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Building and Using Music Playlists for Dementia

Music is a powerful, drug-free tool that can reach a person with dementia even when words fail. Because music is processed throughout the entire brain, it is often the last ability to fade, and familiar songs can unlock memories, emotions, and a sense of self. This guide walks you through creating a personalized playlist and using it to calm agitation, spark joy, and connect with your loved one in the moment.

Key points

  • Focus on music from the person's youth (ages 10–25) — this is their personal 'music set' with the strongest emotional ties.
  • Use music intentionally during specific care moments (calming for stress, upbeat for energy) to reduce challenging behaviors.
  • Encourage gentle participation (humming, swaying, clapping) but never force it — let the person respond at their own pace.
  • Keep a simple observation log to track which songs work best and which cause distress.
  • Repeat the same playlist regularly — it feels fresh to them and builds a comforting routine.
  • Consider using headphones for advanced dementia to provide comfort without overstimulation.

Why music works when little else does

Music is processed across many regions of the brain, not just in one spot. For a person with dementia, this means that even as other areas of the brain are damaged, the parts that respond to music often remain intact. A familiar song from their youth can 'light up' the brain, helping them access words, memories, and emotions that seemed lost. This is why someone who cannot hold a conversation may still sing along to an old favorite or tap their foot to a beat.

The 'music set' and why it matters

Research shows that the music we hear between the ages of 10 and 25 becomes our personal 'music set' — the songs that are most deeply tied to our identity and memories. For a person with dementia, songs from this period are especially powerful. They can trigger strong, positive emotions and help the person feel more like themselves. This is why playlists should focus on music from their teen and young adult years, not just any 'old' music.

How music can reduce challenging behaviors

When a person with dementia feels anxious, agitated, or withdrawn, music can be a gentle way to shift their mood without medication. Playing a calming song during a stressful moment — like bathing or dressing — can lower anxiety and make care easier. Upbeat music can energize someone who is withdrawn or apathetic. Music can also be used as a 'diversion' to redirect attention away from distressing thoughts or situations.

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

Step-by-step

  1. Start by identifying the person's 'music set' — the songs they loved between ages 10 and 25. Ask family members, look through old record collections, or think about what was playing during their teenage years. This is the most important step because these songs will have the strongest emotional connection.

  2. Create a playlist of 10–15 songs from that era. Use a streaming service (like Spotify, Pandora, or YouTube) or a simple music player. If you don't have internet access, you can burn songs onto a CD or use an MP3 player. The goal is to have a ready-to-go list you can play at any time.

  3. Choose a quiet, comfortable setting with minimal distractions. Turn off the TV and put away phones. Sit close to the person, and start the playlist at a low volume. Watch their face and body language — a smile, a tap of the foot, or humming are signs the music is connecting.

  4. Encourage participation without pressure. Say something like, 'I remember you loved this song — let's listen together.' If they want to sing, hum, clap, or sway, join in. If they just want to listen, that's fine too. The goal is connection, not performance.

  5. Use music during specific care moments. For example, play a calming song before a bath or during dressing to reduce anxiety. Play an upbeat song after lunch to lift energy. Music can also be used as a 'transition' activity — play a song to signal it's time for a meal or a walk.

  6. If the person is in a wheelchair or has limited mobility, invite them to move along with the rhythm. You can say, 'Let's sway to the beat together,' or 'Tap your fingers on the armrest.' This adds gentle physical activity and engagement.

  7. Consider adding simple instruments like a bell, tambourine, or rhythm sticks. Hand them to the person and say, 'Can you play along with the music?' This can be especially engaging for someone who enjoys hands-on activities.

  8. If the person becomes upset or agitated by a particular song, stop it immediately and switch to a different one. Not every song will be a hit — that's okay. Pay attention to their reactions and adjust the playlist over time.

  9. For a person who is bed-bound or has very advanced dementia, use headphones with a simple MP3 player loaded with their playlist. This can provide comfort and reduce agitation without overstimulating them. Make sure the volume is low and check their comfort often.

  10. Repeat the same playlist regularly. Because short-term memory is impaired, the songs will feel fresh each time, but the emotional connection will grow stronger with repetition. If it works, keep using it — it's not boring to them, it's reassuring.

What not to do

  • Do not play music that is unfamiliar or from a different era. It can cause confusion or distress. Instead, stick to their personal 'music set' from ages 10–25.

  • Do not force participation. If they don't want to sing or move, let them just listen. Pressuring them can cause frustration or withdrawal.

  • Do not use music as a 'babysitter' or background noise without intention. Music works best when you are present and engaged with the person, not just leaving it on while you do other things.

  • Do not play music during meals if the person has trouble swallowing. Singing or laughing while eating can increase the risk of choking. Keep music for before or after meals.

  • Do not assume all music is calming. Some songs may trigger sad memories or agitation. Watch for signs of distress and be ready to switch to a different song or turn off the music.

  • Do not use the same playlist for every person. Each individual has unique preferences. What works for one person may not work for another.

Practical tools

  • Personalized Playlist Builder

    Create a list of 10–15 songs from the person's youth (ages 10–25). Use a streaming service like Spotify or Pandora, or a simple MP3 player. Label the playlist with the person's name and a theme (e.g., 'Mom's 60s Favorites'). Keep it on a device that is easy to access and play.

  • Simple Music Player (e.g., iPod Shuffle or Mighty Vibe)

    A small, simple music player with only a few buttons can be used independently by the person. Load it with their playlist and show them how to press play. This gives them a sense of control and independence.

  • Music and Memories Program (national/international)

    This program provides pre-made playlists and headphones for people with dementia. It is research-backed and can be a great resource if you want a ready-made solution. Check if it is available in your area.

  • Rhythm Instruments (bells, tambourine, rhythm sticks)

    Simple percussion instruments can be used to engage the person physically. Hand them a bell or tambourine and say, 'Let's play along with the music.' This adds a tactile and active element to the listening experience.

  • Calming Playlist for Care Moments

    Create a separate playlist of slow, gentle songs (e.g., classical, soft jazz, or hymns) to use during stressful care tasks like bathing or dressing. Play it at a low volume to create a soothing atmosphere.

  • Observation Log

    Keep a simple notebook or note on your phone to track which songs get a positive reaction (smile, humming, tapping) and which cause distress. Over time, this helps you refine the playlist for maximum benefit.

Discuss with your clinician

If the person has a history of severe depression or post-traumatic stress disorder, ask their doctor or a music therapist whether music might trigger distressing memories.

If the person has trouble swallowing (dysphagia), ask their speech therapist whether it is safe to play music during meals, as singing or laughing can increase choking risk.

If the person becomes consistently agitated or aggressive when music is played, discuss with a clinician whether a different approach is needed.

If you are considering using music as a replacement for prescribed medications (e.g., for anxiety or agitation), always discuss this with the prescribing doctor first.

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