When designing senior living programming it's important to not overlook the importance of including an arts program. National studies show seniors involved in the arts improve physically and mentally. Music therapy, in particular, offers an essential component in dementia and Alzheimer's treatment plans due to its ability to transport individuals with Alzheimer's and dementia to a different time and place, and help them remember things, events and people buried deep in their memory. The program can use multipurpose space, a specific room or take place during sessions in individual rooms. The technology can be throughout the building, limited to a specific room or as simple as a small, personal music player. While implementation within a community is flexible, the benefits of such programs are clear cut. The power of music and what it does to bring back memories is undeniable. Gene D. Cohen, MD, PhD, director of the Center on Aging, Health and Humanities at George Washington University and former acting director of the National Institute on Aging, explains how the brain reacts to a familiar piece of music:
"Memories are created when clusters of hundreds or thousands of neurons fire in a unique pattern," Cohen writes in his book The Mature Mind. He further explains that when you hear a catchy song your brain neurons light up. Later, when you hear the same song again, those original memory patterns are automatically strengthened. "The more often a particular pattern is stimulated, the more sensitive and permanent are the connections between the neurons in the pattern," Cohen writers. "Not only does learning link neurons in new patterns, it also stimulates neurons to grow new connections."The Levine School of Music in Washington, DC, studied 300 seniors over a two-year period with half enrolled in an arts program once a week and half not enrolled. The study reviewed the health and social functioning of the participants before, at one year and at the end of the study. Cohen reports those who attended the arts program had better health while those who did not attend saw their health deteriorate. The arts group also used fewer medications, had higher morale, felt less depressed and less lonely, and were more socially active. The music with the strongest memory connections are those associated with benchmark memories; the songs familiar to one's family and songs listened to in early adolescence and adulthood. Many memory care communities use iPods for their music and memory programs, and family caregivers can personalize their loved one's playlists; allowing them to enjoy their favorite tunes and the full benefits of music. Familiar songs can also produce a calming effect on Alzheimer's patients and help them concentrate and recognize links. The music also helps them make predictions and update events stored in previous memories, and studies also suggest music helps the brain organize new information as well. Agitation tends to take over as cognitive decline progresses, especially in nonverbal patients. Without the possibility of voicing their thoughts or feelings to others, these individuals can understandably become overcome with frustration. When people with dementia are exposed to extensive music therapy they can experience reduced negative emotions and subdue agitation. Anxiety can slowly dissipate if patients listen to slow, soft, sedative music, and when people with dementia and Alzheimer's make music their focus is redirected so their agitation goes away. Playing music can also encourage engagement, reduce stress, increase an individuals' ability to focus and promote calmness and a quieted mind. Songs of old (including Big Band, swing and salsa music) often inspire dance and movement in dementia sufferers and provide much needed physical exercise. Famed neurologist and author Oliver Sacks states, "People with Alzheimer's disease and other dementias can respond to music when nothing else reaches them. Alzheimer's can totally destroy the ability to remember family members or events from one's own life, but musical memory somehow survives the ravages of disease, and even in people with advanced dementia, music can often reawaken personal memories and associations that are otherwise lost." Examples of arts programs within senior living communities are abundant. The National Center for Creative Aging offers a directory of creative aging programs in America and the National Endowment of Arts (NEA) supports EngAGE–a program supporting more than 30 senior communities across southern California–after the NEA's Creativity and Aging study. The primary investigator of this study determined arts programs within such communities would save billions in Medicare costs. The study also noted the layout and design of facilities can impact resident's emotional well-being, social interaction, cognitive stimulation and physical activity. Both programming and design have the ability to make a significant difference in the physical, mental and emotional health of seniors.