Tkiya For Life
What is the mission and purpose of this program?
Elders with Alzheimer’s, Dementia and Related Disorders (ADRD) chronically suffer from agitation, confusion, depression, pain, and fatigue. Research shows that these symptoms can all be diminished by incorporating alternative interventions, such as participatory music, into their daily routines. While plenty of organizations provide entertainment for the residents of homes, there is a deficit of music programs designed to actively engage them.
Tkiya For Life is led by music educators and music therapists who are inspired to help seniors grow mentally, physically, socially, and musically. Through singing, playing instruments, movement, listening, and collaboration, Tkiya For Life ensure that each participant is able to excel in his or her own way with an emphasis on personal choice.
Taylor Herbert, Director of Senior Services at Sid Jacobson Jewish Community Center, says that Tkiya For Life not only brings back memories for the participants in her programs, but it also “...helps them to feel active and gives them purpose.” Successfully piloting at the Sid Jacobson Jewish Community Center with their GEMS II and Friendship Circle senior day programs, Tkiya is now working to expand this program’s reach by partnering with Jewish nursing homes and assisted living facilities in the NY metro area. Tkiya For Life is currently inspiring 38 participants in group settings through weekly, half hour sessions. Our goal is to be conducting weekly sessions with 240 participants across six facilities by the end of 2016 and 320 across eight facilities by the end of this grant period, facilitated by two Tkiya staff members and a new team member who will be brought on by July 2016. Not only does Tkiya For Life improve the quality of life of the seniors, but their families and caregivers as well.
Tkiya’s three person staff reached 400 students and their families in 2015 through early childhood, elementary, senior, special needs, and camp music programs. Music exists at the core of every culture and we believe that nothing can reach us and teach us like the power of music. Tkiya uses music education to help people of all ages find their unique connection with Jewish culture and to strengthen the bonds of New York’s diverse Jewish Community. Just as Tkiya Tots stands out among early childhood music programs through its emphasis on participation and engagement, Tkiya For Life pioneers participatory music programs for seniors.
Rates of depression for elderly living on their own are just between one and five percent but they rise dramatically with the loss of independence. Twelve percent of hospitalized patients and fourteen percent of those receiving home care suffer from depression. Twenty-nine to fifty percent of elderly people living in nursing homes suffer from depression. Up to ninety percent of people who suffer from depression later in life don’t receive adequate care, with seventy-eight percent receiving no treatment at all. Elderly patients diagnosed with major depressive disorder (MDD) spend nearly twice as much on health care as those without the disease (Kerr, Healthline, 2012, p. 1). Seniors who suffer from ADRD are often alienated from their larger communities due to their physical and mental limitations.
Through peer-reviewed journals such as the Journal of Music Therapy, Music Therapy, Music Therapy Perspectives, as well as extensive articles in journals outside the field, American Music Therapy Association has promoted much research exploring the benefits of music therapy for persons with Alzheimer's Disease. Brotons and Kroger’ 2000 study highlights their discoveries on seniors with ADRD with these findings:
- Music therapy reduces depression among older adults.
- Music experiences can be structured to enhance social/emotional skills, to assist in recall and language skills and to decrease problem behaviors.
- Music tasks can be used to assess cognitive ability in people with Alzheimer’s Disease.
- Music is effective in decreasing the frequency of agitated and aggressive behaviors for individuals diagnosed with Alzheimer’s Disease and related dementias.
- Individuals in the late stages of dementia respond to and interact with music. (p. 4)
Through musical stimulation, elders who suffer from communicative and emotional isolation are suddenly able to interact positively with the world around them. Research from the American Music Therapy Association reports that music reduces muscle tension, improves self-image and self-esteem, improves group cohesiveness and motivation, and provides successful and safe emotional release. Individualized music, “music carefully selected for meaningfulness to the person during his or her younger years” (Gerdner, 1992, p. 42), stimulates memories associated with positive feelings. This stimulation we have found, soothes confusion and helps to comprehend their present time and space.
There is now extensive research that proves that music, especially individualized music, can reduce ADRD symptoms such as agitation, aggressive behaviors, and depression . A group of Suzuki-influenced Japanese researchers evaluated the effects of individualized music on people with dementia through functional, behavioral, and biophysically measured outcomes. Ten subjects living with dementia received individualized musical programs biweekly for eight weeks (16 sessions). Subjects in the experimental group showed statistically significant improvement in the Mini-Mental State Exam, a questionnaire measuring cognitive impairment. They also showed a statistically significant reduction in the irritability and stress “as measured by salivary chomogranin A (CgA) following session 16” (Suzuki et al., 2004., pg. 2).
A recent study by Gerdner and Schoenfelder proves that with the help of music, dementia and Alzheimer’s patients are able to recall memories and emotions. Additionally, their overall mental performance was enhanced after singing classic hits and show tunes from movies and musicals. Another study from Boston University’s neuroscientist and Alzheimer’s researcher Brandon Ally, proves that music can help Alzheimer patients retain new information. In his BU study, 32 subjects were put through a series of memory tests and were found to learn more words when set to music rather than just spoken. These results, Ally notes, could lead to a new way of helping Alzheimer’s patients to remember tasks required for their well-being and maintaining independence. For example, a song might help patients remember which medications to take and when (Ally, 2010).
Tkiya for Life provides spirituality, excitement, freedom of expression, and hope for participants who are suffering a variety of ADRD conditions and other symptoms of aging. Harkening to Jewish cultural roots makes Tkiya an anomaly and leader in our field, profoundly connecting participants to their memories, ancestry, and spirit. Although there are music programs in senior living facilities that successfully engage residents through musical performances and recorded music, there are none that also give focus to Jewish music, while introducing therapeutic music sessions and individualized music techniques in a group setting. In this way, Tkiya for Life is unique, flexible, and constantly improving and adjusting our program based on the needs of the groups.
Tkiya for Life inspires, opens hearts and minds, and brings joy to the senior community as well as their families and caretakers. Over the course of this upcoming year, Tkiya for Life will constantly be at the forefront of exploring the most current and effective forms of music therapy and individualized music for seniors, doing the best we can to help the senior community rise to their fullest potential. As we are in the process of setting up relationships with various Jewish nursing homes, our pilot programs continues to be successful: “Tkiya’s music elicits memories, makes them feel alive, and gives them something they can achieve” (Taylor Herbert, Director of Senior Services, Sid Jacobson JCC).
How do you measure the success of your program?
Tkiya is currently in the process of developing a system of evaluation to measure the effectiveness of Tkiya For Life. This process will evaluate staff, content, frequency of sessions, and more. Our goal is to develop an in-depth evaluation to occur at each location annually, as well as a less involved evaluation to occur quarterly. Assessment will involve directors at partnering facilities, staff working directly with the participants on a regular basis, support staff who are present during sessions, as well as families of participants.
In October 2015 when our pilot program began, only one or two seniors were fully engaged in the Friendship Circle group at Sid Jacobson JCC. Some participants were completely unresponsive and others were even sleeping. Over the course of several weeks, participants grew more comfortable with Tkiya for Life staff and the structure of our program. As of January 2016, just three months later, 16 out of 20 seniors are now fully engaged, singing, and moving. This response is a result of developed relationships and comfort with Tkiya staff, the efficacy of the repertoire chosen, the expressive outlet we provide, and the growing familiarity with our structure. Participants are grateful for the music that has entered their daily life. Taylor Herbert, Director of Senior Services at Sid Jacobson Jewish Community Center, says that Tkiya For Life not only brings back memories for the participants in her programs, but it also “...helps them to feel active and gives them purpose.”