On Sunday I saw the documentary ‘Alive Inside’, which tracks the campaign by US social worker Dan Cohen to bring personalised music to residents of care homes. It’s a remarkable record of determination and persistence: after 3 years, 650 homes in the United States have introduced the scheme, and his organisation Music and Memory continues to campaign for the iPod programme. The bones of the story will already be familiar to many since a video clip of one care home resident and his ‘awakening’ went viral three years ago, with over 11 million views. I expected to be absorbed and moved but, with some prior knowledge, hoped to avoid the ‘sobbing and smiling within minutes’ effect promised by the publicity material. What did for me was the woman about my age and who looked rather like someone I know and the dramatic transformation once the headphones were in place. My mum used to have a book beside her bed, a C.S. Lewis title, I think, called Surprised by Joy. That’s exactly what it looked like.
The power of music to awaken, particularly those who have become deadened by disease, was not news to me. Almost five years ago now, in the early stages of rediscovering Argentine tango and its extraordinary impact on the experience of Parkinson’s, I read neurologist Oliver Sachs’ Musicophilia. In his chapter on Parkinson’s Disease and Music Therapy, he recounts his experiences in Beth Abram Hospital, New York in the 1960s, when he witnessed the ‘instant transformations’ of patients rescued from the ‘abyss’ of parkinsonism by music. Sachs saw how music was able to restore normal movement – to do ‘everything that L-dopa, still in the future, was subsequently to do’. More remarkable, he witnessed the reawakening of ‘emotions and memories, fantasies, whole identities’ in response to music: exactly the effect demonstrated in ‘Alive Inside’.
Of course I have a vested interest in all this. Aside from my own present circumstances, my age alone makes it very likely – a 1 in 3 chance – that I will develop dementia. My gender increases the odds: two thirds of those with Alzheimer’s are women. Also I am learning at one remove, through my mother, Clarice, about some of the difficult and curious features of the condition, and what helps. Although Clarice has lost track of all but the closest relationships, she likes to be in company, ideally one family member and perhaps one optional extra, in a place where she is surrounded by other people; not a crowd, but a sense that she is part of life going on around her, perhaps. So a fairly busy restaurant works well, although not if it means a wait! She also loves warmth, so the Botanic Garden on a sunny day is ideal. She seems to enjoy neutral social interaction, chatting away happily to taxi drivers. She likes big things – she’s always liked trees, and these are still a winner. She has always hated open spaces and feared the sea, so not surprising that one of her favourite paths leads through the currently rather overgrown Woodland Garden – ‘the jungle’, we call it. She also seems to like things that move so, although she has never seemed even slightly interested in animals, she now loves petting my niece’s horse, which she does with no sign of fear. This may be simply that small and still are harder to enjoy with failing eyesight. She likes small children, though, often waving at those who pass as we trundle round the Botanics. They’re usually pretty keen to wave back. Is this because the wheelchair puts her physically on their level, or is it some innate grandma response? And she likes physical contact, so we touch – hands, shoulders – much more often than has been our habit. Whatever we do, it’s certain that it won’t be remembered, so it’s a good reminder for me to be fully present in that moment.
Particularly tricky for a well-intentioned relative is how far to challenge. I’ve finally grown used to the pointlessness, and maybe even the potential distress, of correction: what does it matter that Mum believes much of the time that she still lives in Baldock? What about other challenges, though? Because my business is words, it’s disappointing for me that Clarice no longer reads, listens to the radio or even watches TV. I know that ‘hard stuff’ is reputed to protect the brain from age-related degeneration, and to slow the process – one of my friends is learning Russian with that in mind – and also that poetry has links with regions of the brain linked to memory: researchers at Exeter University used brain imaging to explore brain activity and found reading poetry, in particular a favourite poem, had an effect similar to hearing music. Which is presumably behind the same university’s project where students volunteered to read favourite poems with care home residents, a programme which has attracted interest nation-wide. And then there’s exercise. The first episode of BBC Radio 4’s current series ‘How to have a better brain’, broadcast yesterday, considers some of the ‘overwhelmingly strong’ evidence that exercise is good for the brain. Cambridge neuroscientist Dr Hannah Critchlow, for example, recounts studies with mice which suggest that exercise doesn’t just slow neurological deterioration but also leads to the creation of new nerve cells and circuits in the hippocampus. This effect seems to be enhanced if the exercise is combined with exploring new and enjoyable activities, and with social interaction. Hence the well-documented benefits of music-related activities, such as dance and song. I know there are Singing for the Brain and Dancing for Dementia groups in Cambridge, but I don’t think either operate in care homes.
I don’t know about music. Although my father was a fanatic and she regularly accompanied him to concerts, Clarice has never seemed interested on her own account. As I watched the film unfold, I struggled to think of anything that I could confidently suggest for her personal playlist. Then I remembered a moment about ten years ago, sitting in the stalls of the Theatre Royal in Newcastle with Mum some months after she was widowed, for a production of ‘The Mikado’. At those first notes of the overture – ‘p-o-o-m pă pom pom pom pom’ – instantly I was back in our old front room, with Dad banging out a Mikado medley on the piano. I caught Mum’s eye – the same memory, surely – and we snivelled our way through the show. So might this be the first tune on an iPod selection made with Clarice in mind? And perhaps, given that in Cambridge we are particularly fortunate in the number of students, there may be one or two who would value and enjoy one-to-one contact with a care home resident like my mum, whether to explore and produce an individually tailored playlist or share a once-loved poem? Until then, we’ll settle for the powerful horticultural therapy of the Botanics, and the very engaging pottery class which has just been introduced for St George’s residents.
Clarice is fortunate to be a resident at St George's Court Care Home in Cambridge. The pottery class is run by Bob Race.
In addition to the usual websites, some interesting links relating to dementia can be found here.
Information on the US iPod project, including Donate an iPod and Adopt a Care Home, here.
'Alive Inside' is showing again at the Arts Picturehouse in Cambridge this Thursday 20th August at 18.30, and again at Addenbrookes Hospital in early September as part of their Dementia Awareness campaign.
All photographs taken on recent visits to Cambridge University Botanic Garden.
Clarice is fortunate to be a resident at St George's Court Care Home in Cambridge. The pottery class is run by Bob Race.
In addition to the usual websites, some interesting links relating to dementia can be found here.
Information on the US iPod project, including Donate an iPod and Adopt a Care Home, here.
'Alive Inside' is showing again at the Arts Picturehouse in Cambridge this Thursday 20th August at 18.30, and again at Addenbrookes Hospital in early September as part of their Dementia Awareness campaign.
All photographs taken on recent visits to Cambridge University Botanic Garden.
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