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Using Music to Calm or Energize a Person with Dementia

Music is a powerful tool that can either soothe agitation or gently lift energy in a person with dementia. Because the brain's music-processing areas often remain strong even as other functions decline, familiar songs can reach your loved one in ways words cannot. This guide gives you concrete steps to use music intentionally, whether you need to calm a sundowning moment or spark engagement during a low-energy afternoon. You don't need to be a music therapist to make a real difference.

Key points

  • Music can either calm or energize, depending on tempo, volume, and personal meaning.
  • Use songs from their 'music set' (ages 10-25) for the strongest emotional connection.
  • For calming, use slow, simple songs in a low-stimulation environment; for energizing, use faster songs with a clear beat and invite movement.
  • Start with a low volume and watch their reaction; switch songs if they show distress.
  • Consistency matters: use the same calming playlist at the same time each day to create a comforting routine.
  • Your presence and gentle participation (humming, clapping, swaying) amplify the benefits.

Why Music Works for Arousal and Calming

Music engages the whole brain, including parts involved in emotion, memory, and movement. For someone with dementia, the areas that process familiar music are often among the last to be affected by the disease. This means a song from their youth can still trigger feelings, memories, and even the urge to tap a foot or hum along, even when they cannot remember what they had for breakfast. Music acts like a gentle guide: it can either rev up the brain's arousal system or quiet it down, depending on what you choose and how you play it. As one expert puts it, music is like a 'drug or device' that can move a person's energy in either direction when applied well.

The Two Directions: Calming vs. Energizing

When you use music to calm, you are aiming to reduce anxiety, agitation, and the restlessness that often comes with sundowning or overstimulation. Calming music typically has a slow tempo, simple melody, and no jarring surprises. It helps the brain organize itself and relax, creating a sense of safety. On the other hand, energizing music is used to lift mood, encourage movement, and combat apathy or low energy. This type of music has a stronger beat, a faster tempo, and often comes from the person's 'music set' (songs heard between ages 10 and 25). The key is to start slow and build up intensity if you want to energize, or to stay steady and gentle if you want to calm. The same playlist can even be used to first energize and then wind down, by ordering songs from more upbeat to more soothing.

How to Choose the Right Music

The most effective music is personally meaningful. Think about what your loved one enjoyed in their teenage and young adult years. That is their 'music set,' and it carries strong emotional and memory connections. Avoid music with loud commercials or abrupt changes, as these can cause confusion and disorientation. For calming, choose songs with a slow, steady rhythm, like soft ballads, classical pieces, or gentle hymns. For energizing, pick songs with a clear beat that makes you want to clap or sway, such as big band, early rock and roll, or folk songs. Always watch their reaction: if a song seems to cause agitation or distress, switch to something else immediately. The goal is a positive emotional response, not a forced experience.

The Role of Environment and Timing

The setting matters as much as the music. For calming, reduce other stimulation: close blinds, dim harsh lights, and minimize background noise. For energizing, you might open curtains, sit in a brighter room, and even invite gentle movement like clapping or swaying. Timing is also crucial. Use calming music about 30 minutes before a typically difficult time of day, such as late afternoon when sundowning often begins. Use energizing music in the morning or early afternoon to help start the day with purpose. Studies show that even 30 minutes of preferred music three times a week can reduce agitation and depression symptoms.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Identify the goal: Decide whether you want to calm or energize. For calming, aim for a slow tempo (60-80 beats per minute) and a simple, repetitive melody. For energizing, choose a faster tempo (100-120 bpm) with a strong, danceable beat.

  2. Create a short playlist of 3-5 songs from their music set (ages 10-25). For calming, include songs like 'Somewhere Over the Rainbow' or a slow hymn. For energizing, use upbeat songs like 'Twist and Shout' or a big band number. Avoid songs with sudden loud sections or complex arrangements.

  3. Set the environment: For calming, close blinds, dim lights, and remove clutter. For energizing, open curtains, sit in a well-lit area, and clear a small space for movement if possible.

  4. Start the music at a low volume. For calming, begin with the volume just above a whisper. For energizing, start at a comfortable listening level, but not so loud that it startles.

  5. Observe their reaction for the first 30 seconds. Look for signs of relaxation (slower breathing, softened facial muscles) or engagement (tapping foot, humming, smiling). If they seem distressed, switch to a different song or stop entirely.

  6. If calming, sit with them and model calm breathing. You can gently pat their hand or sway slowly in rhythm. If energizing, clap along or tap your foot, and invite them to join by saying, 'This one always makes me want to move!'

  7. For energizing, gradually increase the intensity over 5-10 minutes. Start with a medium-tempo song, then move to a faster one. After 15-20 minutes, transition to a slower song to help them wind down if needed.

  8. For calming, keep the playlist consistent and predictable. Repeat the same calming songs at the same time each day (e.g., 4:00 PM before sundowning typically starts). This creates a comforting routine.

  9. If they are able, encourage gentle participation. For calming, invite them to hum or breathe along. For energizing, hand them a small instrument like a bell or tambourine, or simply clap together.

  10. After the music ends, stay with them for a few minutes in the same calm or gently active state. If calming, offer a warm drink or a blanket. If energizing, suggest a simple activity like folding towels or looking at a photo album.

What not to do

  • Do not play music with commercials or abrupt interruptions. Commercials can break the mood and cause confusion. Instead, use ad-free playlists on a streaming service or a CD without breaks.

  • Do not force a song if they react negatively. If they turn away, grimace, or become agitated, stop immediately. The goal is comfort, not a test. Switch to a different song or try again later.

  • Do not use music as a 'babysitter' while you leave the room. Music works best when you are present and engaged, even if you are just sitting quietly nearby. Your presence reinforces the sense of safety.

  • Do not play music too loudly. For someone with dementia, hearing changes can make loud sounds painful or disorienting. Keep the volume at a level where you can easily hold a conversation.

  • Do not assume all familiar music is calming. A song from their youth might be linked to a sad or stressful memory. Watch for signs of distress and be ready to change the song.

  • Do not use the same playlist for every situation. A song that energizes in the morning might overstimulate in the evening. Create separate playlists for calming and energizing, and label them clearly.

Practical tools

  • The 'Music Set' Playlist Builder

    Create two playlists (one calming, one energizing) using songs from their teens and twenties. Ask family members for song suggestions. Use a streaming service like Spotify or YouTube to build ad-free playlists. Name them clearly, e.g., 'Mom's Calm Afternoon' and 'Mom's Morning Boost.' Keep them short (3-5 songs) and repeat them consistently.

  • The 30-Minute Wind-Down Routine

    Set a timer for 30 minutes before a known difficult time (like 4:00 PM for sundowning). Dim lights, close blinds, and start a calming playlist. Sit with them, breathe slowly, and avoid talking about stressful topics. This proactive approach can prevent agitation before it starts.

  • The 'Start Slow, Build Up' Energizing Sequence

    For a low-energy morning, begin with a medium-tempo song (e.g., 'You Are My Sunshine'), then move to a faster song (e.g., 'Rock Around the Clock'), and finish with a moderate song to avoid overstimulation. Use hand clapping or gentle swaying to invite movement.

  • Simple Participation Tools

    Keep a small basket with a bell, a tambourine, or rhythm sticks. During energizing music, hand them one and demonstrate a simple rhythm. For calming, offer a soft scarf to hold or a stuffed animal to pat in time with the music.

  • The 'Reaction Check' Log

    Keep a small notebook or a note on your phone to track which songs they respond to positively and which cause distress. Note the time of day and their mood before and after. Over a week, patterns will emerge that help you fine-tune your playlists.

  • Environment Setup Checklist

    For calming: close blinds, dim lights (use a lamp instead of overhead), remove clutter, and ensure the room is a comfortable temperature. For energizing: open curtains, sit near a window, and clear a small area for movement. Post this checklist near the music player.

Discuss with your clinician

If your loved one has a history of seizures, ask if certain music tempos or frequencies might trigger them.

If they are on medications that affect heart rate or blood pressure, ask if energizing music could cause any physical strain.

If they have hearing aids, ask the audiologist about the best way to deliver music (e.g., through the hearing aid's Bluetooth or via external speakers).

If agitation worsens after music, discuss with the doctor whether this could be a sign of pain, infection, or medication side effects.

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