Hansel and her more than 3,200 colleagues of the American Music Therapy Association practice two types of music therapy: active and passive. Familiar and, most importantly, likable, music elicits the best responses. For example, Big Band music motivated social interaction more than making a puzzle in one 1993 study, and another study that same year found playing music of a patient’s choosing six days a week reduced his or her agitation.
Music therapists work directly with family members, caregivers, and patients to find the best music for a desired goal of dementia therapy, such as to “improve memory,” “lower agitation,” or “improve cognitive skills.” According to Tomaino, music can be used mnemonically to “retune” the brain to remember certain tasks during early stages of Alzheimer and dementia. But in later stages, music is most helpful in maintaining motor skills. In all cases, music is known to reduce anxiety and stress while increasing attention, motivation, and focus.
Unlike passive music therapy, or simply listening to live or recorded music, active music therapy uses real instruments, such as drums, harps, harpsichords, or the voice, to engage a patient in play. Hanser once helped a man with Alzheimer’s and his wife dance for the first time in years after Hanser played some familiar ragtime music and had his wife strum an autoharp. The sound and vibration of the autoharp motivated the man to move his legs to the music, whereas before the music began he only stared into space.
Tomaino has found that active music therapy can have immediate physical benefits. “Say a person doesn’t use their hands to pick up things very much any more,” she says. “Engage them in a drumming circle for a while, and in the process of hitting the drum they can maintain the strength of holding a fork or glass.”