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Transcript: AARP Family and Caregiving Expert Discusses Music Therapy Treatment

Amy Goyer shares how music can help dementia and Alzheimer's patients

If you missed our live online chat with Amy Goyer, an AARP family and caregiving expert, read the transcript of the conversation.

Comment from Sally: My mom enjoys big band music, so I love to play music to help her get going in the morning. Is that considered music therapy?

Amy Goyer: Music therapy is the use of music by a trained music therapist to help people achieve individualized (nonmusical) goals that address their physical, emotional, cognitive and social needs. So you may be using music therapeutically, but it's not considered true music therapy unless you're a trained, credentialed music therapist.

See also: Caregiving Resource Center

Comment from Millie: Are there real benefits to music therapy for all people, or just some? My mom has early-onset dementia but is still quite feisty. How do I get her to listen to music?

Amy Goyer: Music can be a wonderful tool for those who have dementia. The key is to pick music your mother enjoys; the wrong music or musical experience can make any undesirable behavior worse. Music that was popular during her teens and 20s is a good place to start. Or you could try religious music, show tunes or songs she sang as a child, if she enjoys them.

It may be that making music works better than just listening for your mom: Singing her favorite songs may be optimum for her, whereas sitting and listening may not be her thing. For others, dancing or other movement (like walking) to music is the key.

In my experience, it's rare that an individualized approach, designed by a music therapist who has assessed their client, would not work. But some people simply do not respond favorably.

Comment from Rich: The long-term care facility where my dad lives has an activities director who sometimes does music activities, but I don't think she's a music therapist. What exactly does a music therapist do?

Amy Goyer: Music therapists are specially trained and credentialed health professionals who have completed an approved program in music therapy. (I have a degree in music therapy and completed an internship many years ago.) First, music therapists establish a therapeutic relationship with their clients; they then assess their needs in terms of physical abilities and health, communication challenges, cognitive abilities, socialization and interactions with others, and emotional challenges. Finally, they create individualized treatment plans that include a wide variety of music-based interventions to help their clients address these challenges.

Therapists use a variety of approaches. They might create music with clients, sing, listen to music, write songs, use guided imagery or relaxation with music, perform music or learn new skills or new information to music. A music therapist is usually part of an interdisciplinary team with doctors, nurses, physical and occupational therapists, recreation therapists or art therapists.

A key part of music therapy is ongoing evaluation: Is the therapeutic approach working? Is there another music-based intervention that might work better? Would an integrated approach (such as visual arts and music) work well?

Next page: Will medical insurance pay for music therapy? »

Comment from Guest: Where did you study music?

Amy Goyer: My degree in music therapy is from Ohio University. Go Bobcats!

Comment from John: Will medical insurance pay for music therapy?

Amy Goyer: According to the American Association of Music, in some cases it will: "music therapy is a reimbursable service under benefits for Partial Hospitalization Programs (PHP). Falling under the heading of Activity Therapy, the interventions cannot be purely recreational or diversionary in nature and must be individualized and based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176." AMTA says, in terms of Medicare, "The music therapy must be considered an active treatment by meeting the following criteria:

  1. Be prescribed by a physician;
  2. Be reasonable and necessary for the treatment of the individual's illness or injury;
  3. Be goal directed and based on a documented treatment plan;
  4. The goal of treatment cannot be to merely maintain current level of functioning; the individual must exhibit some level of improvement."

A few states allow payment for music-therapy services through the use of Medicaid Home and Community Based Care waivers with certain client groups. Contact your state Medicaid office to find out the laws and rules in your state.

Comment from Ellyn: I'm trained as a caregiver but have used music from the 1930s and 1940s to pump up my 84-year-old client.

Amy Goyer: That's a wonderful use of music, Ellyn! I'm so glad to hear you're getting creative with music as a motivator!

I frequently use music in taking care of both my parents. My blog post this week outlines some of the things I do. And — bonus material! — you might even see a video of my dad singing!