What can music therapy for older adults support and what can you do at home? Memory work with old songs, music in dementia and loneliness, and the research.
On a bayram (religious holiday) visit to his grandfather's home, a sixteen-year-old finds a dusty cassette player and a box full of cassettes on the top shelf of a cupboard. Curious, he puts one in; a crackly uzun hava (a free-rhythm Turkish folk song) rises from the speaker. His grandfather, who until that moment had been sitting quietly in the living room giving short answers to questions, sits up and begins to sing along with the melody; then he tells how he learned this folk song during his military service and how he and his friends used to sing it on night watches. That evening the family hears stories they have not heard for years. Music therapy for older adults aims to use moments like this not by chance, but within a planned and safe framework. In this article we look at what music-based work in later life involves, what research supports, what you can do with your older relative at home, and what to be careful about.
What Is Music Therapy for Older Adults?
Music therapy is the use of music and musical experiences, that is listening, singing, keeping rhythm and moving to music, within a therapeutic framework and with specific goals. In Cochrane reviews, music therapy is defined as a therapeutic framework plus musical interaction between practitioner and participant. So simply listening to recorded music does not count as music therapy under this definition.
In later life, music-based work is mostly carried out in the following settings:
- Care homes and care centres,
- Day care services and community centres for older people,
- Rehabilitation and palliative care units in hospitals,
- At home, in activities involving family members.
In all of these settings, the goals vary from person to person. For one person the aim may be to ease feelings of loneliness, for another to help them calm down in moments of restlessness, and for another to reconnect with family members.
Let us make an important distinction from the outset: a weekly singing hour in a care home, a grandchild listening to old records with their grandfather, or an elderly mother singing along to the radio in the kitchen are very valuable activities; but they are not therapy, they are creative activity and self-care. This distinction does not reduce the value of these activities; it simply helps us to place our expectations in the right place.
What Can Music Therapy for Older Adults Support? What Does Research Say?
The effect of music on older people has been researched most in the field of dementia. The updated Cochrane review examining music-based interventions for people living with dementia covers 30 studies and a total of 1,720 people. According to this review, music-based interventions:
- Probably reduce depressive symptoms,
- May bring some improvement in overall behavioural problems,
- But should not be expected to have a clear effect on agitation, aggression or cognitive functions, that is, memory and thinking skills.
These findings are important because they both offer hope and clearly show the limits. Music does not bring back what a loved one with dementia has forgotten, nor does it change the course of the illness. But it may help to support mood and make time spent together more meaningful. For more on the particular place of music in dementia, you can read our article on music for people with dementia.
The Cochrane review on depression (Aalbers et al., 2017), meanwhile, states that music therapy in general, when added to usual care, may reduce depressive symptoms in the short term, but that the evidence is of low to moderate certainty. This review is not specific to older people; but it also offers a guiding framework with regard to the low mood that is common in later life.
It is also worth knowing the shared limitations of the research: studies are mostly carried out with small groups, blinding is not possible because participants know what they are taking part in, some of the measurements rely on observation or self-report, and long-term effects are often unknown.
How Do Music Therapy Sessions for Older Adults Go?
Although practice varies from institution to institution, a small group session at a care centre might proceed like this:
- Welcome: The session begins with a simple greeting song in which participants' names are mentioned, or with a melody everyone knows. This makes it easier to notice who is there and to join the group.
- Warm-up: Light movements are done from a seated position, such as rolling the shoulders, taking a deep breath and making a long sound, or clapping to keep rhythm.
- Main part: Songs from the group's youth are sung or listened to. After the songs, the practitioner asks short questions: "Who does this song remind you of?" Sometimes one participant plays the tambourine and another starts the chorus.
- Winding down and closing: The session ends with a slower piece and a short farewell.
In individual sessions, the work is adapted more closely to the person. For example, a calming routine might be created for someone who becomes restless in the evenings, or communication with someone who struggles to speak might take place through rhythm and melody instead of words. By observing the person's reactions, the practitioner notes which music does them good and which makes them restless, and shares this with the care team.
Why Are Old Songs So Powerful?
Many families witness their elderly relative quickly forgetting a piece of information they have just learned, yet being able to remember the songs of their youth, words and all. This experience shows how closely music is intertwined with memories. A song is often not just a melody; it also brings with it a wedding, a summer evening, a period of military service, the balcony of a first home or a spouse who is no longer alive.
For today's older people in Turkey, these songs can be very varied: Turkish classical music songs heard on the radio, folk songs sung at village weddings, uzun havas listened to while working away from home, hymns heard on bayram mornings, or the light popular songs of their youth. What matters here is not the music you like or think is "suitable for older people", but music that has meaning in your relative's own life.
One of the loveliest questions you can ask an older person is: "Which song did you listen to when you were young?" The answer is often much more than a song.
Another important aspect of music relates to loneliness. For many older people who have lost their spouse, whose children live in other cities and who spend their days in front of the television in an apartment, the day can feel very long. Joining a choir, a music activity at a neighbourhood centre or a community gathering in the local area brings both structure to the day and contact with others.
What Can You Do With Music at Home With Your Older Relative?
Beyond structured work led by a professional, time spent with music at home can also be valuable for both your older relative and the family. Here are some ideas you can try:
Prepare a personal playlist
By talking with your relative, or with family members who know them well, create a list of songs from different periods of their life. A lullaby their mother sang in their childhood, a song played at their wedding, pieces by an artist they love... You can save this list to a phone, a music player or, the old-fashioned way, a cassette.
Ask about the stories behind the songs
After listening to a song, ask questions such as "Where did you first hear this song?" or "Where were you living back then?" Writing down the answers, or recording them with your relative's permission, can become a valuable source of memories for the family. We look at conversations built around memories in more detail in our article on reminiscence therapy.
Sing together
Your voice does not have to be beautiful. Singing a folk song together regulates breathing, brings a smile and creates a sense of closeness. If your relative mixes up the words, do not correct them; what matters is not singing correctly but singing together.
Add rhythm and movement
Clapping from where they sit, keeping rhythm by tapping their knees, or accompanying the music with a simple tambourine or maracas can be possible even for older people with limited mobility. If their health allows, moving the arms and shoulders to music in a chair can also be enjoyable. Take into account the recommendations of their doctor or physiotherapist for this.
Involve the grandchildren
Between grandchildren and grandparents, music can build a bridge across generations. A grandchild can play a song they love, and the grandmother can teach them a song from her own youth. This mutual sharing helps your older relative feel valued and listened to.
Build it into the daily routine
It can also help to turn music from an occasional activity into a natural part of the day. For example, a gentle fasıl (a classical Turkish music suite) at breakfast, a folk song sung together at afternoon tea time, a calm melody before bed in the evening... These small repeated rituals may help make the flow of the day predictable, especially for people living with dementia. Family members who live far away can also join this routine by singing a short song on video calls.
Things to Be Careful About
Music is generally a safe and much-loved tool; but some points need attention:
- Hearing: Hearing loss can be common in later life. Rather than turning up the volume, sitting closer to your relative, reducing background noise or making sure their hearing aid is in and working may be more helpful.
- Tiredness: Long activities can be tiring. Short, frequent sessions generally go more comfortably than long, infrequent ones.
- Sadness and grief: A song may bring to mind a spouse who has died or a homeland that can no longer be seen, and your relative may cry. This is not always a bad thing; make room for the feeling and listen. But if a particular song consistently causes intense distress, take it off the list.
- Respecting preferences: Some older people may not want to listen to certain kinds of music; they may stay away from music because of their beliefs, habits or the losses they have experienced. Do not force it.
- Moments of restlessness: Some people living with dementia may become restless with noisy or unfamiliar music. Choose familiar, calm music that your relative enjoys.
- Commercial claims: Approach products sold with claims such as "music that restores memory" or "frequency music" with caution. These claims are not supported by scientific evidence.
In a care home or care centre
If your relative lives in a care home or care centre, you can ask about the institution's music activities. Sharing a list of your relative's favourite songs with the staff may help them take part in activities more easily. During your visits, listening to a song together can be a way to connect even on days when conversation is difficult.
When Should You Seek Professional Support?
The losses, loneliness, health problems and growing dependence experienced in later life can deeply affect mood. Even if music helps, it is wise to see a mental health professional in the following situations:
- If your older relative has been listless, withdrawn or unhappy for weeks,
- If they no longer enjoy things they used to love, including their favourite music,
- If there are marked changes in their sleep and appetite,
- If they frequently say things like "There's no point in my living any more" or "I'm a burden to you",
- If they talk about thoughts of harming themselves or ending their life. In that situation, do not wait; in an emergency, call 112 (emergency services).
Depression in later life is often missed because it is mistaken for "the natural state of old age". You can read our article on depression in later life for symptoms and ways of getting support. You can find general information on assessing depressive symptoms and the psychotherapy process on the depression and mood page. Where needed, it is important that an assessment is carried out together with a psychiatrist and the other doctors following your relative.
Remember that as family carers you may also need support. Caring for an older relative is tiring even when it is done with love; making room for your own feelings is part of being able to sustain long-term care.
Frequently Asked Questions
Does music therapy cure dementia in older adults?
No. Research shows that music-based interventions may probably reduce depressive symptoms in people living with dementia, but that no clear effect on memory and thinking skills should be expected. Music is a supportive tool that sits alongside medical follow-up and care, not a replacement for them.
My relative cries while listening to music; should I turn it off?
Not always. Music sometimes makes suppressed longing or grief visible, and crying can bring relief. Staying by their side and listening is often enough. But if the crying turns into constant and intense distress, take a break from that song and consult a professional if necessary.
How can we decide which music to choose?
The most important criterion is music that has meaning in your relative's own life. Ask them and the family members who know them well; find out which songs they listened to in their youth and which artists they loved. By observing their reactions, you can update the list over time.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
Eğitimler
