The influence of singing on social engagement for persons with severe frontotemporal dementia

Panksepp (2010) describes how the pain of social loss opens the gateway to depression, and how the chronic sense of aloneness pervades many mental health illnesses and pathologies. In relation to this, psychological and behavioural symptoms of neurodegenerative diseases like dementia are reported to increase when psychosocial needs are not met (Kitwood 1997). Thus there is a growing need to address psychosocial needs, while at the same time psychosocial needs are increasing difficult to help as a result of frontotemporal dementia. In frontotemporal dementia the progressive loss of cognitive functioning (e.g. the lost ability to process language, to focus attention, to remember and to act in what is defined as a socially appropriate manner) makes it very challenging to engage in social interaction, especially in groups.

Music therapy is applied as a non-pharmacological treatment of psychological and behavioural symptoms of dementia. Based on evidence from clinical research (Ridder 2003; Ridder, Wigram & Ottesen 2009) the method of intervention utilises the musical and communicative aspects of therapeutic singing in order to focus attention, retrieve memory, regulate arousal and engage in social interaction at different phases of the music therapy session. Processing of the human voice is neurologically different from the processing of other acoustic signals. This has an impact on social engagement via hippocampal function, stress-related responses and self-calming behaviours. This way of working with a person with dementia and difficulties in social engagement in clinical practice is illustrated with video examples from individual therapy in a Scandinavian health care model.