8 MT Activities to Use with Older Adults
Music therapy has been represented in the media many times for its use in helping older adults with dementia reminisce and remember their younger days by listening to music that was significant to them at the time. In fact, studies have shown that, “between the ages of 12 and 22, our brains undergo rapid neurological development—and the music we love during that decade seems to get wired into our lobes for good” (Stern). This is one idea to keep in mind when planning for your sessions with older adults. For example, if they are 80 right now, think of what music was popular around 1961.Chances are, they will connect with music from Elvis, Ray Charles, Buddy Holly, Frank Sinatra, The Beatles, Johnny Cash, and the Beach Boys (just to name a few).. With that in mind, let’s talk more about what specific music therapy interventions/activities you will bring with you to these sessions.
- Singing/Singalongs
Don’t underestimate this one! While a very simple idea, singalongs can be really effective in reminiscing, uplifting spirits, and increasing camaraderie between residents while building rapport with the therapist. Live music is usually best, so music therapists typically bring an acoustic guitar with them for sessions, or use an electric keyboard or piano if there is one present at the facility. It can be helpful to bring printed lyrics with a large font, or to have them written on a whiteboard. Usually, though, it’s good to choose really songs with lyrics that are so well known, everybody will recognize them and sing along (i.e. “Hound Dog” by Elvis).
- Reminiscence
This activity can be done at any time during the session; while receptively listening to music (recorded or live), when playing instruments, or completing an activity or game. The therapist is there to support the clients, as the music allows access to memories that are in parts of the brain stimulated by specific familiar songs. The therapist could ask questions like: Do you know this artist? When was the first time you listened to this song? How old were you? How did this song make you feel when you first heard it? (Bailey). If not referencing a specific song, the music therapist can still support the act of reminiscing by providing live or recorded instrumental music gently in the background while discussing. Music can provide a medium to explore memories safely and make the task less daunting than just sitting and asking questions about their past and what they can remember from it. The purpose of reminiscence is to improve interpersonal skills and mood based on remembering happy memories. In addition, the goal is to stimulate the client cognitively, help them connect to their identity/sense of self and gain confidence in social situations (Storii care).
- Reality Orientation
This is a technique that music therapists use to help the client orient themselves to things around them. Depending on the situation and progression of dementia, you can talk about the date/day of the week, or you can use broader concepts like the weather, seasons, or upcoming holidays. Having a theme for your sessions is a great way to incorporate information about the seasons and holidays. For example, this past March, we had Easter as well as St. Patrick’s Day (lots of music can be used for both of those holidays) and we also began a new spring season. All of these ideas were talked about in the session to bring awareness to the current times and the music and activities were planned around those Easter/Spring/St. Patrick’s Day themes. Music therapists, keep in mind that certain holidays may not be celebrated by all residents. In addition, be intentional with your session planning and while executing them, be aware of the residents’ responses to holiday music, which can bring about a lot of memories and emotions. Be there to support and validate their emotional and verbal responses while reminiscing on these memories. For the purposes of reality orientation, ask questions about the songs that have more straightforward answers such as: what season does this song mention? What city/state does this song sing about? (helpful for “New York, New York,” “Georgia on My Mind,” “Take Me Home, Country Roads,” etc.) and any other discussion-based questions about the seasons/holidays. It’s okay for a reality orientation activity to blend with reminiscence; the point is to help bring the clients out of a foggy state of mind and help them interact and participate in the music-making.For more reality orientation question ideas to incorporate into your music therapy sessions, check out this article.
- Movement
Music is great for getting bodies to move! Put on some big band music or some other upbeat classics and see if you can get your residents to dance (while sitting in a chair is still great!), to stretch, to reach across their midline, and to do some body percussion such as stomping, clapping, snapping, patting, and kicking. Giving the clients scarves are another way to help increase movement, and can be used alongside any of these movement ideas!
- Music BINGO
BINGO is big in many older adult communities, so why not make it musical? Instead of calling out a letter/number combo, play a song (live or recorded, but I find recorded is best for quicker recognition unless you can recreate the song really closely) and then have them cross out the song on their game cards! Be sure to let the residents know the name of the song at the end of each turn, as some may be familiar but the title may elude them. For this activity, you will also want to be sure to choose really popular music that will be easily recognizable, and even better if the track title is easily noted in the chorus. Check out the very end of this blog for more info and how to get some FREE music bingo cards!
- Songwriting
You don’t have to be a musician, or even musically inclined, to be able to write a song! Encourage your residents to have fun with this activity and not take it too seriously. You can do a piggyback song (this is when you take a popular tune and write all new lyrics to it), or a fill-in-the- blank songwriting activity. This can be done Mad Libs style for fun, or with a specific purpose in mind.For example:Moon river, wider than a _________(noun- thing)I'm crossing you in style ________(day of the week)Oh, dream maker, you heart breakerWherever you're goin', I'm ________(verb) your wayTwo drifters, off to see _________(noun- place)There's such a lot of world to _________(verb)We're after the same rainbow's endWaitin' 'round the bendMy _________(adjective) friendMoon river and meThis activity can be silly or serious, and it helps to have a large whiteboard or giant notepad to write it on for residents to be able to see. After writing the song, it’s fun to sing it together! For this, playing live is best, either on piano or guitar.
- Instrument Play
Bring lots of variety of small instruments to your sessions to try to retain interest- drums, shakers, tambourines, hand bells, wrist bells, foot tambourines, boomwhackers, cabasas, castanets, claves, and guiros (to name a few)! Be sure to help your clients that need assistance holding the instruments, or knowing how to play them. If you hand them an instrument and they don’t play it the whole time, that’s okay. Encourage them to participate by singing or talking about the song afterwards! Just having the client present in session is already a win, as music has its way of breaking through walls and helping you reach inner thoughts and feelings on its own. You are just there to provide music, support, and validation for the clients.
- Guided Imagery/Relaxation
*This activity is not to be confused with the Bonny Method of Guided Imagery and Music (GIM), which requires additional training and a certificate to be able to practice. A guided relaxation with imagery activity is one where the music therapist provides low-stimulating, relaxing music, and encourages the residents to imagine beautiful scenery, breathe, and to gradually relax their muscles. Choose a basic picking pattern on guitar to slowly play while you narrate breathing exercises and paint a beautiful picture for the clients to imagine. If this is a new concept to you, I encourage you to look up relaxation scripts like this free one from Music Therapy Ed, which also comes with an mp3 download to help you practice this! That’s it, folks! I hope this has given you plenty of ideas for what kind of interventions to plan for your older adult sessions. What is your favorite theme or activity that you’ve planned for your groups? Let us know in the comments below! Written by Molly Harrell, MT-BC FREE BINGO CARDS HERE: (link to pdf) BINGO card playlist: (it’s helpful to have these all in a downloaded playlist ready to go before your session)Hound Dog - ElvisJailhouse Rock - ElvisGreat Balls of Fire - Jerry Lee LewisI Walk the Line - Johnny CashStand By Me - Ben E. KingSurfin’ USA - The Beach BoysBeyond the Sea - Bobby DarinMy Way - Frank SinatraWar - Edwin StarrWhat a Wonderful World - Louis ArmstrongAt Last - Etta JamesLove Me Tender - ElvisLet the Good Times Roll - Ray CharlesI’ll Be Seeing You - Billie HolidayHey, Good Lookin’ - Hank WilliamsWouldn’t It Be Nice - The Beach BoysLollipop - The ChordettesCrazy - Patsy ClineRing of Fire - Johnny CashBrown Eyed Girl - Van Morrison References: Booke, Lauren. (2020, April 20). Reminiscence in music therapy among clients with dementia. Therabeat. https://www.therabeat.com/news-and-events/2020/4/20/reminiscence-in-music-therapy-among-clients-with-dementiaStern, Mark Joseph. (2014, August 12). Neural nostalgia: Why do we love the music we heard as teenagers? Slate. https://slate.com/technology/2014/08/musical-nostalgia-the-psychology-and-neuroscience-for-song-preference-and-the-reminiscence-bump.htmlStorii Care. (2020, June 18). 3 Overlooked reminiscence tools for seniors. Storiicare. https://www.storiicare.com/blog/3-overlooked-reminiscence-tools