Music as Medicine
Somewhere over the rainbow, way up high, there’s a land that I heard of once in a lullaby.
Music and voice major Jessica Voutsinas ’18 was singing the classic song “Over the Rainbow” to a resident at Longview—an adult residential facility near the Ithaca College campus—when the woman unexpectedly lit up and began telling stories about her life and children in a breakthrough of memory recall.
At the Beechtree Center for Rehabilitation and Nursing in downtown Ithaca, Kathryn Kandra ’19 began playing music from the show Annie on an iPod, and suddenly the resident she was sitting with started singing along and conducting the music. When Kandra first saw the woman, she had been slumped in her wheelchair, her head tucked down toward her lap. But halfway through act one of Annie, the woman began talking to Kandra and asking about her life at Ithaca College.
“When I met her, she was completely nonverbal,” Kandra says. “It was amazing that I could give her at least 10 minutes of this lucidness and companionship.”
These two women, whose lives were momentarily touched by the power of music, are among dozens with dementia and Alzheimer’s disease in Tompkins County who have been affected by a groundbreaking program launched at Ithaca College.
Drawing on faculty and students from six departments on campus, the two-year-old project began with the creation of a new course called Exploring Music as Medicine and later spawned a student organization, Healing through Musical Companionship.
“The class was a transformative experience for me,” says Voutsinas. “It seemed unbelievable that music could do something that pills can’t. But after witnessing this and experiencing it for myself, my whole perception of music changed.”
“This really is, on all our parts, a journey into a new place in terms of understanding music as medicine,” says Karl Paulnack, dean of the School of Music. “’We don’t claim to know what we’re doing yet. We just want to jump in with both feet and explore it.” Beyond the intense interest the class and student organization have generated on campus, faculty and staff members say the cross-disciplinary project is distinctive because it involves such a wide range of departments: music, recreation and leisure studies, gerontology, speech-language pathology, occupational therapy, and writing.
“In higher education, it’s pretty unusual to have people across departments zero in on a topic and cover it so differently,” says Teri Reinemann M.S. ’00, gerontology programs manager at the Ithaca College Gerontology Institute. “That’s been the most fascinating part of this.”
COURSE BRINGS STUDENTS INTO ADULT RESIDENTIAL FACILITIES
Employing music to heal people is not a new idea, but when Elizabeth Simkin, associate professor of performance studies, told Paulnack about the bedside playing she had done on her sabbatical leave, he had the idea of turning it into a formal program. Simkin had spent a yearlong sabbatical trying to combine the musical intimacy she experienced as a mother singing lullabies with her training as a professional and cellist. She improvised, playing Bach suites, Celtic tunes, and familiar songs for patients, residents, and their families at Cayuga Medical Center, area nursing homes and residential facilities, and as a hospice volunteer. Most of these listeners were either in acute pain or hooked up to life-saving machines.
As the idea for the class began to germinate, Simkin worked with Jayne Demakos ’78, now a lecturer in the music school, to establish Exploring Music as Medicine in spring 2015. David Pacun, associate dean in the School of Music, was instrumental in getting it listed in the catalog. The course, which is limited to 12 students each semester, teaches those enrolled how to explore music for elders, especially those with Alzheimer’s and dementia, and then has them visit a local facility to sing or play their instruments for the residents.
“Students in our class are asked to make a paradigm shift from a performance or educational model as musicians,” says Demakos, who has co-taught the course with Simkin since its first semester. “Our class helps orient them to what it might mean to use music as restorative for those with Alzheimer’s, dementia, depression, and/or isolation. We research and learn the music that is most familiar to the people we visit. We all know it’s not about being flashy and takes an emphasis off of perfection. It’s about reaching out musically to people, human to human.”
RECORDED MUSIC OFFERS AN ALTERNATIVE FOR RESIDENTS
In February 2015, just a few weeks after the new course had begun, Reinemann arranged for an on-campus showing of the film Alive Inside: A Story of Music and Memory, which documents a program where music is played on iPods for those who have dementia. Retired associate professor of recreation and leisure studies Barbara DeWall attended the screening and after seeing the film wanted to secure funding for a pilot project to be launched in Ithaca.
DeWall contacted the organizers of An Evening to Remember, an annual gala event that benefits the Alzheimer’s Association of Central New York and local programs in Tompkins County, and the organizers agreed to donate a portion of the money they would raise during the gala to start a “music and memory” program at Beechtree.
With funding secured, associate professor and chair of the department of recreation and leisure studies Janice Elich Monroe and assistant professor Christopher Klinger, along with Reinemann, met with Eric Krause, director of recreation and volunteer services at Beechtree, to discuss piloting the program with recreation and leisure studies and gerontology students. The funding, which was used to purchase iPods and a three-day training webinar for those planning to volunteer at the facility, was critically important. As Beechtree relies heavily on Medicaid revenue, the facility would not have been able to adopt the program without the financial support and help from students and faculty at Ithaca College.
“Bringing in that money was huge,” Krause says. “A lot of the focus on what we do is getting donations. The money just isn’t there to do whatever you want. You’ve got to fight for it.”
One of the first students to work on the project at Beechtree was Holly Signor ’16, a therapeutic recreation graduate student who was completing her hours for a service-learning course. She interviewed family members of the residents to identify the type of music they liked and then built individual playlists for them on the iPods.
Signor recalls working with one man at Beechtree who happened to be her father’s former music teacher at Southern Cayuga High School in Aurora, New York. The man rarely spoke, kept his eyes closed, and seldom moved from his chair. But when Signor began playing classical music and show tunes from the 1940s for him, his demeanor changed.
“His wife was sitting next to him, and he just opened his eyes and looked at her,” Signor says. “All he did was open his eyes and look at her. That was it. It was so moving. I don’t know what it was about it. It was so simple, and it was so subtle but so beautiful.”
After Reinemann showed the movie Alive Inside to skilled nursing administrators in other facilities, several began asking Ithaca College to bring the program to their residents. Students from courses in speech-language pathology, recreation and leisure studies, and gerontology soon began playing recorded music to residents at Beechtree, Oak Hill Manor Nursing Home, and Longview, in some cases using a slightly different version of the program with MP3 players or YouTube videos.
Linda Kaplun M.S. ’17, a graduate student in speech-language pathology, remembers visiting a resident with dementia at Oak Hill Manor who was sitting in a wheelchair in her room, staring out the window. After Kaplun played a YouTube video of Mozart for her, the woman raised her head and quietly said, “It was like listening to a friend.”
While Kaplun said she had figured out that the woman enjoyed classical music, she quickly learned that her favorite composer was Mozart. “It was great to see what music could do for someone and how a lot could be said without using words,” Kaplun says.
NEW STUDENT CLUB FORMS
As faculty from across campus incorporated the recorded and live music programs into their courses, student interest in the initiative snowballed. Ryan Mewhorter ’19, a voice and performance major, was introduced to the idea of the medicinal power of music when he heard Dean Paulnack speak during the music school convocation at the beginning of his first year at IC.
Having lost his grandfather to Alzheimer’s disease, Mewhorter immediately wanted to become involved in the project, and by his second semester on campus, he had founded a student club called Healing through Musical Companionship. Now with 50 members, the club has given students the opportunity to volunteer in Beechtree’s “music and memory” program and play recorded music for residents on a weekly basis.
Last fall, as a student in the Exploring Music as Medicine course, Mewhorter began singing Broadway show tunes to residents at Cayuga Ridge Skilled Nursing & Rehabilitation Center in Ithaca. From his perspective as a participant in both the recorded and live music programs, Mewhorter says he felt that singing the music himself definitely allowed him to make a more direct connection with the residents.
"Live music has this feeling that is more personal,” he says. “When you put headphones on a resident, there isn’t a whole lot of room to communicate because there are headphones on their ears. When you perform music for them, they can sing along and make eye contact with you and follow the beat.”
Whether the music is live or recorded, the hope is that residents with dementia who have access to songs that are familiar to them may experience a positive emotional response.
“We know that music can make people happy, but now nursing facilities are going to look at how this can help prevent some of the negative impulses that exist in their patients,” says Susan Durnford, clinical associate professor of speech-language pathology and audiology. That strategy, she adds, could lead to “reducing some of the medications that are being used to control some of these negative behaviors.”
Given the enthusiasm for both programs, Paulnack says it is possible the School of Music may consider creating a major or minor in music as medicine—if the faculty request it—which would emphasize both a high level of musicianship and the therapeutic power of music.
“People tend to think of music as entertainment or art or culture,” Paulnack says. “It can be all those things, but I do dream of a world where people think of music not only as a performing art but also as a form of medicine, and we have enough resources to serve those students interested in exploring it.”