Hana Barber’s Research Journal

Alzheimer’s Observational Research notes

Quail Ridge Musical Memories:

Date: 8/6/22

Observations: Today was my first time playing music at the Alzheimer’s memory care facility in Quailridge, Barlett. I was surprised to see around twenty to thirty people attending, many in wheelchairs. Many residents seem to have severe cases of Alzheimer’s; I observed that most of the residents were disconnected from those around them. Many initially were slumped over as if they were sleeping and did not make many movements. However, once we began playing music, the residents suddenly began to lighten up: they clapped along to the music and even sang. Despite having severe cases of Alzheimer’s, many residents recalled lyrics to songs we played like Let It BeGod Bless America, and Moon River from Breakfast at Tiffany’s. Many transformed their slumped-over position and became more attentive and connected to their surroundings. The most popular song among the residents was God Bless America as almost everyone joined in and sang. We also gained some recommendations like Down in the Valley and My Mother’s Prayer, which we will play next time. We were surprised and overwhelmed by the appreciation of the residents for our music playing and how it brightened their moods and even overall posture and behavior.

Date: 8/14/22

Observations:

Today was my second time playing piano at Quail Ridge Memory Care Facility. Today, a couple of residents stood out to me in particular: Ms. Adele and another resident. Ms. Adele and another resident (I was not able to get her name) were the most vocal of the entire group. Ms. Adele has the most bubbly and energetic personality than any other resident I have met even from the first step into the room. She is a white lady who seems to be in her 80s– if so, she looks extremely fit and healthy for her age.  She always has a huge smile on her face, is attentive, and knows most of the lyrics to the songs. She claps along to the songs and now and then taps her feet to the rhythm of the songs. The other resident also sings along and has a beautiful voice. I asked her if there were any songs she would like to hear the next time and she told me “Down in the Valley” which I now know is an old American folksong. However, I recall approaching her in the hallway about five minutes later (at most) to ask her if she enjoyed the performance and she looked confused and asked who I was despite talking to me five minutes before.[1] 

Today, their responses to the music were very similar to those of the last time. When we came into the room, many were bent over and

Date: 9/3/22

Observations: As usual, the residents sang along to the songs they knew like Let It Be by the Beatles and What a Wonderful World. However, I have noticed something about the physical appearance of many of the residents. Today, and over the past few weeks, I have noticed many bruises on many of the residents, most significant on their arms, legs, and (not as often) the face. I have researched what this could be and determined it could be senile purpura, or skin hemorrhages in the skin of the elderly, as shown below. Although I was concerned at first, according to https://gesund.bund.de/en/senile-purpura, this occurs without any major impact and appears on areas of skin that were exposed to UV radiation throughout that person’s life. 

Date: 9/30/23

Observations: Today, I noticed a change in one specific resident: Ms. Adele. Ms. Adele, as I have documented in the past, is one of the most vocal residents. When she sings, she tends to sing the correct lyrics more often than she does not. This is emphasized especially in famous songs like “God Bless America.” However, today Ms. Adele sang along with drastically incorrect lyrics, even to “God Bless America.” She is still as lively as usual, but I am afraid her Alzheimer’s has taken a turn for the worse.

I have thought that by having residents sing songs that elicit strong emotions from their childhood or youth, they could restrengthen the synapses connected with this music. For example, if one were to hear God Bless America at a family reunion when they were 25 years old, is it possible that if they heard that music enough times, they can restrengthen that memory?

Most people without Alzheimer’s or other memory-impacting diseases can carry out Long Term Potentiation, or the strengthening of synapses over time, through activities like the repetition of information and the high-frequency usage of this information. [2] This is the basis of memory. However, the cognitive decline of Alzheimer’s is directly correlated to the decrease in synapses in the brain. In Alzheimer’s, astrocytes, that would remove excess and weakened synapses in a healthy brain, remove both weakened and healthy synapses.

Alzheimers:

  • Hyperexcited: causes spread of proteins to other region of the brain

Date: 11/4/23

Observations:

Today, Ms. Adele did not show up. Although this happens a lot with the residents because they sometimes forget that we have performances due to the severity of their Alzheimer’s, I am afraid Ms. Adele’s Alzheimer’s is progressing drastically. My mother found Ms. Adele in the hallway in a chair when we were beginning the performance. She is typically very active, probably our most active and excited

Date: 2/14/24

Observations:

On Valentine’s Day, I distributed Valentine’s Day Cards to the residents at Quail Ridge Memory Care (and Page Robbins). While distributing the cards, I came across a resident and her 2 daughters who were visiting her. I stopped to hand the resident a card and began to speak with her daughters. I recall seeing the resident at my performances almost every time I’ve played (if not every). The daughters told me their mother had stopped talking about 2 years prior. However, she fortunately began speaking about 2 weeks before our encounter. They told me that the first time they heard her talk most recently, she told them about the music played at the Musical Memories performances. As they told me this, their mother began to talk; although almost incomprehensible to me. However, the daughters quickly deciphered their mom’s words: she talked about the music played at the Musical Memories performances and how much she specifically loved piano. Although I could tell she had trouble pronouncing certain words and constructing sentences quickly, I was very surprised at how naturally she was able to speak about her love for music.

Date: 4/20/24

Observations: Today, after my performance, I was able to talk to some of the residents before I left. As I might have documented before, a resident named Ms. Sue always visibly shows her enjoyment of the song Humoresque by Dvorak, which I performed on the piano today. After the recital, I asked Ms. Sue if she knew the song Humoresque. The question immediately brightened the look on her face. Through clear excitement, she told me that the song was her favorite because it constantly reminded her of her mother, who used to listen to the song with her when she was a child. She also told me that she and her mother used to have a small joke, calling the song “Humorest” instead of Humoresque. She begged me to come back and play the song again soon. I also had time to talk to Ms. Glenda, another resident at Quail Ridge. Ms. Glenda is always extremely interested in listening to our music and watching our performances– she never fails to drop by and say hello before (and during) our performances. She is also very healthy, as she rarely sits and loves to walk around the building. After today’s performance, I asked Ms. Glenda what she enjoys the most, to which she responded dancing for fun. She told me she enjoys fun, upbeat music like Elvis and would love to dance with someone next time. Possibly, we could integrate dancing for anyone who wants to next time, of course with safety precautions in mind.

Page Robbin’s Adult Care Center Volunteering:

Date: 8/07/23

Client: Ms. Claudia

Activities: Coloring, Talking

Case: Mild Alzheimer’s

  • Sometimes uses words that sound similar to the correct words
  • Forgets what was said every 3-5 minutes
  • Retells the same stories with slightly different details (ex. She has 1 sister and 1 brother vs. only 1 sister; Attended University of Iowa vs. University of Memphis)
  • Reflects on college a lot
  • Tries to remember something and sometimes forgets what she tries to remember
  • Confused between now and the past (ex. Thought sister was still in college, then, 5 minutes later tells me she ‘had’ a sister, inferring her sister had passed)
  • Common questions Ms. Claudia asked: Do you have brothers or sisters?

Summary

Ms. Claudia focuses on significant moments in her life, like college. I recall her telling me that leaving her home state and moving on to a more independent life away from home was a difficult yet rewarding decision for her. It seems as if talking to a young teenager, like I, unlocked many memories from her high school and university life. Possibly, this was the happiest (or most memorable) time for her as she talks about it the most. I think her case of Alzheimer’s is quite mild because she is mostly fairly articulate, capable of detailed movement, and, surprisingly, sometimes realizes she already asked some questions (sometimes herself and sometimes after observing my subtle reaction). She talks a lot and maintains conversations with consistent attention. Even after walking away to do another activity (a sitting group exercise, which is supposed to be independent of volunteers like me), she insisted I join her and pulled up a chair for me.

Date: 3/15/43

Client: Ms. Susan

Activities: Talking

Case: Mild Alzheimer’s

  • I was talking to Ms. Susan throughout the day, and I had spoken to her in the past, which she did not recall. However, the second or third time I spoke to her on March 15, she suddenly asked me if I was there to play music, which she had difficulty verbalizing but demonstrated with her fingers: wiggling her hands in the air as if playing a keyboard. When I clarified (verbally) “to play music” she responded “Yes! You play piano, right?” Although this could have been a coincidence, I have been playing piano at Page Robbins 1-2 times a month for at least a year at this point, and she could have watched me play before. Shocked, as she has never recalled anything from prior encounters with her and that the last time I had played piano in front of her was easily weeks before that moment, I asked her how she knew I played piano. She confidently told me “it must’ve been your voice!”

Date: 4/24/23

Client: Unknown
Activities: Musical Memoires Performance
Case: Unknown (Supposedly fair-mildly severe)

During today’s performance, there was a male audience member in his 70s who caught my attention. He was very interactive and excited from the beginning of the performance, particularly when listening to the music. In fact, he sang the most out of all the audience members. What I found most interesting was that whenever I introduced a piece, such as “Down In the Valley” or “Let It Be” by The Beatles, he would claim to not know the piece. However, he would then proceed to sing all the lyrics to many of the songs. This is a great example of how people with Alzheimer’s can still recall musical memories subconsciously. Today, the most popular songs were God Bless America followed by Down In the Valley. I noticed that the clients are still engaged with the music even if they are not singing or clapping: many look into space or change the expressions on their faces as if reflecting on past experiences or appreciating the beauty of the music.

Youtube:

What is Alzheimer’s Disease?


[1]. I am unsure of what exactly I was expecting; however, I can vividly recall my sorrow and shock with my interaction with her. Although this was not my first time surrounding myself with people with Alzheimer’s, I believe this was my first genuine interaction with someone with more severe Alzheimer’s. Despite this, she continues to remember the lyrics to many songs and sings passionately to many.

[2] https://www.youtube.com/watch?v=4Hm08ksPtMo