英语语言学习：音乐与回忆

(Music excerpt: Minnie the Moocher)

Hello, it's All in the Mind on RN, Lynne Malcolm with you. Today, music and memory.

Excerpt from Alive Inside:

Man: Henry…

Henry: Yeah?

Man: Do you like the iPod, do you like the music you're hearing?

Henry: Yeah, I'm crazy about music, you play beautiful music, beautiful sounds. Beautiful.

Man: Did you like music when you were young?

Henry: Yes, yes, I went to big dances and things.

Man: What was your favourite music when you were young?

Henry: Cab Calloway was my number one band guy I liked.

Man: What was your favourite Cab Calloway song?

Henry: [Sings 'I'll be Home for Christmas']

Lynne Malcolm: That's from a documentary called Alive Inside, when a dementia patient called Henry is awakened from an inert unresponsive state after being played his favourite Cab Calloway music on an iPod. Henry's response to the music was so moving that the film clip of him went viral through social media.

Dan Cohen was at the centre of that documentary. He knew how powerful music can be for all of us, so he wondered what benefit it could offer people with dementia. So why not use digital music technology? He founded the program called Music and Memory. The idea is to set up residents in nursing homes with an iPod containing their favourite music tracks. Henry was one of the first to try it.

Dan Cohen: Henry has advanced dementia, and here was somebody who was really head down, non-communicative for years, but when he gets his favourite music, Cab Calloway, he just lights up, and we happened to catch this on film and that became what is now the most viewed video ever on dementia globally. And the people even who worked with him, and this was a great place he lived in, just had no idea this was inside of him. So music kind of a side door, that when we love music it's not our cognition are saying, 'I like this song,' our emotional systems are very much intact, and so as we get older whatever happens to us in terms of Alzheimer's disease or whatever, we are still going to love the music we love now.

Lynne Malcolm: How did you react when you first saw Henry's reaction?

Dan Cohen: I was in disbelief, I really was. I thought, wow, this is really cool. I looked around him and everybody was in disbelief, the staff, the fellow residents of the nursing home, because even other people around who have dementia, even though they are not very communicative, they notice when one of 'theirs' is really just lighting up themselves. So it's really something.

Lynne Malcolm: So can you give me another couple of examples of people that really moved you?

Dan Cohen: Sure. I'll often say in an aged care home, 'Do you have someone that's just very disruptive or agitated?' Yep, we have that person, he knocks with his hand away the food and drink from nurses, he is cursing at staff and it's very draining for everybody. And so, well, what do we know about him? Well, not much. What about his family? No, there's no family that we know of. But they did know he was a veteran, and so they made up a list of patriotic songs, and as soon as they put the headphones on him he snapped to attention and started humming to the music, and the end of his disruptive behaviours, bingo, just problem solved. And so that was just a huge change.

Another woman in Pennsylvania, she would always say the same four words, kind of repeating the same four words all the time, and she saw a John Wayne movie and she'd say, 'Quick, get the gun!' But the problem is she'd say this any time of day or night, loud, so it bothered everybody. And so the son, who was very attentive, we said, 'Can we try the music with your mum?' 'Oh no, she never liked music, it won't work.' But they prevailed and they tried it, and in two or three weeks she was singing the songs, she wasn't doing the iterative behaviours, wasn't disrupting everything, and everybody was thrilled.

Lynne Malcolm: Dan Cohen.

Dr Amee Baird is a clinical neuropsychologist. She studies the relationship between music and our memories.

Amee Baird: I think music is really unique in that it has a powerful ability to elicit memories, particularly personal memories and associated emotions.

Lynne Malcolm: And what is known from research about what areas of the brain are associated with music and memory?

Amee Baird: Well, music stimulates all regions of the brain, both parts of the brain that control emotion and memory and movement, because we dance to music, parts of the brain that control reward, so it really activates wide regions within the brain. And memory for familiar music in particular activates the temporal lobes and the frontal lobes of the brain. And what's interesting is that in conditions like Alzheimer's dementia, the parts of the brain that control memory for familiar music seem to be relatively preserved, which is why we have this amazing effect of familiar music on people with Alzheimer's dementia.

Lynne Malcolm: Amee Baird has just been awarded an NH&MRC and ARC Dementia Research Fellowship to look at why and how music benefits people with dementia.

Amee Baird: I got into this area of research because I read some really inspiring case studies about musicians with Alzheimer's dementia who were still able to play their musical instruments, and I think that just inspired me to look at this topic further. And there are some amazing stories of people, even in the severe or late stage of dementia, being able to respond and recall music by singing or playing their instrument or even composing.

And I guess I could share some recent research that I've done with a 92-year-old lady who was not a musician but always loved music and always sang a lot, and her daughter contacted me and said she can sing along to new pop songs that come on the radio. And what was really exciting about this was that's a type of memory that is hard for people with dementia, to learn new things is something that's difficult. So I was really fascinated by this and went to meet this lady in the nursing home and actually taught her a new song.

24 hours later she could sing along to the new song that she'd heard that I'd taught her and even one week later she could sing along with me to the new song that we taught her. And this was despite not knowing who I was. She had no idea who I was when I came to visit her a week later. She couldn't recall three words that I taught her after three minutes, but as soon as I started to sing the song, she could sing along with me, and I think this is really exciting, that there is this potential for music to be used as a memory aid to maybe learn new information or be reminded of where you are or who your family members are. It's just this ability for music to tap into that learning ability potentially.

Lynne Malcolm: So from your experience in research, how can playing music to people with dementia or other brain injuries help them?

Amee Baird: What it can do is it can transport these people quite quickly back to their personal memories. So it's a means of bringing them back to their personal past and a means of non-verbal communication. So really it's an ideal stimulus to use with people who have memory impairments, and it's an important topic for more rigorous scientific research because of its amazing potential to do this.

Lynne Malcolm: Can the effect enhance mood?

Amee Baird: Yes, absolutely, and I think we see that in this beautiful clip of Henry and other people in the film Alive Inside that you can see in their face just within seconds the joy and they do literally come alive. There's this immediate emotional reaction to music. And there have been studies of the positive effect of music on mood and in reducing depression and anxiety in people with dementia and other conditions.

Lynne Malcolm: Is the effect likely to last beyond the period of listening to the music?

Amee Baird: This is something that needs to be looked at more rigorously scientifically, but from anecdotal evidence there is certainly a sustained effect for a period of time.

Lynne Malcolm: And is it likely to improve other areas besides mood?

Amee Baird: There have been studies of very strong effects on behaviour, in particular agitation in dementia, that music can reduce agitation. And also cognition in that it can improve memory, as we've talked about, memory for the past in particular. But also in cognition it can improve people's language, expressive language. People start singing or they produce more language in their responses after listening to personally preferred music.

Lynne Malcolm: Dan Cohen has certainly seen some of the remarkable effects that personalised music can have on residents in nursing homes, and he's rolled out the Music and Memory program to hundreds of care facilities throughout the United States and Canada. However, the music strategy is still somewhat unconventional.

Dan Cohen: You know, a geriatric psychiatrist who is really very supportive of this who I spoke to, I said, in using a nonpharmacological approach, 'Aren't all of you guys like this?' 'No, I'm part of a little tiny sliver. We're used to as a profession just writing out the drug prescription, this is our response to everything; oh, if this prescription doesn't work we'll try another prescription, we'll change the dose, we'll change the drug.' And that's not good because people could be on 15, 20 drugs and that's just bad news for people, it just scrambles their brains.

So we just really want to…there are many doctors now that are getting it because they are seeing it first-hand. The program now operates in more than 2,000 care homes and hospitals and hospices around the world, and so I'm actually going to speak to 1,500 physicians in the US at a conference coming up and really talk about how this should be part of what they prescribe. If they are looking to generate better outcomes for people, that drugs are not the only way.

Lynne Malcolm: What sort of evaluation and research has been done on the program and how effective it is?

Dan Cohen: So in the University in Wisconsin, the Department of Health, when they saw the Henry clip in 2012, they said we want to do this. They said we're going to set 1,500 people with dementia in 100 nursing homes up with their own music and we are going to have the University of Wisconsin track that over 18 months. Six months into the process, the secretary of health for the state, and state has about 400 nursing homes, says the results are so clear from these 100 facilities, we're funding another 150 facilities with another 1,500 people. And so the research is still underway, but there is research also going on by the California university system and Texas and Ohio, and the federal government is now getting into the act because they want to take into account what has been done and come up with cohesive results as well.

Lynne Malcolm: So in terms of the resources, what's necessary to provide these iPods with these playlists on them to enough people? How challenging is that?

Dan Cohen: It should be simple. These are really inexpensive devices. I mean, if you take one person who is on a drug that costs the government $200 a month, well, that's $2,400 a year. You could pay for iPods for a lot of people, and all of their music. You can get 10, 20 people for one person coming off the drug, if you take 50 people off it…so the money is there.

Alzheimer's support organisations around the world say, well, we are all about supporting the carer and there's really not much we can do for the person with dementia but now with this we can, we can advise the families to use this and you will significantly change the quality of life of that person and you as the carer at home.

Lynne Malcolm: Dan Cohen, founder of Music and Memory. His vision is that everybody diagnosed with Alzheimer's dementia and and other cognitive and physical challenges be given access to personalised music on a portable audio player to enhance their well-being.

You're with All in the Mind on RN, Radio Australia and on your portable listening device. I'm Lynne Malcolm.

Music can evoke powerful memories and emotions from our past, and when Dr Maggie Haertsch heard about Dan Cohen's movement to bring personalised music to dementia patients, she was determined to bring it to Australia.

Dr Maggie Haertsch is the CEO of the Arts Health Institute, a non-profit organisation working to improve the lives of the elderly by integrating the arts with healthcare, so the Music and Memory program is a perfect match for them.

Maggie Haertsch: Music is such a powerful universal language, and it's so scalable that we can really reach out in a very big way. It's a wonderful, elegant, simple system. So we are launching for the first time in Australia and we've got the exclusive licence, so it's us that are actually responsible to really make sure that we roll this out well.

The thing that is important here is that this is a way of systematically integrating a process of being able to enable staff to be trained to put these playlists together and to deliver music. Imagine a medication trolley filled with pills that are all individual for each different person. Just replace the pills with iPods, and then you could see that you dish out music on a regular basis. If you can think of it a bit like that, it's not about replacing medications, but it certainly has an effect on, like what Dan has been saying around antipsychotics, antianxiety medications, it's got a really powerful effect there.

Lynne Malcolm: Maggie, what have you seen as examples of the effect that this has had on people in organisations you've been in?

Maggie Haertsch: We've been in a community care setting, and it has been extraordinary. There's been one couple, they've been married for a very long time, they were dancing partners for 56 years. And the wife told us a lot about the music that her husband, who has dementia, would like to hear. The moment we put the headphones on him with 'Rock Around the Clock', he was sitting at the kitchen table and his feet were going crazy, and then he started jigging up and down, and he was just alive. It was just lighting him up. And his wife was just near tears. They suddenly shared a moment back in time together that really connected them. And then that went on, and I've been following her, and she says that she put the iPod on him when she ever sensed that he was getting a bit agitated, and it just made such a difference.

You know, we've had experience too with a woman who's got MS, and she hadn't listened to her favourite music for a long time. She is an '80s kind of girl, so we put on Spandau Ballet, and the tears just came rolling down her face, it just brought back all these wonderful memories. And she found it just joyful.

Lynne Malcolm: Maggie Haertsch. The Arts Health Institute is launching the Music and Memory program into residential care homes across Australia, starting with Leigh Place in Sydney.

Aimee Cavanagh from Arts Health begins by finding out what music each resident will respond to best.

Aimee Cavanagh: Mavis, my name is Aimee. How are you?

Mavis: Well thank you, dear.

Aimee Cavanagh: Do you mind if I have a seat?

Mavis: No, not at all.

Aimee Cavanagh: I've brought some music along with me today to Leigh Place where you are living, and I was wondering if I could find out a bit more about some songs that you might have liked, and I can bring you some music to listen to. Somebody told me you like the song 'Blue Moon', do you like that song? Yes?

Mavis: I think I practically have liked everything, you know? I didn't have any ups and downs, what came along was pleasant listening to…

Aimee Cavanagh: So some Frank Sinatra maybe? Did you like Frank Sinatra?

Mavis: Yes.

Aimee Cavanagh: What about Elvis? Did you like Elvis?

Mavis: Oh yes.

Aimee Cavanagh: So if I went and found you some music and got you some piano music and maybe a bit of Elvis and some Frank Sinatra, would you like that?

Mavis: I don't know that I'd have time to listen to it.

Aimee Cavanagh: Well, it's portable, you could take it around with you wherever you go and listen to it whenever you like.

Mavis: Oh yes, I don't say I wouldn't like it.

Aimee Cavanagh: Great, well, I'll go and prepare something for you and I'll bring it back in a little while, is that okay?

Mavis: Yes, fine.

Aimee Cavanagh: Okay, great.

Lynne Malcolm: It's important that the playlists are really personalised so that it has the best chance of tapping into their individual memories.

Aimee Cavanagh: We have spoken to the husband of a lady called Nancy to find out a little bit more about her life, and he told us that she was a dancer and that she really liked The Carpenters. So I hope to get a few things together for her that she might respond to, which would be really good. I had a lovely chat to a gentleman by the name of John, and he was a sailor, so we will see what we can find about that. I asked him where he travelled to while he was a sailor and he said the pub, so we'll see what happens there!

So I've just set up the playlist for John, and to start with we're going to try some Bing Crosby because he said he liked that, so I'll put 'As Time Goes By', 'It's Only a Paper Moon'. We'll give Cab Calloway 'Minnie the Moocher' a go, 'Drunken Sailor', a little pub song for him, and 'Leaning on a Lamp Post', Herman's Hermits, is something that the girls found out that he liked as well. And he also responds well to 'It's a Long Way to Tipperary'.

How are you?

John: Very well thank you.

Aimee Cavanagh: That's good. We came back with the music, like we promised. John, I'm going to put these on your ears, you're going to listen to some music. Tell me if you can hear it.

John: [Singing]

Lynne Malcolm: Carmen is the Leisure and Lifestyle Manager at Leigh Place Residential Care in Sydney. She's interested to see how Nancy responds to the iPod play list they've compiled for her.

Carmen: Nancy used to be a ballet dancer, and she used to dance to a lot of classical music. So we are hoping that we will get some sort of reaction from her. She and her husband are very close, they love each other very much and they are very devoted to each other…

[John singing]

Lynne Malcolm: That's John singing! He's so enjoying that music, isn't he.

Carmen: So you can see with John that some of the songs will reach him deeper than the other ones. So what we're going to do is when we have reactions like that we will keep them on, but the reactions from the second song, which wasn't really any reaction at all, we will take it off the playlist and try to find more songs that elicit this response.

Lynne Malcolm: I noticed a couple of people joined in too then.

Carmen: Yes, so 'A Bicycle Built for Two' is one of the songs that me and my team actually sing together while we are serving morning tea or afternoon tea, while we are doing our tasks. So these songs kind of became familiar to us and we just sing it out of habit, and everyone joins in even though we are halfway through an art class or we get up and we dance to concerts. I think 'Bicycle Built for Two' is one of those songs that the majority of people in this place can relate to.

[John singing]

He's loving it. The happiest I see him is when he has his music, he just really, really comes alive.

Lynne Malcolm: Yes, he is really off in his own world with it, isn't he.

Carmen: Yes, always. We actually use music with him to help his personal care, or if he wants…when he used to want to walk away we used to sing him songs and walk with him, and then he'll I guess relax and then allow himself to be led into whatever, personal care or things that needed to be done. So it has a practical side to it too. I've been here for about a year now, and so I've watched him go through the changes of his mobility and the changes in everything.

Lynne Malcolm: How does it make you feel to see John enjoying that music?

Carmen: It makes me feel really happy, just to know that we can give him a little bit of happiness each day. I think it's going to make a big difference throughout his day. What we find actually is when we sing to him and we leave him be, he actually keeps singing, so it keeps that mood. So I would love to see this program be able to keep that sort of mood throughout the whole day.

Lynne Malcolm: Nancy, one of the residents at Leigh Place is in a late stage of dementia. Her husband Maurie is sitting close to her, tenderly stroking her hair as Aimee Cavanagh approaches with her with the iPod. She's found out that one of Nancy's favourites songs is 'Close to You' by The Carpenters.

Aimee Cavanagh: Hello Maurie, how are you? We spoke before about some music that Nancy might like.

Maurie: Yes, yes.

Aimee Cavanagh: I brought it for her to listen to, and I've got some headphones for you as well. Do you mind if I pop them on her?

Maurie: No.

Aimee Cavanagh: Nancy, I'm just going to pop these headphones on you so you can listen to some music. There we go. Can you hear the music?

Maurie: [laughs, tearful]

Lynne Malcolm: Morrie, do you remember listening to this together?

Morrie: She loves that one.

Lynne Malcolm: Do you think Nancy remembers Morrie?

Maurie: Remember that, love? Lovely. [tearful]

Aimee Cavanagh: You notice that it's just such a beautiful and emotional moment for them as a husband and wife, and it's affecting Morrie just as much as it's affecting Nancy, just the simplest…what seems the smallest response from Nancy, but her eyes are more awake, she has moved up to hold his hand. It's really quite profound and beautiful actually, really beautiful.

Lynne Malcolm: Graham, tell me what your reaction is to just seeing Nancy and Morrie there?

Graham Hooper: I had really high expectations of this Music and Memory program, but it has even surprised me, and particularly Morrie's reaction, how much it has brought back his memories and his memories with Nancy and something that they can share together.

Lynne Malcolm: All the staff here and the volunteers are just as touched as Morrie is.

Graham Hooper: Yes, we'll have to order in more tissues I think, there's lots of tears, but you can't help but be touched by what we can see and the reaction that such a simple thing, to play some music, but to have that connection and to be able to help Morrie connect with Nancy again is a wonderful thing.

Lynne Malcolm: Graham Hooper, general manager of Leigh Place residential aged care in Sydney.

You'll find details from today's program on the All in the Mind website, which you can get to from the RN home page.

We'd love to hear about the music that brings backs memories for you, the music you'd like your loved ones to know about. Tell us by leaving a comment on the webpage, joining us on Facebook, or tweeting with the hashtag 'RN mind music'.

Thanks to producer Diane Dean and sound engineer Judy Rapley.

I'm Lynne Malcolm, thanks for joining me.

And I'll leave you with Frank...and John:

[Music: 'As Time Goes By', Frank Sinatra…and John singing along]