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Health & wellness

Q&A | Dan Cohen

He brings music and harmony to nursing homes

“I was driven by the reaction, how people lit up,” says Dan Cohen of his efforts to give nursing home residents iPods containing their favorite songs.

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“I was driven by the reaction, how people lit up,” says Dan Cohen of his efforts to give nursing home residents iPods containing their favorite songs.

Dan Cohen started as a volunteer, hoping to bring his love of music and his comfort with technology to people in nursing homes. When he gave residents access to music of their choice, he saw that many of them completely transformed. A man who sat silently in a chair all day in a catatonic state suddenly started singing; a woman who had no memories began recalling her past. Cohen became convinced that nearly everyone in institutional settings could benefit from having an iPod loaded with their favorite tunes. Michael Rossato-Bennett, a filmmaker Cohen hired to shoot his work for one day, ended up following him for more than three years. The product of their collaboration, the film “Alive Inside,” opened Aug. 1 at
the Kendall Square Cinema in Cambridge.

Q. What is the problem that people with advanced dementia face in nursing homes?

A. People view you as no longer able to experience pleasure because you’re not responding in the “normal” way. So we give up on [you]. “Just let them sit there all day, it doesn’t really matter.” That’s a recipe for decline even if your physical health is stable.

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Q. After you realized the power of giving people access to their own music, you set out to get more nursing home residents iPods, but hit roadblocks.

A. There are 1,600 nursing homes in America. I couldn’t find one that was making them available to someone.

Q. So that became your mission?

A. I was driven by the reaction, how people lit up.

Q. Do you blame nursing homes for not trying harder to provide personalized music to residents?

A. The people in nursing homes are dedicated and passionate, but they’re limited in their resources. I think nursing home workers are heroic in many ways. They’re working in a very stressful environment and still bringing life to these places. That’s really the saving grace for people who live there — the relationships with these staff.

Q. You mention one man, a veteran, who was very disruptive at the nursing home, lashing out at staff and throwing food. What effect did music have on him?

A. We made a playlist of patriotic music. As soon as we put it on his head, he snapped to attention and that stopped the problem. Everybody was thrilled. This is huge for staff who are very stressed because people are all agitated. Their job quality improves when the people they serve are more cooperative and more engaged.

Q. How much does it cost to provide personalized music?

A. It’s $49 for a brand new iPod shuffle; you can buy a used one for $19. Most people have old ones in their drawer at home.

Q. How do you pick each person’s music?

A. There are 320 Frank Sinatra tunes on iTunes. You don’t want to pick one the person doesn’t recognize. You have to be careful to give people something with personal meaning.

Q. Isn’t it time consuming to build a list?

A. Once you have that list, you save the time in terms of a more cooperative resident, without having to give them drugs that have all these side effects.

Q. Are nursing homes really able to reduce the amount of medications they give residents simply by providing access to an
iPod?

A. The antipsychotic piece is pretty huge. Nursing homes are reducing between 30 and 60 percent the need for these antipsychotic drugs. That’s $400 a month. And a few nursing homes have 50 people stopping their meds.

Q. Isn’t this something many families could do themselves?

A. We should all be setting up playlists for the elderly. Five years ago, I set my father-in-law up with a playlist. He had a heart issue — he made nine moves in not so many months. He always had his music with him. It transformed his experience, it transformed the experience of his family members, and it transformed the experience of the caregivers.

Q. Does music always have this miraculous effect?

A. It works most of the time. It does not work all the time. People who have more advanced dementia, maybe 25 percent aren’t responding at all. My guess is we just haven’t figured out what’s personally meaningful to them.

Q. And an hour a day of listening is enough?

A. It’s no different than when a family member visits. They don’t know who the person is, they can’t tell you it’s their daughter, but they know it’s someone they feel good to be with. It lasts the day and maybe longer. These are things that are calming and life-affirming, as opposed to being ignored.

Q. How do families respond when you show them the effect music can have on their loved one?

A. They watch [their parent or grandparent’s] foot start to move back and forth, and the family’s like ‘Wow, they’re in there.’ They’re able to increase the amount of time they’re with the person they knew.

Q. Wouldn’t giving residents access to the Internet be even better than music alone?

A. [We’ve had people ask] “Can you get my mom an audio book of the Bible?” Boom, you can do that. There are many apps that are good for people with Alzheimer’s. Many people in nursing homes love to watch YouTube. Pull up Jack Benny’s favorite skits and get them all laughing. Even with dementia, you can enjoy these things.

Q. Has this work changed your own view of aging?

A. I’m not afraid of it so much anymore.

Interview was edited and condensed. Karen Weintraub can be reached at weintraubkaren@gmail.com. Follow her on Twitter @kweintraub.
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