Common Perceptions of Cognitive Decline and Dementia
There is a common idea of dementia as the “wasting away” of a person. There is some accuracy to this; a key characteristic among the many diseases that can cause dementia is a progressive and irreversible decline in independent functioning. People may start exhibiting symptoms of cognitive decline, such as irritability, forgetfulness, and less coordination. In many cases, various forms of dementia can cause memory loss, confusion, disorientation, aphasia, personality changes, mood swings, and even hallucinations. This progresses to the extent that people become unable to care for themselves. Unable to recognize familiar faces. Unable to fully relate and connect in ways they were once capable of.
This was my understanding of dementia before working with individuals in this population. From stories of friends whose loved ones slowly lost their ability to recognize them, to hearing sonic representations attempting to capture the experience of losing first one’s memories and then oneself, my idea of dementia was of a gradual death of the self precipitated by losing contact with one’s identity and sense of reality.
How Music Therapy has Changed and Refined my Understanding of Dementia
My work as a music therapist has given me a different idea of what dementia can be.
There has been a lot of research on how music therapy can benefit those with dementia. Music has been shown to improve mood, communication, and relaxation skills. Yet, I believe the largest benefit comes from a deeper place–an affirmation of humanity. Through music, I have learned where people come from, what they value, their favorite kinds of songs, what makes them laugh, what makes them cry, and who they love. I have come to understand that, despite how challenging it may be at times, learning does not stop when people have dementia. It simply looks a little different. I have learned that dementia is not the end of someone’s humanity. It is the beginning of a new relationship with it.
The Benefits of Music Therapy for those with Dementia
At Annapolis Music Therapy, we understand and embrace the people we work with through the lens of neurodiversity. With this lens, instead of viewing conditions like Autism or ADHD as defects or diseases, people who are neuroatypical or neurodivergent are seen as equally valuable parts of a broad human spectrum that makes up society. There is no right or wrong way of being a person in the neurodiverse framework, only differences. This being said, if neurodiversity promotes viewing people as different and not deficient, and people with dementia are in a period of life where their relationship with functionality can be seen as changing rather than simply diminishing, what happens if we view dementia through the lens of neurodiversity?
This is what I’ve been trying to do as I begin my journey as a music therapist. With this reframing, I’m not providing music experiences just to slow an inevitable decline, I’m helping people find new ways to express themselves and understand the world around them. It’s a shift from focusing on deficits and mourning who they were to strengths and celebrating who they are.
As a music therapist, I believe it is my ethical obligation to ensure that the people I work with feel empowered and safe to be their most authentic selves. This is true no matter how much a person changes throughout their life. If someone is disconnected from their past, it is my job to meet them in their present.
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Seth Greenberg, MT-BC, LPMT
Annapolis Music Therapy Services
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