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Musik & demens

Ridder, Hanne Mette. (2005). Musik & demens: Musikaktiviteter og musikterapi med demensramte. Århus: Klim.

Reviewed by Solgunn E. Knardal, Bergen Red Cross Nursing Home, Bergen, Norway.

The area of music therapy in the care for elderly is becoming increasingly significant. Reflecting demographic changes, we are seeing an increasing number of music therapists working in the field and also more research is being carried out in the area. Hanne Mette Ridder’s Musik og demens provides a thorough and excellently presented overview on music activities and therapy with people with dementia.

This book is divided into three parts. 1: Music Activities 2: Theory 3: Literature Review. In this format it is both easy to read and also simple to use as a reference resource. This is a book to come back to, to reflect, to read again and is a place where the reader can find everything from practical descriptions to relevant references to published material. The book outlines ways in meeting patients suffering from dementia and describes the differential competences that are needed to do this.

Part One, titled “Music activities” is organized and presented very clearly, and takes the perspective on music therapy from a level of using music simply “to make the elderly happy” to provide a deeper understand of the mechanisms of change in music therapy which are grounded in research findings. The ways of working are also presented systematically: basis principles, setting, content, examples, comments and discussion. I imagine that music therapists working with elderly people will nod and recognize the descriptions of the work also some characteristics of the case narratives.
The section describes the diverse use of music in the care for elderly, from meeting a basic need for pleasurable experiences – to finding space for inner peace, something this section portrays very well in addition to describing how music becomes relevant in meeting the patient with dementia in the very last phase of life. The section demonstrates how music therapy with people with dementia is diverse and contrasting. The use of music is one major factor whereby the individual has great possibilities to be clear and to be seen. With the use of music can calm down, relax, stimulate and increase the quality of life for the individual. Several of the surveys show this. The use of music when being around others (fellow patients, relatives, personnel) can also show favorable effects.

Part two, titled “Theory” is divided into three sections: The pleasure of music – constructive regression, the inner space of peace, where making routines in everyday life gets essential. A person suffering from dementia will often have challenges on regulating oneself, and music has been shown in its use in reducing extreme states of arousal. In this section a systematic review is presented of music therapeutic interventions to meet these patients. The section shines with an open attitude towards people suffering from dementia, and how interventions should be considered in terms of providing space for the individual to be a whole human being. Three different types of interventions are shown to be relevant; activities for pleasure, therapeutic activities and psychotherapy. It is suggested that therapy is very beneficial where it is dialogue-based, and the aims are clearly communicated to those involved, including to relatives and caregivers. The chapter on ‘music in the brain’, where studies have been selected to shows that music can “bypass” the brain, and create new links to non-damaged areas, is useful both when working with people with dementia, and also for the music therapist when communicating about work with this group of individuals.

Part three, titled ‘Literature review’ includes 92 studies from 12 different countries that were selected with specific inclusion criterion. The review is an excellent resource and provides a solid and reliable basis for understanding themes and topics that have received research attention during the development of music therapy in this area.

Though “quality of life” is often challenging to capture in research, this review shows how there is openness and interest also for this dimension in research in music therapy. In this review, Ridder provides clear and succinct information about the benefits of using music activities and music therapy in the care for people suffering from dementia, and how it can have positive effects on communicative, cognitive, physiological and social domains. Even if active participation reduces as dementia increases, it is possible to observe how people with dementia react positively with and through music. Still, as a conclusion, there is a large amount of research to be done on this significant and valuable topic.

With ‘Musik og demens’ (Music and Dementia), Ridder has provided a most valuable contribution to the literature. It is written by an experienced music therapist, educator and researcher who clearly has great expertise in working and writing about music therapy with people living with dementia. The knowledge and overview of the practice, theory and research is well balanced and integrated and throughout the book, there is a sense of the author’s deep respect for each individual, just as they are. As a result, this is a book that will be of interest to students, therapists and researchers interested in the role music can play in the lives of those with dementia.

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