Ipods being used to care for patients with dementia

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MEXICO - Health care professionals expect the number of patients with dementia to rise with people in the baby-boomer generation reaching their 60s and 70s. According to the Alzheimer's Association, Alzheimer's was the sixth leading cause of death in Missouri in 2014. The state also has the ninth highest Alzheimer's-related death rate in the U.S.

In 2014, the Music and Memory organization released a documentary, Alive Inside, and shared a new way to treat dementia patients using no medications. The organization used music by creating a personalized playlist for residents in care facilities. The personalized playlist is customized specifically for the residents and is created by the resident's family member based on the resident's favorite artist.

Deborah Ferris, regional director for Music and Memory, based in Tennessee, said it is important that only the resident's favorite artist and its popular music is used. The organization takes the time to discover specific songs that are unique to the individual.

"It does not yield the same results when they use songs popular in the era or genre only. We want to find the patient's 'musical fingerprint', or their favorite music," she said.

Ferris said the personalized playlist on the iPods stimulates activity, both verbal and/or physical; reduces agitation; reduces the use of pain, anti-anxiety, and/or anti-depressants medication; reduces stress; increases cooperation and alertness; and for individuals with dementia specifically, increases communication.

Ferris also hopes this will change the way physicians diagnose a patient with dementia.

"The long-term goal is a physician will write a prescription for a personalized playlist, rather than medication. Traditional medicine can't do what music does. Medications don't always accomplish the best results," she said.

When the movie debuted, only 35 facilities became certified to use this technique, which represents only 1 percent in America. Ferris said the number of facilities has since quadrupled, and she expects more to open this year.

The Missouri Veterans Home and Ashland Health Care said they both were inspired by the documentary.

The Missouri Veterans Home in Mexico recently became certified by Music and Memory to use iPods for its 50 veterans with dementia. Marlene Benne, special dementia unit manager, said she has used music with two veterans prior to the certification. She said she has seen a big change in attitudes, and it has been easier to communicate with those veterans. The veterans home held a fundraiser last February, raising $1,200, and received a grant to certify for the facility.

Although Benne said her unit hasn't started the program officially yet, her staff can't wait to start.

"It feels like we've been working on this forever, and we're trying to get it going. But anyway we'll keep trudging along. We really want it to work, I know it will work. I just believe in it wholeheartedly, and I've seen the success stories and I want that for our veterans," she said.

She hopes her facility will use less medication to treat its patients once it has the certification.

"There's a big push out there to reduce the anti-psych meds and that we use with the patients with dementia for many reasons. It's a good change, and that's what we're really hoping, is that we will be able to impact them in such a way that we can reduce those medications eventually," Benne said.

The biggest obstacle she's had so far is not having enough people to help manage the equipment.

Ashland Health Care also had similar problems starting out. The facility has used the iPods for around nine months so far. Ben Brazell, activities director and social services, said he's seen nothing but positive feedback from families and residents.

"It's really helped with anxiety with a lot of the residents and that's been our biggest notice that we've seen with the residents," he said.

Brazell said the benefits are apparent in the patient's faces.

"Smiles. Just joy of hearing, you know when you hear a song it brings back a memory of that time, I mean it just, lights their face up," he said.

Brazell said he doesn't give the residents the iPods everyday, only around three to four times a week. Sometimes the staff doesn't need to ask; the residents will request when they want their music.

Brazell said staff just added their eighth iPod, but this isn't enough for all the residents to have one for their own. The residents have their own headphones, but sometimes two residents share the same playlist because they have the same list of songs. Other times, the residents have completely different music tastes. One of Ashland Health Care's residents, Jenny, likes classic country and another, Nancy, can be found singing along to classic rock songs like "Bad To The Bone".

"She knows all the words to the songs and that's impressive, that's amazing to be able to see that," Brazell said.

Although it's been a slow and steady progress, he's very happy with the results so far.

"We haven't seen any miraculous people with advanced dementia all of the sudden talking, we haven't had anything like that, but just from what I've seen it's been exciting to see a resident who's getting really anxious who does have dementia. And then listening to music and they seem to calm down, so I mean it's exciting," he said.

Brazell said music has been a great alternative to medications.

"The music actually calms them down, they can actually sit down and find peace. A lot of residents are on 'as-needed-medications'. If they're not anxious and not feeling fidgety and move about, they won't give them medications, so that's where the music really helps with that," he said.

David Beversdorf, MU radiology/neurology researcher and physician for memory loss/dementia, said although he has not used this method to deal with his patients, he has seen data and results supporting the method.

"First, we know that mental physical activity are beneficial, so it certainly qualifies as a mental activity. And second, the recent paper came out in the Journal of the Neurology that indicated that musical processing is actually relatively preserved in Alzheimer's disease," he said.

Although he has seen plenty of evidence in support of music, he thinks many entities have not seen this yet.

"Everybody likes to see evidence, and I think the evidence is still in development. Another layer is insurers, to get insurers to pay for things that don't have overwhelming evidence. Also there is not a drug company that is going to profit from this new music thing so there aren't very large payers that are willing to do a large study to explore this," he said.

Brazell said Ashland Health Care's goal by music the music is simple.

"Keeping the residents happy. My biggest goal is to keep the residents happy and for them to listen to their music," Brazell said.

Beversdorf and Benne also said with some patients, when they are diagnosed with dementia, they become more artistic. Beversdorf said the minds of patients with frontal degeneration start to become freer and flow with painting and drawing. He also mentioned an artist who documented his Alzheimer's journey through paintings. The New York Times has an article written on this artist. Benne said the veterans' home has started to make coloring available for some patients and is hoping to add painting as one of their activities.

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