These suggestions are based on the experience of Playlist for Life and others in introducing personal playlists to a growing number of people with dementia around the world.


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1. Why personal? Won’t any reasonably familiar music from the right era do?

To be as effective as possible a playlist for life must be uniquely personal and full of meaning for the individual.

All the evidence suggests that the personal nature of the music is what triggers autobiographical memory, renews a sense of identity and gives someone who spends a lot of time feeling ‘out of it’ a wonderful feeling of belonging.

 

2. What if music has not been a big part of this person’s life?

We are all musical, often without realising it. Even someone who appears, or indeed claims, not to have any time for music will still have been exposed to it and have the capacity to appreciate it. It is nearly always possible to find music that has (even unconsciously) provided the soundtrack to a life.  And don’t forget radio and television. Old radio series with familiar catchphrases and opening tunes can be part of a playlist.  Even the dialogue has been known to work. Television or movie theme tunes are often effective, along with catchy adverts from the past.

Psychologist and neurologist Dr Oliver Sacks says he has watched music of this kind sparking a response in everyone he has encountered with dementia ‘without exception’ (see VIDEOS > A Neurologist’s Opinion).

 

3. What is the main challenge?

It’s not always easy to build a genuinely personal playlist for someone else, no matter how close – especially someone whose own memory may be of little help. How much do grown-up children necessarily know about what their parents listened to, or danced to, before they were born?  How aware is a spouse of the musical influences in a partner’s early life?

But with perseverance, detective work and (where necessary) trial and error, everyone ought to be able to put together a playlist for the one they love. Non-family caregivers can do this, too, even in the least promising circumstances. If someone has no family and no memory, you can still follow the suggestions below to learn about that person’s life, make an informed guess about the music they might have liked and try it on them.  Nobody should be beyond the reach of a playlist for life.

In the earlier stages of dementia people can be helped to come up with their own selection: the best playlist for life will always be the one we choose for ourselves.  But whether someone is at the beginning or near the end of the dementia journey, making a good playlist is about getting to know that person’s life better.

The right music will work its magic – but so will the enhanced closeness and interaction involved in finding out about a person’s past and then sharing it together.

4. How do I discover the right music?

  • Research suggests the most potent period for musical memories is from the mid-teens to early twenties (although later music can, of course, also be evocative). What might your loved one have been doing and hearing around that time?  Do they have a brother or sister you could ask, or could you hunt down an old friend for clues?
  • Did your relative go dancing in their youth? What songs or bands might they have listened to?
  • Did he or she go to the cinema and enjoy particular films?  Some of the old ones have memorable theme tunes.
  • Did he or she ever mention a particular radio or television show? A theme tune could prove evocative.  Some people have also responded to dialogue from familiar old programmes.
  • Did, or does, your relative go to church and enjoy hymns?  What are the favourites? A minister or priest, past or present, might have some suggestions.
  • What music did your mum or dad walk down the aisle to?  What hymns were sung at their wedding? Which songs did they dance to afterwards?
  • Did he or she go to Sunday School as a child, or was a member of the Boys’ Brigade, the Guides or Brownies, or the Scouts? They all have songs associated with them.
  • Did your relative sing in a choir – a church choir, perhaps – with a repertoire that others in the choir would remember if he or she does not? The current choir leader would know the perennial favourites.
  • Was there a school song that an old school-friend might remember?
  • Is your relative of an age to have been in the war, either at home or on the front, and familiar with wartime songs?  Which in particular?
  • Did your relative play the piano or another instrument?  Might there be old sheet music around to give you clues?
  • Did he or she play in a band ever? What did the band play?
  • Do you yourself remember any records being played at home?  Do you have them still? Might a relative or friend have records in the attic you could ask to see?
  • What memories do you have of music in your own childhood?  Were lullabies sung to you, nursery rhymes, traditional songs in English or Gaelic that would mean something to the person who was singing them?
  • What music was sung or played at family parties? Hogmanay celebrations, for instance, or Highland ceilidhs.
  • Were there family holidays where you listened to particular music?
  • Are there scrapbooks around, old concert tickets tucked into a drawer, photos from  a concert perhaps that might provide clues?

5. What if I’m not sure about a piece of music?

On Spotify (www.spotify.com) you can search for songs and keep listening until you find the right one. It’s free, easy to use and allows you to listen right through to just about any song you can think of, as long as you know the title. iTunes also gives you a 90-second burst of any song. The Genius feature on iTunes provides recommendations of other music based on your existing playlist, which might give you ideas. Increasingly there are also apps to help you find music. (For a guide to all these, see HOW TO > Use the Technology).  

If you’re not sure whether a particular song is meaningful or not, try playing it – on Spotify perhaps or from a CD  – and watch for the reaction. Someone in the early stages of dementia will be able to say right away whether a song means anything; later on you can tell by watching face, hand and foot movements whether a song is hitting the spot or not.

6. How long should the playlist be?

Best to aim at between 50 and 100 songs or more, although you can start with 20 or so and build up.  But try not to keep the playlist too small. Nobody wants to hear the same tune all day, no matter how much we like it.

7. How many songs from one artist?

It’s best not to have more than five to seven songs from any one performer, unless you are sure each one really matters.  Avoid the temptation to fill the playlist with lots of Greatest Hits albums. Try to identify particularly meaningful songs within any album rather than incorporating the whole lot willy-nilly.

8. Once the playlist is drawn up, what then?

Introduce the playlist as often as you can and use it as an opportunity for closeness and, to whatever extent is possible, conversation.  Of course someone enjoying their playlist can be left to listen in peace, but this is an intervention that both encourages and demands social engagement.  That’s why it doesn’t matter that an elderly person with dementia is unlikely to be able to switch on an iPod themselves – the point is that there is someone at hand to do it for them, and with them, as often as possible.

9. Playlist at Home

At home you may find that what works best is a routine of offering the playlist at particular times of day, with more get-up-and-go music chosen on some occasions and calmer pieces at other times. Or it can be offered in response to agitation, boredom or feeling low – or indeed in anticipation of these. Getting in first with the music when you know a particular activity is likely to prove difficult is often helpful. Try it out and see what works best.

Identifying critical periods for offering this intervention is a focal point of our ongoing research.

Remember the iPod can stay with your relative – added to and refreshed as more pieces occur to you – the whole length of their dementia journey. Wherever they go, their playlist for life is an introduction to the person they really are.

10. Playlist in Care

If your loved one is in a care home, listening together can be an integral part of every visit. Relatives have found this gives a welcome structure to visits and something to talk about, through shared understandings and mutual appreciation. They report joy and delight at the additional closeness this sharing brings, as well as their appreciation of the effect of the music in stimulating thought and engagement in their loved one.

If care home staff see an improvement, they may be prepared to introduce the playlist into your relative’s care plan.  Offering someone their personal music half an hour before an activity they find difficult, such as bathing or eating, or in anticipation of the sundown blues, can help ease them through it.

11. What can the music do?

Virtually everyone will experience improvements in wellbeing that may seem small to an outsider but are of great significance to relatives. These typically involve their loved one seeming happier, becoming more lucid, finding it easier to think, losing the sense of vacancy and becoming more ‘themselves’ for a time. Sometimes the improvement is dramatic.

Music can also help with agitation, which often occurs out of a sense of urgency when people feel under threat or impelled to go somewhere.  Personal music engages them in something safe and secure.  It grounds them and gives a sense of belonging. Some relatives have found that their loved one is at last able to sit with them during a visit, without moving around restlessly.

For some people it may help to bring words back, both while listening to the music and afterwards.  Sound and melody are so connected to the words of a song that even when normal word retrieval has gone, the words return to the tongue.  Researchers suggest that singing and connecting to deeply familiar music on a daily basis can increase verbalisation and preserve mental engagement and recognition.

More contentious research suggests that personally resonant music may in some cases even aid the formation of new memories by supplying a degree of resiliency to fundamental brain areas that support learning and memory.

12. What if the music brings tears?

Music is a powerful tool.  When it triggers the emotional limbic areas of the brain, the emotion released might involve crying. It is always distressing to watch someone you love crying, but experts suggest we shouldn’t always leap to switch the music off. If your loved one becomes deeply agitated and obviously unhappy, then do stop. But it may also be right to carry on. The tears, as many of us find with music from our past, may well be cathartic.  Hold your loved one’s hand through it, stroke or cuddle them.

After decades of experience, music therapist Dr Concetta Tomaino says: ‘Chances are that if you let the tears come, you let the deepest emotion come out.  By holding their hand through it you’ll find they will stop crying soon and begin, if they are able, to talk.’ (See RESEARCH > Pioneers)

13. How long should this music be offered at a time? 

Structuring the listening to occur 15 minutes at a time throughout the day has been shown to increase the beneficial effect.  Alternatively an hour or so would be a good session of passive listening.  Ultimately it’s whatever you can manage, as often as works for all parties. But remember that if music is left on all the time, people are only intermittently engaged and it becomes environmental noise.

14. Is there a downside?

Some people who have over time become pleasantly unaware of their surroundings may become increasingly aware of being in a place they don’t recognise among people they don’t know. If that happens, the advice is to stop listening to the music for a while and simply be with the person as much as possible to ease the transition. Music is powerful. Using it intensively to affect emotions and memory is a delicate matter.  There are no rules. In every instance this is about responding lovingly to a unique individual and taking our cue from them.

15. I see the value, but this digital thing is beyond me.

Use any youngster within reach to help you.  This is a way of involving the generation who lives and breathes computers with the generation who mostly missed it. Music is a bridge.

Our Use the Technology guide should help you.

 

Share your own experiences of using a playlist for life with your loved one in YOUR SPACE.

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Disclaimer: Playlist for Life does not accept responsibility for the effect upon any individual of the introduction of a personal playlist. No severe adverse effects have been recorded.


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