with dementia?

Music and singing should be purposeful; they should be valuable, and they should be fun. We have seen Teepa sing crossword clues in the form of song lyrics where her audience has to find the next word in that stream of lyrics—that word then being the solution to a part of the crossword.

We recognise how this use of singing activates the brain, not just in memory recall but also in how Teepa’s singing, pitch, tone, and rhythm generate movement in her seated audience. We have observed

foot-taps and head-nods. We have witnessed a brain engaged through music and seen how it impacts the likelihood of finding answers to crosswords and quizzes and finding words for conversation.

Through altered rhythm, tone, and volume, it is possible to guide the brain towards being alert and active or rested and calm. An animated, upbeat voice or a loud piece of music with a well-defined rhythm will often result in tapping hands on a chair or the swaying of arms in the air. Those able may well rise to the music’s beat and shift their weight from one foot to the other. However, a quieter piece of melody-led music accompanied by slow, mindful breathing will help create a reassuring state of calm.

As Teepa often reminds us, where an individual’s physical movement is limited, interaction, connection, inclusion, and fun does not have to be. What is essential for those living with dementia is for individuals not to be pushed beyond where they are comfortable, but instead, encouraged to use their existing abilities, be that spelling out answers to crosswords, singing along to a remembered melody, or dancing to their favourite band. Roger, one of our residents living with dementia at Leaf Dementia Care Home, currently enjoys singing and foot-tapping to Wake Me Up Before You Go-Go, by Wham—it is heart-warming to see.

There is music and rhythm all around us—from the pitch, tone, and intonation of our voices to birdsong, the rustling of leaves in the wind, and each breath that we take. These sounds evoke emotions; they are responsible for whether we feel energised or peaceful, anxious, or safe.