Music for the Aging Mind

“Music is the healing force of the universe”
-Albert Ayler, the late jazz saxophonist

Coincidentally or not, on the day after my last post, “Two Zorbas on Aging“, was published, I happened upon a column by Zorba Paster in the Lacrosse, Wisconsin Tribune titled “Patients need help with noisy hospitals,” that discusses a recent study in the Journal of the American Medical Association.

As Dr. Paster describes it, the study was of 400 ventilated patients in an ICU unit. Ventilators are known to be uncomfortable at best, and terrifying at worst. The silence of the patient necessitated by the ventilator is coupled with the noise of the unit. Given that scenario, it is not surprising that ventilation in an ICU is associated with agitation, anxiety, depression, and insomnia. Up to 25% seem to develop PTSD later on.

Patients who listened to music they liked were significantly less anxious than patients receiving usual care, and required fewer doses of sedating medication.

Then, as I was thinking about this post, I read the obituary of Patricia Lyons Simon Newman in the Chicago Tribune. Her dying and death had already gone “viral” with the Twitter documentation by her son, the NPR host Scott Simon. What caught my eye in the obituary was a comment about music. Scott Simon described how his mother asked for opera music to be played, hoping it might ease her anxiety:

” ‘Maybe opera will help. It always put me to sleep when I went’, she told her son, he said with a laugh.”

I’ve come to a conclusion, right or wrong, as I age that such connections should not be ignored as mere coincidences. In fact, after reading the obituary, my unconscious mind must have immediately associated to my mother-in-law and her response to music during the progression of her Alzheimer’s Disease before she died. When most memories failed, she still remembered music and invariably was cheered up when my wife sang songs to her that she knew and loved earlier in her life.

These examples made me wonder whether music can play more of a health-promoting role as our minds age. Indeed, new research, as summarized in a recent New York Times article, “Fond Remembrances“, suggests that nostalgia generally is a positive emotion. No wonder, then, that music from the 60s is so popular still with us aging baby boomers. Bob Dylan and The Rolling Stones still do sold out tours. So does Leonard Cohen, whose well-loved song, “Dance Me to the End of Love“, would have been loved by Zorba the Greek. Cover bands of Beatles and Elvis impersonators abound.

Recorded music, of course, doesn’t need much mobility. Favorite music is readily accessible in a variety of mediums on-line, including videos of past concerts. Unfortunately, hearing is often impaired with age, perhaps in part due to listening to loud music when younger, and since Medicare does not cover hearing aides, that may be a limitation to full enjoyment for some.

For those who have continually played music, while skill may diminish with age, music-making can still be a great source of satisfaction. Some research is emerging that suggests that musical training of at least 10 years may reduce the effects of mental decline in seniors, possibly via the widespread brain effects of music on neuronal growth and connections. Mom seems to have been right in insisting on your piano lessons, even in a preventive sense. Learning new musical skills or returning to the abandoned lessons of childhood may be beneficial. Come to think of it, that should be me with my accordion.

Music, too, can play a role in preparing for death. I find myself listening to the “Four Last Songs” by Richard Strauss more and more. Most recently I heard them at a summer seminar titled “A Song in My Heart” led by the famous opera singer Dale Duesing. Most attendees were elderly, many using canes or wheelchairs, but all seemed lifted up every morning with music. At some level we all know that we’re dying, but it comes more to mind with serious medical illness. Strauss wrote these songs when he was ill. He never got to hear them, but we can. My favorite is the third song, “While Going to Sleep”. Here, I think Strauss uses dreams (and maybe nightmares) as a metaphor for death. It closes with these lines, translated from the German:

“And my soul, unobserved,
Will float about on untrammeled wings
in the enchanted circle of the night,
living a thousandfold more deeply.”

Music is common at funerals. My wife and I spend much more time, I have to admit, talking about the music we want played at our funerals than we do discussing advance medical directives. For me,  as of now that I’d like the cantor to sing Irving Berlin’s song “Always,” in honor of my wife as well as those others that I’ve loved. Instead of a minute of silence, why not the 4 minutes, 33 seconds of silence in John Cage’s infamous piece of the same name, designed to have the audience hear the “musical” sounds around them? That period of silence may force attendees to hear the breaths of life. To close, I’d like to have a sing-along of Woody Guthrie’s “This Land is Your Land”. My psychiatric career was devoted to social justice. So were Woody Guthrie’s songs. Moreover, this song takes on new resonance and meaning with the global climate threat to our environment, which has been the ethical advocacy cause of my recent years.

To the enhancers of well-being discussed by Jim Sabin in his recent post, I would add more music. Music also has virtually no short-term side effects (unless forced to listen to something one doesn’t like) and research continues to emerge about its healthcare benefits.

What is your favorite music? What, if any, would you like played at your funeral?

H. Steve Moffic, M.D., 66, recently retired from clinical practice. He identifies himself as “psychiatric gadfly.” His book “The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare” (Jossey Bass, 1997) was the first extended discussion of the ethics of managed mental health care.