The Healing Power of Music

by Steve Toll and Linda Bareham

What better “medicine” than a “treatment” that has only positive side effects and “therapy” that is actually enjoyable? That is the “miracle of music” when applied with intention. Music is shown to have the ability to help organize the brain; especially vital to those who are afflicted with Alzheimer’s. Usually after twenty minutes of music, there are observable effects, such as singing, foot tapping, and clapping. Studies have shown that the results of a musical therapy session last for several hours afterward. Positive results include elevated mood, increased socialization and appetite and reduction in agitation. These benefits are attributed to the stimulation the brain receives during a music therapy session, a sort of “cognitive workout” inspiring us to coin the phrase, “What exercise is to the body, music is to the brain.” The power of music often inspires physical movement and can be used in combination to encourage gentle exercise. As speech, writing, and traditional forms of communication are compromised, music provides an alternative means of maintaining a connection, thereby helping to normalize interaction between caregiver and patient. Music used therapeutically creates an environment where the patient can be nurtured and cared for in a way that is safe, gentle and appropriate. Music is central to maintaining human bonds when those with dementia have lost the ability to initiate communication or to respond verbally.  The powers of music when focused and used therapeutically are many. Critical to maintaining quality of life for those with Alzheimer’s is management of emotions and preserving the connection with others. Music is conducive to keeping those connections strong as long as possible while helping the participant to focus, increase awareness and orient to the environment. A number of research studies have looked at music therapy as an important adjunct to medical treatment and findings suggest a possible link between the use of music and slowing the progression of dementia. From the rhythms of the heartbeat experienced in the womb to the stirring sounds of a marching band, rhythmic patterns and music surround us. Language itself has a musical quality to it and from the beginning of mankind, as expressed through chanting and drumming, resembled music more closely than speech. Music is primal to life and expressed by each of us every day whether through dancing to a favorite tune, keeping rhythm with a pencil or remembering a special time when hearing a forgotten melody. It is central to our lives and is embedded in our culture, defining how we acknowledge milestones, rites of passage and celebrations as well as providing comfort, transformation and inspiration. Music links us to our world and provides a pathway back to our past. You don’t need to have any special musical training to institute a therapeutic music program. You will need to select appropriate music, however. This music consists of familiar tunes from the 30s, 40s and 50s with more contemporary music included, depending on the preference or age of the participant.   Before you invest in any CDs, check in your own home for possible sources of music. Your local library is a good source. Consider individual preferences and select music that is singable and upbeat. Steve Toll, a professional musician and trainer, and his wife Linda Bareham, a writer and researcher in the area of alternative therapies for seniors with dementia, formed the company Prescription-Music.  Mr. Toll is on the Speaker’s Board for the National Alzheimer’s Association and trains professional and family caregivers in the development of music therapy programs where his intent is to spread the word of the healing power of music for those afflicted with Alzheimer’s.

Caregiving For A Loved One With MS

By Lainie Messina and Renata Gelman, RN, BSN

Multiple sclerosis works silently and swiftly, sometimes moving from symptom to symptom in a matter of weeks, but also possibly years. MS affects how signals are sent to the brain, which can often be crippling. The average diagnosis of MS is between ages of 20 and 50, making those suffering from MS much younger. It also affects one in 750 people. MS impacts the body, but not the mind, so someone suffering from MS could be paralyzed physically and require significant caregiving for MS, but be completely mentally capable.

Experts in delivering care to individuals with MS can help patients who wish to remain independent and happy in the comfort of their own homes. Home modification is often a major factor for a person with MS, and an assessment from an experienced health professional can guide you through this process. The following tips can help people and families who have someone living at home with MS.

Tips For MS Caregivers At Home
Multiple sclerosis caregiving involves a unique set of responsibilities as the person with MS loses physical abilities. These guidelines can help caregiving for MS patients:

• Create and follow a healthy well-balanced diet for the loved one with MS.
• Develop an exercise program that will help increase energy, balance and flexibility.
• If the MS patient is in a wheelchair make sure that it is fitted properly.
• Ask a professional about making necessary changes and home modifications so that your loved one is able  to move as freely as possible and can safely shower and bathe.
• Check regularly for skin irritations—MS patients have loss of nerve fibers and are less likely to notice bedsores or major skin irritations.
• Be mindful of the heat. MS makes people very heat sensitive, which can bring on fatigue or affect the level of their strength.
• Be careful not to speak to an MS patient like they are hard of hearing or cognitively impaired. Fatigue can bring on speech impairment, but this has no affect on their ability to hear or understand.
• Help loved ones stay intellectually stimulated through interests, whether it be through reading books, learning a new language or watching movies; having such connections can help them to avoid depression.
• Maintain a positive attitude and encourage your loved one with MS to maintain a positive attitude as well; this will help lower the stress that comes with living with MS.
• Show patience and understanding. Realize that MS is an unpredictable disease, and your loved one’s ability will vary day to day, so it is important to be able to adapt.
• Allow the person to do whatever they are able to on any particular day. While simple tasks like brushing teeth may take a long time, the feeling of accomplishment from having completed that task independently can be a major motivator.

When To Hire A Home Health Aide
Caregivers tend to shoulder too many responsibilities, putting their own health and well-being in jeopardy. Be aware of the signs and signals that you need help to provide the highest level of multiple sclerosis caregiving for your loved one:

• When it becomes too difficult for you to provide the needed day-to-day care, due to a job or other family responsibilities.
• If the person with MS is becoming depressed because they feel they are a burden to their loved ones.
• If you notice that you are becoming impatient when supporting a loved one who attempts to do tasks more independently.
• When caring for a loved one begins affecting your or another family caregiver's health.
• When getting your loved one to and from appointments becomes difficult to do by yourself—at some point this may require two people.

Should you or your family experience one or more of these issues, contact Absolute Care Mangement, to hire a nurse to come out and do an assessment and/or a home health aide to provide personal care, companionship or respite care.

The Home Safety Checklist For Loved Ones With Dementia

By Renata Gelman, RN, BSN

Minimizing household dangers and providing safe home health care for dementia patients can be simple and effective with proper preparation. Caregivers of a loved one with dementia can easily improve home safety in order to help them live better and to ensure a comfortable environment.

• Create a “wander loop” that allows the patient to move around freely.
• Use reflector tape to create a guidance path into commonly used rooms such as the bathroom or kitchen.
• Cover electrical outlets and radiators.
• Lock doors to basements and garages.
• Lock cabinets containing liquor, medications, cleaning supplies and toxic substances.
• Remove firearms from the home or store them in a locked cabinet. Keep bullets separate.
• For home safety, install safety locks and alarms on doors and gates.
• Eliminate glare from counters and floors by covering shiny surfaces, and remove lamps and lighting that may create confusing shadows.
• Remove mirrors for dementia patients with hallucinations.
• Keep car keys out of reach or in a locked compartment.
• Do not allow unattended smoking.
• Hire an aide who is certified and trained to work with dementia patients and is under the supervision of a nurse.
• Constantly reassess your loved one’s abilities with the help of a nurse or physician. Make necessary changes in dementia care as the illness progresses, for the better or worse.

7 Ways To Talk To Your Parents About Getting Help At Home

It can be difficult to acknowledge the fact that your parent needs some help with day-to-day activities, let alone introducing to them the idea of hiring a professional caregiver for help. Your parent is likely to react to this decision with some resistance. Approaching the subject requires patience and tact. However, there are certain considerations to keep in mind that can help you approach a conversation about in-home care with your parent with greater success.

Below are some ideas to consider, based on our years of experience with families facing these struggles:

1. List the advantages. Make quality home care provided by a hired caregiver desirable to your loved one. Some benefits for hiring in-home care for your parent may be: rather than having to move to an assisted living facility or nursing home, they can remain at home; in-home care is often less costly; they will be given one-on-one attention when their caregiver is there.

2. Focus on independence. Explain why hiring a caregiver is a way for your parent to maintain their independence in their own home. Of course, this is easier said then done. Perhaps paint a visual picture for them. Have they already fallen once or twice? Explain what could happen if they fall again – how it could lead to broken bones, surgery and hospitalization, followed by a lengthy recovery period. The same method could be used if they frequently forget to take their medications, or often miss doctor appointments.

3. Try a different approach. If your parents are still living together, try suggesting that in-home care would benefit their spouse. They may be more willing to accept the care for the sake of their loved one, even if in reality it is equally beneficial for both parents. If they live alone, focus on concerns or activities that are important to them.  For example, your parent may deny needing help, but may be amenable to someone helping with housekeeping and preparing some meals. They may acknowledge that they don’t like to drive at night but still want to attend their weekly bridge game.

4. Make it about you. Explain to your parents how much you worry about them. Or if you have been acting as primary caregiver, explain that it has become too much on top of career or parenthood responsibilities. According to a recent study by Genworth, 55 percent of Americans say being a burden on their family is their biggest concern regarding long term care issues. Take this into consideration when approaching your parent about accepting in-home help. You might say, “Mom, I worry about you…and even if you tell me I shouldn’t, it keeps me up at night. Would you try having someone come in once a week for me?”

5. Mitigate fear.  An elderly person can act hostile towards a hired caregiver at times, but this action is most likely out of fear. Prior to attempting to alleviate this fear, it is important to understand it. Common fears include loss of independence, losing control and dignity and financial worries. The presence of an outsider is likely to leave the elder feeling vulnerable. Take this into consideration when communicating with them, and respond with empathy rather than with frustration. Realize how your own emotions may be impacting the conversation and increasing resistance. It is important to choose an appropriate time and place for these discussions and set aside time for them.

6. Test it out on a trial-basis. Try hiring an outside caregiver for in-home help on a short-term basis for respite or recovery care, after being discharged from the hospital or after a fall. This provides an opportunity to show your parent that having a caregiver is not something to fear and often leads to them being open to receiving ongoing care. If they currently rely on you or another family member or friend as their primary caregiver or source of help, try using a vacation as an excuse to bring in a professional caregiver while gone. Explain that it is for your own peace of mind.

7. Get advice from a professional. Try discussing the situation with your parent’s primary care physician (this is most likely someone they have known for years and trust). If he or she shares your concern for your parent, they are likely to help by talking to them, explaining why in-home care is the best option for them. Another option is to consult a geriatric care manager, a professional with special expertise in making these assessments, who will be able to provide you with further advice on how to prevent resistance when introducing the new living arrangements with your loved one.