Perhaps one of the most difficult aspects of caring for someone with Alzheimer’s Disease or a related dementia is this: When the person with dementia starts needing help with their activities of daily living (ADLs).
ADLs are the basic tasks like dressing, bathing, eating, and walking that healthy adults can accomplish with little thought. For a person with dementia, however, these tasks get harder and harder until they need complete assistance with all of them.
Imagine how you might feel in the shoes of a person with dementia. You might get frustrated at not being able to do something that used to be simple. You might feel ashamed at needing help to use the toilet or get your body clean. You might be totally confused and even fearful at being asked by a stranger to take off your clothes.
Sometimes people simply refuse assistance, even when it’s necessary. Sometimes people fight back against what they perceive as a threat. For the caregiver, then, making sure these daily routines get done – without screaming, crying, hitting and biting – requires patience and sensitivity in what can be an upsetting interaction.
Music can help to make these daily, routine interactions much smoother for the caregiver and more comfortable for the person with dementia. Why? Because music signals that the caregiver is someone safe and caring, and because music provides motivation for the person to actually do the task at hand.
Here are four times to use music to support ADLs:
1. When It’s Time To Move
Sometimes, the most difficult part of helping someone with ADLs is when they are planted firmly at the door or on the couch and aren’t willing to get up and walk with the caregiver. This can be problematic when someone has been incontinent and needs help cleaning up, or when they are in an unsafe place.
What To Do: Sing your instructions to the person with dementia. You can sing a well-known song to get the idea across (such as “Shall We Dance”), or change the words to any familiar tune with a strong beat (such as “Yankee Doodle”). This feels much less threatening than barking an order and much more like a game, or just a normal human interaction. As an added bonus, singing is calming for the caregiver, too.
2. At Mealtimes
Mealtimes can be noisy and chaotic in some settings, which can lead to over-stimulation and agitation for people with dementia. Or, someone might be so distracted or lethargic that it takes many prompts for them to get through the meal. Music can mask the noisiness in the dining room and, at a neurological level, provide motivation to stay alert and keep eating and drinking.
What To Do: Play recorded music in the dining area, according to the diners’ preferences. Choose calmer, slower music when the mood is agitated, and choose upbeat music when people need help staying awake and active.
3. At Bathtime
Bathtime can be terrifying for a person with dementia who is physically uncomfortable, getting cold and wet, and who may not recognize or trust the person bathing them. Music can signal safety and foster a relaxing environment.
What To Do: Sing or play recorded music for the person with dementia as you help them with undressing, bathing, and dressing. Make sure to choose that person’s preferred music.
4. To Encourage Exercise
Regular exercise helps older adults maintain physical strength in the long-term. This reduces falls and helps people stay mobile and flexible. Ultimately, when older adults need less physical assistance, caregiving is easier. Getting people to repeat routine exercises can be tricky, but with music, exercising is secondary to the joy of moving with the music.
What To Do: Pair exercises with music that has a strong beat. Let the music guide your movements and vice versa.
As much as music can help caregivers get the job done, it also helps to strengthen their relationships with the people they care for. Sharing music, sharing stories – sharing life, really – makes caregiving more enjoyable for the caregiver and care recipient alike.