iPods vs. Music Therapy: Is There Room for Both?

In recent years, new services have emerged to bring individualized music programs on iPods to residents in long-term care. As a music therapist who loves bringing music in all forms to older adults, I have a few thoughts to share.

Here’s the short version:
Is it a good idea to provide iPods with individualized playlists to residents in long-term care? Yes. Should all long-term care residents have access to this kind of program? Yes. Can individualized iPod playlists replace music therapy? No. The thing is, individualized iPod playlists and music therapy are two different animals. Each has its own advantages and disadvantages.
Individualized playlists place a premium on individual choice and accessing music at any time.
It’s pretty easy to see the appeal of residents having the music they want when they want it. Individualized playlists offer certain advantages:
  • Residents get the chance to hear their chosen music at any given time, regardless of what’s on the activity schedule or the radio. They can have special music to relax when they’re feeling agitated (like bath time), and music to energize when they wake up in the morning or get ready to do their exercise.
  • Because the playlists are individualized, they can choose music based on their preferences: love Frank Sinatra? You could fill hours listening to his music. Hate that big band stuff the older residents love? Then fill your iPod with Lynyrd Skynyrd and the Eagles.
Of course, with headphones on, it might be hard to have those pleasant conversations with fellow residents, but at least you don’t have to listen to Bob sing “You Are My Sunshine” for the 1000th time, right? As I see it, individualized playlists have one main advantage and one main disadvantage compared to music therapy:

Advantage: Music is available whenever needed or desired.

Disadvantage: It does little to build relationships with others.

Music therapy places a premium on relationships.
In fact, several relationship are involved: the relationship between the resident and the music therapist, relationships among residents in a group, relationships with staff members who participate in music therapy programs, and the relationship between all of the people participating and the music they share. This relationship element offers certain advantages to the long-term care resident:
  • Residents find common ground and shared experiences with the other people who participate in music-making with them.
  • As the relationships among the music therapist and the participants and the music change moment to moment, the live music therapist has the flexibility to adapt music experiences in the moment. (“Wait – did I say I hated ‘You Are My Sunshine?’ Well, today it’s reminding me of my grandmother. I guess I want to sing it after all.”)
In fact, music therapy certainly does address individual needs and preferences, even as they evolve. The problem is that you need a live music therapist, in the flesh, to facilitate these in-the-moment experiences. Thus, the advantage and disadvantage of music therapy compared to individualized playlists:

Advantage: Music therapy nurtures relationships.

Disadvantage: You can’t have a music therapist around the clock.

What this comes down to is this:
Individualized playlists are a tool to be used by residents (perhaps with the help of nursing staff) to meet their individual needs at any time of day. On the other hand, music therapy is a process, a medium for relationship-building experiences that also promote well-being and nurturing of the individual resident. Both are good. Both are necessary. “So, okay,” you might be thinking. “I’d love to have iPods and music therapy BOTH available for my residents, but my budget is limited. What do I do?” Here’s my suggestion: hire a music therapist. Your music therapist will get to know your residents personally through the assessment process. Your music therapist can help you figure out what kind of equipment to buy to make an individualized iPod playlist program a reality in your facility, and she/he will already have a good idea of what kind of music would be helpful for your residents. Your music therapist can even provide an inservice to your staff to help them know how to help the residents use their iPod playlists effectively. All the while, your music therapist will be providing a stellar direct music therapy program to help residents build relationships and experience music in a healing way. What do you think about using iPods in long-term care? Do you see a place for both iPod playlists and music therapy? Please share your own thoughts and experiences below!]]>


  1. JoAnn Jordan on January 11, 2012 at 1:19 pm

    Amen! Well said. There is definitely room for both. And, you are spot on for reasons to employ a music therapist. For those in the Hays, KS area I am welcome an opportunity to assist you in developing a iPod program.

  2. Megumi on January 16, 2012 at 2:37 pm

    I agree that It is not one way or another to implement the best possible solution for the residents/clients/patients. And I liked how you stated “tool” vs. “process”. Thank you, Rachelle– I’ve always enjoyed your posts!

  3. Ashley on August 8, 2014 at 10:24 am

    One question I have, which I believe makes a sound argument for having music therapists oversee these programs and train staff implementing them, is: Can music provided in this manner act as a restraint in some cases? We know how powerful music can be, and that power sometimes manifests in unwanted feelings, or emotions that startle us, or past issues the music conjures up that we need to safely express to a therapist. This is extra challenging for people with dementia, and if we put headphones on them and they’re not (conceivably) able to remove them, we could potentially be creating an auditory restraint. My understanding is that, ideally, staff are there to monitor responses, but in that case, why not make it a music therapist in a live, person-to-person interaction anyway?

    • Rachelle on November 13, 2014 at 4:53 am

      I think you’re right, that iPods could be a restraint. Certainly with people with dementia, staff should be there to monitor responses and turn the darned music off if it’s making things worse!

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