Music & Memory #199

Andrea Graichen:

It is true that music is used in therapy with dementia patients because somehow those vestiges of the brain are left somewhat intact and through music we can somehow elicit responses from dementia patients that they might not otherwise be able get out. And it was a very profound, very powerful, positive experience for all of us.

William Kirkpatrick:

Music is one of the last connections or last abilities that people have probably right to the end of their life. And it is amazing to see the impact that music has in all forms on the person's ability not only to get connected with more of those remote memories, but get in touch with happiness and joy and that connection with people around them.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to Love Maine radio show number 199, Music and Memory. Airing for the first time on Sunday, July 5, 2015, music can unlock memories that we may have otherwise lost. This past spring, the Choral Arts Society of Maine presented Time Remembered, Time Forgotten, the New England premiere of Alzheimer's Stories, to create awareness of the link between music and memory. Today we speak with Choral Arts Society Board member and vocal soloist Andrea Gration and Bill Kirkpatrick, Program Director for the Alzheimer's Association Main Chapter, about this interesting collaboration. Thank you for joining us. Today we have with us Andrea Gration. She is a frequent soloist in the Greater Portland area and a longtime member of the Choral Arts society in the St. Mary Scola early Music Ensemble. Andrea serves on the Board of Directors of the Choral Arts Society. In the past, she has worked in senior care and in healthcare. Currently, she is working as a classical music vocal soloist. Thanks so much for coming in today.

Andrea Graichen:

Thank you for having me.

Dr. Lisa Belisle:

You've been doing an exciting We've been doing a lot of exciting projects, but One exciting project that I know you did recently in May was having to do with Alzheimer's disease.

Andrea Graichen:

That's right. We had a program that we presented on May 9th that was the New England premier of a piece called Alzheimer's Stories by Robert Cohen. And the particular project was about two years in the making. We had a lot of moving parts. Very early on, we partnered with the Alzheimer's association main chapter over in Scarborough, and they were so helpful in getting us connected with some of the important things that we might consider. We had a pre concert forum that featured our conductor, Robert Russell, the composer Robert Cohen, who came up from New Jersey, Kate Beaver, a music therapist, Bill Kirkpatrick, who's the program director at the main chapter. And we invited a poet, Judy Prescott, whose mother was cared for here in Maine. It was a very serendipitous connection. I was in a coffee shop waiting to meet a friend, and I saw your magazine, actually, and I opened it up at the time. And the column that said what Mainers are reading? Featured Judy Prescott's book, Searching for Reflections on Alzheimer's. It was Judy's way of processing her experience as her mother descended into the Alzheimer's disease. And I thought, well, I'll reach out to her and see if we could maybe use her poetry or some artwork, which is really beautiful. Family members contributed artwork to her book. And she said, absolutely, anything I can do to help. Which became, I wonder if she'd actually come. And she was so excited to plan to come, but at the last moment, she got very sick. And her brother helped out by reading some of her poetry in our concert. And he sat on that forum panel as well. And so we had the pre concert forum planned. We also did a slideshow tribute that audience members and chorus members could participate in. We invited people to send in photographs of loved ones or caregivers, friends who are either dealing with the disease or have unfortunately passed away. And so we did an in memory of and in honor of slideshow. And then we had two halves of a concert. The first half was music of celebration and remembrance, and the second half was the New England premiere of Alzheimer's Stories.

Dr. Lisa Belisle:

So tell me about Alzheimer's Stories. Why was this an important piece for him to compose?

Andrea Graichen:

It was a commission from a chorus in Pennsylvania. One of the chorus members lost both parents to the disease, wanted to honor them somehow, and proposed a commission of some kind of piece that could do that. And Robert Cohen was engaged to do the piece. He writes a lot of musical theater, so he knew how to deliver a Very powerful message in a careful, profound, yet powerful way. And he frequently works with Herschel Garfein, who is a librettist who had a very innovative idea. How do we tell this story? How can we honor the people in a true and valid way? So he invited Coors members, community members, to contribute to a blog, tell us your stories. And they did. And some of the stories actually wound up as part of the music. There were different characters. The first movement is simply called the Numbers. And the chorus sings very dry data about the unfortunate number of victims that we had in 2009 when the piece was written. And then projecting 20, 50, for example. And in the middle of the first movement, the two soloists, the baritone soloist and the mezzo soloist, become characters, and the baritone soloist becomes Dr. Alzheimer. The mezzo is Augusta Dieter, who was a very unusual patient at the time, back in 1901, she was 51 and committed to a mental institution where Alzheimer rounded and he did not know what he was seeing with her. She was like you might see with Alzheimer's, aggressive, unpredictable, couldn't remember things. So unusual for a 51 year old. And what we're guessing now is it was early onset. He worked with her for five years, went. When she passed away, he actually looked at her brain and found some of the hallmarks of the disease, which are the pockets of emptiness in there, the tangled fibers and such. And so that comprised the first movement of Cohen's piece. And the second movement was called the Stories. The chorus tells a story of visiting with mom or visiting with dad. And then unusual things happen, like mom can't remember how to drive, or we might need to put dad in a nursing home. And again the soloists say, please don't do that, or I'm fine driving. Then the mezzo takes on the role of a woman in a nursing home, but she doesn't realize she's there. She thinks she's back on a boat to Panama. And the handrails. She used to run along with her sister and grab the handrails and swing on things. And the chorus comes in to remind her, mom, those are handrails in a nursing home. They help you walk, but she doesn't want to hear that. And the baritone soloist tells the story of being in the Navy. And the corps is. Oh, here we go again. Another classic hallmark of the disease, the repetition of stories, repetition of words. The third movement is dedicated to the caregivers, and it, I believe, was the hardest one for Cohen to put together. How do we make this piece hopeful and positive? And he did he and Garfein put together the words that love and music are the last things to go? And it is true that music is used in therapy with dementia patients because somehow those vestiges of the brain are left somewhat intact. And through music, we can somehow elicit responses from dementia patients that they might not otherwise be able to get out. And it was a very profound, very powerful, positive experience for all of us.

Dr. Lisa Belisle:

Tell me what it felt like as you were yourself part of this. Tell me what you were experiencing.

Andrea Graichen:

Well, I was very fortunate to sing the mezzo soloist role, and so I. I wanted to be accurate, but not overdo the portrayal of the characters. Augusta Dieter, for me, was confused, but not angry, just confused. She didn't know where she was. Alzheimer's said to her, what's your name? Augusta. What's your husband's name? Augusta. What about your children? I have children, but I wanted it to be subtle and confused, a little detached. In the second movement, telling the story of the little girl running along the boat to Panama, it was joyous because I pictured someone remembering that memory and having so much pleasure reliving that. And in the last movement, the caregiver, I wanted to make sure that it was positive, that it would honor the families and the caregivers in all that they did, to let them know that we understood some of their struggles. So it was. It was wonderful. And going to the rehearsals every week, there were stories in the chorus, too. A lot of people have dealt with this, so there were some struggles. Sometimes people couldn't sing, but every week people got more invested, and the end result was so exciting, so moving. Everybody really had ownership of it and was really proud that we were doing something meaningful and helping out the Alzheimer's association because it was a benefit in part to help them.

Dr. Lisa Belisle:

How did the audience respond?

Andrea Graichen:

They loved it. We got so much positive feedback. We had one woman in particular who spoke in the pre concert forum, talking about her own mother who could not verbalize with her Alzheimer's disease, yet she heard some African dialects here in Maine that reminded her of her work as a youth over in Africa, and that opened her up. So she spoke to us in the forum about how important it is not just with music, but to remember languages, with people, to try to reach them. And she approached me afterward and she said, my mother passed away a few months ago. I'm still processing it, but tonight I cried from the beginning to the end, but it was very healthy. It really helped me process all of this. So we helped some people.

Dr. Lisa Belisle:

Why are you yourself so invested in choral arts in Maine?

Andrea Graichen:

I've always been involved with music since about the age of 10. We had a great music teacher in my elementary school who got us singing. We had a great orchestra. There was a string program as well. I know a lot of the schools now do band, but I'm 58 and so at the time it was orchestra. So I had those two outlets and it gave me a chance to make friends, to pursue some things, to express myself. And when I married my husband, we went off into the Air Force and wherever I went, wherever we were stationed, I'd find music. And I think it's so important for young people because it offers an outlet if they may be struggling to try to find themselves. It offers a safe place where they can discover and explore, find friends, forever friends, I hope. But the Choral Art Society in Portland is an important part of my life. There are three ensembles and I am fortunate to sing in all three. And early on I was invited to sit on the board and I try to participate in programming and whatever I can do to help get our message out. I think it's important to try to keep the arts alive. Portland is a very vibrant place for the arts and we're so lucky to have the Friday art walks and the courses, ballet, symphony, string quartets, jazz. There's everything here. It's wonderful and I just think it's important to keep it in the forefront.

Dr. Lisa Belisle:

is there something for you about the singing that keeps you linked to your essential self? Absolutely.

Andrea Graichen:

Yeah. Singing is different. I've played instruments as well and it's great to make music with instruments, but there's so many, something so personal about a singing voice. Some of the research I've read indicates that people who sing have a great sense of community. There is a shared experience, getting the message out. One of the things I love about singing is being able to tell the story, whatever it is, whether it's early music or jazz or Broadway or opera. Why did the composer write this? Why were the words chosen that are on that paper? What can I do to honor what the composer probably meant? But what can I do to put my own stamp on it? And I like being able to do

Dr. Lisa Belisle:

that, knowing how connected this makes you to yourself. It must have been very interesting to offer this to a group of people, Alzheimer's caregivers, maybe even some patients in the audience who were themselves connecting through the words that were coming out and through the music on the stage.

Andrea Graichen:

Right. Right. The first half, as I said, was music of celebration and reflection. And what the music director was trying to do was perhaps honor the love that we've all felt. One of the points of a lot of the therapy is to try to recapture some of the memories from someone's youth, where some of those memories may be the most available to a patient. So he wanted to focus on love, to maybe recapture young love when people might have been married. I had the great fortune of working with a support group during my work in senior care, and I got to know some people who were struggling. Should I put my loved one in a nursing home or I have put my loved one in a facility? Will that person remember me if I skip a day? Will that make a difference? A lot of guilt, a lot of love, but the love was always really paramount. And so I think it was important to honor some of that in the first half of our concert. One of the things that I've learned in some research on dementia and music therapy is that it is those younger songs, the things that help give us identity, national identity or social identity, family identity. Some of the things that we experienced as young people are the songs that really bring the strongest responses. Even if people are non verbal, the songs can draw them out. They'll sing along, they remember the lyrics where they might not remember a family's name. So it was important to keep all that in mind, no matter who was sitting in the audience that night, that we were trying to honor, some of the things that might bring them pleasure, no matter where they were in their journey.

Dr. Lisa Belisle:

How was this performance different from other performances that you have done either with the Choral Arts Society or with other organizations.

Andrea Graichen:

This one involved some outreach, which the Choral Arts Society hasn't really done. A lot of it was a partnership from the start with the Alzheimer's Association. So it was a very clear goal that we wanted to help them. They, in turn, helped us get the word out about the concert and were totally invested in what we were doing from the start. But it was different. It felt different that we were not just performing music, but there was a very particular purpose in mind. We also had a lobby gallery of some therapy ideas for people. We had Kate Beaver, our music therapist, on the panel, who was available to talk to people. The Alzheimer's association was there. We had photos of an early stage activity group from the main chapter in Scarborough. Pictures of doing wonderful things, hiking and art therapy, snowshoeing, skiing, and how brave are these people living their lives knowing what's coming? So we had displays of that. We had a photographer displaying pictures of his dad. That was his way of processing his own feelings, going into the nursing home to see his dad. We had a list of memory cafes, which are safe places where people can go and share their experiences. The social networking, I think, is very important for them. So if people want to investigate where some of those memory cafes are, I think it's available on the Internet. What else did we have? We had Judy Prescott's family there with some of her poetry books. We had a display from the Harmoniers Chorus group up in Brunswick. It is comprised of dementia patients and their caregivers, and they are wonderful. I got to hear them perform at a state education conference, and they are really good and fun to watch. They memorize their music. It's all right there and it's so fun. They get such joy out of singing. So we had a lot of things available for people. They could take information home with them. They could take the program home with them that had the information in there as well. It was a very different program from Corel Arts Society with the outreach and a lot of moving parts, but it gave us a model for what we may do in the future if we want to try to do some innovative programming. We've done collaborations with other arts organizations, ballet, opera, organ. But this was the first time we ventured into more of a social outreach purpose.

Dr. Lisa Belisle:

What do you have coming up for the second part of 2015?

Andrea Graichen:

For myself personally, I have early music concerts. The Choral Arts Society will be singing with the Portland Symphony in October. And then we move on to our Christmas at the Cathedral weekend. The first weekend in December, we Have a Messiah Sing along, which is very popular.

Dr. Lisa Belisle:

Andrea, I'm not sure everybody knows how early music is defined, so if you could tell us what that is and why are you attracted to that? What is it that this does for you in general?

Andrea Graichen:

Absolutely. I am not an expert by any means in early music, but I was invited to in an ensemble that does perform that particular genre. So I've been learning on the fly and learning a lot and having a great appreciation for what these musicians do. There are what are called baroque instruments, different types of violins and bows, violas, early cellos, which are called viola da gamba, which are different. We have a wonderful lutenist who plays with us, plays lute and Theorbo, and I love to listen to them play. It's a different style. It's a very dry style. Not romantic necessarily, but what was appropriate in, say, the 1600s, early 1700s. We have even performed some pieces in one of my ensembles as early as the. The eight hundreds. And it's fascinating to think what would be historically accurate, what would be correct in singing. There are different styles, for example, different ways to treat some of the music that would perhaps harken back to that time. The languages we sing in. Italian, German. We've done some Spanish, French. Some of the French is early French. It's not what you might hear today. So that's a learning process as well. I think what I like best about that is making that music available here in the Portland area. It's unusual. People don't get to hear it all the time. For example, this past weekend, we performed music by Monteverdi. He composed a wonderful mini drama about love in a loving way, but also in a bit of a combative way. He wrote for the first time some of the darker sides of love, and it was fascinating to bring that to life. One of the focal pieces was the story of a warrior who fell in love with a woman, but she also dressed as a warrior, and he did not know that. And they battled each other, and she happened to succumb to a mortal wound, and he took her helmet off and realized it was the woman he loved. So there was a wide range of emotion in that. A lot of that type of music and express was heard for the first time when Monteverdi wrote that. And we paired with the Portland Ballet Company, had two dancers tell the story through dance as it was being sung. And it added a wonderful element for the audience and for the performers as well. We got to see a dancer interpretation, singer interpretation, musician interpretation of early music. The audience loved it. I loved made such a difference to hear that music brought to life here in Portland, but also with a dance element as well.

Dr. Lisa Belisle:

It seems like there may be a future collaboration, maybe with the Alzheimer's association, but maybe with other social groups. But if not, people can certainly experience the joy of the Choral Art Society work. How can people find out more about the Choral Art Society?

Andrea Graichen:

They can find us on the web@www.choralart.org. they can also send an email to inforalart.org or call our number at 828-0043. Anybody could investigate our performances or audition opportunities if they'd like to be part of the organization or contact us if they'd like to volunteer and find out more about us.

Dr. Lisa Belisle:

Well, those of you who are listening, who are singers and have been singing in your shower for years, but would like the opportunity to actually have a greater voice, maybe this would be me. John John McCain is pointing at me.

Andrea Graichen:

Great.

Dr. Lisa Belisle:

I encourage you to look into what's being done with the Choral Arts Society. This is certainly something I have learned a lot about during our conversation today. Andrea We've been speaking with Andrea Gration, who is on the board of directors with the Choral Arts Society and also a frequent soloist in the greater Portland area. Thank you so much for doing what you do.

Andrea Graichen:

Thank you very much for having me. It was great to talk to you.

Dr. Lisa Belisle:

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Dr. Lisa Belisle:

As a physician who has patients suffering from dementia and also family members who are caring for these patients, and also as a woman who has a grandmother who suffered from dementia, I'm very interested in the topic of dementia and Alzheimer's. Today we have with us Bill Kirkpatrick, who is the program director for the main chapter of the Alzheimer's Association. Bill received his master's of social work from Boston College in 1978 and a certificate in bioethics and health policy from the Niswanger Institute of Bioethics at Loyola University in 2010. He has over 30 years experience in health and mental health. He lives in Brunswick. Thanks so much for coming down and speaking with us today.

William Kirkpatrick:

Thank you. I'm very happy to be here.

Dr. Lisa Belisle:

Now tell me a little bit about your interest in this. If you have more than 30 years of experience in health and mental health, you probably could have chosen any number of places to focus your interests, but you've chosen this one. Why is that?

William Kirkpatrick:

Well, my wife and I moved up to Maine a little over three years ago, and part of our preparation was finding work. I had recently taken, quote, early retirement package from my previous work, which was in a health system in Rhode Island. And the one thing I did know is I did not want to work in an acute care setting. And so much of what happens, I think, in life is timing is everything. And there were only two jobs available. One was in a hospital and the Alzheimer's Association. Originally it was the manager of education. And the more I learned about the association and the more I learned about the mission, it just seemed like a perfect fit for my interest and my passion. And it turned out to be absolutely that. It's a wonderful organization. And ironically, again, it was almost chosen for me and I think it turned out to be a great connection. So I'm very thankful of that.

Dr. Lisa Belisle:

What has your experience been with the diagnosis of Alzheimer itself and the caregivers of people who have Alzheimer's?

William Kirkpatrick:

Well, by virtue of working in the social work field for 30 years, mostly in health settings I've worked with in the acute care setting. People with Alzheimer's are another form of dementia. I served as the social worker in a memory loss clinic at a hospital in Rhode island for a period of time, and that's really where I started to get a little bit more of an immersion in what the impact was beyond the diagnosis on families and people with the disease. And in all settings in the hospital, I had some exposure, some connection in working with people. It really wasn't until I started to work for the association, though, that I was able to do much more of a deeper exposure or research into what it means to have the diagnosis and what it means to live with dementia and the long term impact on caregivers and families.

Dr. Lisa Belisle:

There are other forms of dementia other than Alzheimer's. There's small vessel disease, there's other brain issues. Does your chapter of the Alzheimer's association, do you deal with patients and caregivers who suffer from those diseases as well?

William Kirkpatrick:

Yes, we do. The formal title of the association association is the Alzheimer's association and Related Dementias. And my understanding is that There are over 70 different types of dementias that have been identified. Alzheimer's is the most common form, represents about 60 to 70% of all dementias. So in this country, over 5 million people are living with Alzheimer's disease. In Maine, it's about 26,000 people. And if you combine the other dementias in Maine, it's another 10,000 people who are living with another form. Vascular dementia is the second most common type. And many folks end up being diagnosed or living with both, which we refer to as a mixed dementia. And then there are other forms, such as frontotemporal dementia, very complex disease, Wernicke, Korsakoff's dementia, Lewy Body dementia, Parkinson's dementia. So all of those folks are served through the association and we're able to provide some education and resources for anyone who's living with any type of dementia.

Dr. Lisa Belisle:

Going back to my own family situation, my grandmother was quite old when she passed away and she didn't have dementia until, until the very, very end of her life. And that's the way we often think of dementia. She was in a nursing home. My mother was around to care for her. My uncles were around. Our whole family was able to kind of collaborate in that way. But then I also have had patients recently who are relatively young, in their seventies. They have dementia. They need to move from their home to maybe the home of a child to be cared for in the longer term. Tell me what your experience has been with that and what services you are able to offer through your chapter.

William Kirkpatrick:

Well, we understand Alzheimer's disease in a series of stages. There are seven discrete stages, but we usually think about them in terms of early, middle and late stage. And the typical picture I think, that many people have is of the older Person in a wheelchair, in a nursing home, sort of disconnected and not able to provide care for themselves. That's certainly true, but that's only one aspect we emphasize, early detection. We emphasize that people need to pay attention to the signs that may mean that someone is having a sort of early signs of dementia. So one example of a program or service that we provide is education around know the 10 signs. Early detection matters. So our goal is to reach people earlier for several reasons. One is that there is information and resources that they can take advantage of. People can begin to plan for their future and participate in that planning ahead of time because this is a progressive disease that ends in death. There's a lot of preparation and planning. And a big part of what we do through the association and our helpline services is to help people anticipate what will happen as a result of progressing through the stages over the number of years. So that includes legal and financial planning, safety planning, paying for care at home or in a long term care facility, providing care, care and support for care partners and caregivers. That's a huge issue, a huge impact on families. The stress of caring for someone with dementia is enormous. So lots of our services and emphasis is on providing support for the caregivers. It's a matter of trying to tell those stories and raise concern and awareness. Early on in my professional career, I worked on an oncology unit 30 plus years ago. And in those days, similar to what's occurring now with Alzheimer's, there's a huge amount of stigma and fear that kept people away from getting a diagnosis, kept people away from getting treatment. And that's certainly changed over many years. We see very significant success stories in terms of treatment for many different types of cancers and hiv, for example. Alzheimer's still carries with it a huge burden of stigma and fear that does keep people away from treatment. So a big part of what we do is to try to raise that awareness and provide hope and access to services. So through the events like the Choral Art Society or other people programs, that gives us that chance to sort of be out there and connect with people earlier and earlier. So that's hopefully where we're going to continue to go.

Dr. Lisa Belisle:

The Choral Arts Society event was pretty special. Something that hasn't been done here in Maine before.

William Kirkpatrick:

No, I understand it was the first production in Maine of that work. And we were very fortunate to have the creator of the Alzheimer's stories, Robert Cohen, with us on May 9th for the event. Prior to the event, there was a slideshow, there were some invitations sent out to families to send pictures in to be able to display of their loved ones who are either living with dementia or have died from Alzheimer's or another form of. Of dementia. The panel included Robert Russell, who is the choral director. Robert Cohen. Tom Prescott, whose sister, Judy Prescott, wrote a beautiful work of poetry called Searching for Sisi, which is poems and artwork in honor of her mother, Their mother, who died of Alzheimer's. She unfortunately had laryngitis that night. So Tom was there reading poetry, and that was sort of incorporated in the musical work. And then there was the production. That was really very special, very powerful way to tell the story of Alzheimer's disease.

Dr. Lisa Belisle:

The interesting thing about doing work with the Choral Arts Society about music is that we know that music actually does do something with the brain that actually brings back memories in some ways. So you're doing something that is raising awareness, but you're also doing something that is helping the people who actually have dementia.

William Kirkpatrick:

Absolutely. One of the other panel members was Kate Beaver, who is a music therapist. And she was able to articulate very clearly that power of music and that in many ways, music is one of the last connections or last abilities that people have probably right up to the end of their life. And it is amazing to see the impact that music has in all forms on the person's ability not only to sort of get connected with more of those remote memories, but get in touch with happiness and joy and sort of that connection with people around them. So there are some very interesting, more and more programs out there that are using music therapeutically to help stay connected with people in the later stages of the disease. So I'm not a music therapist, so I can't talk a whole lot about the nuts and bolts of that. But it is something that we hear, hear all the time. That and artwork, any sort of creative arts, really is very therapeutic and helps provide that sort of positive connection with people throughout the disease. Not just end stage, of course, but throughout the disease.

Dr. Lisa Belisle:

We've heard about right brain, left brain, and how one has to do with the more creative aspects of ourselves. One is more organizational. Is there some sort of relationship between dementia and right brain, left brain? And is that brought out by the music itself when it's played or heard?

William Kirkpatrick:

Well, my understanding is that there is no one site in the brain where music resides per se. I'm not an expert on this, but that it's more of a global phenomena if you. And that music also allows access to more remote memories or pleasure because of the context of music in people's lives. There's a very powerful documentary called Alive Inside, which tells the story about a project started by a social worker down in a long term care facility on Long Island, I believe, in which he provided ipods to residents there with advanced stages of dementia. And music that families told the social worker this resident really loved in their life were loaded onto the ipod. And it's really remarkable to see the almost immediate connection when that ipod is turned on and there's music being played. So I think there are. The reason why it's accessible even late into the disease is because it's sort of connected to different parts of the brain in different ways. It's the creative part, certainly, but it's also connected to emotion, an emotion, whatever that emotion is, often lasts right to the end, probably to the end of the disease as well. That has real relevance for providing training for caregivers, both professional and family caregivers. Because while cognitive memory fades, emotional memory does not fade. So we do a lot of training around the hippocampus, which is where early memory is formed, and the amygdala, which is the emotional center of the brain. And that we can't rely on memory for caring for people or connecting, but we can rely on that emotional connection and to pay attention to that throughout the disease. Music is one way to sort of tap into that emotional side of the life, emotional side of communication.

Dr. Lisa Belisle:

My observation is that there's not right now, the therapies that we have, medical therapies are not as useful as hopefully they one day will be. So we actually need to rely on therapies like music and art to help people and the people who are caring for them.

William Kirkpatrick:

Exactly. We do have some drugs, some medications that can help symptomatically. But Alzheimer's disease is a fatal disorder, fatal disease. It's now the sixth leading cause of death in this country and in Maine, and it's on the top 10 list. It's the only one that does not have a cure nor any disease modifying treatments. So the drugs we do have do help some people for a period of time, time, with improving memory, maybe improving or reversing some of the social isolation that occurs. But more drugs are needed and that's the connection to research, of course. And while those medications are helpful for some people, it is other forms of therapies that are really needed, such as music or other kinds of creativity. It's the way that caregivers also understand how to maintain that communication and understand behavior as communication. So as language fails, we need to rely on other forms of staying in contact or communication with people. So there is a lot of knowledge and aspects of that delivery of care. That's something also that we provide.

Dr. Lisa Belisle:

one of the things I remember about my grandmother being sick was the loss that I felt that my mother felt that this was a person who had been so vibrant. She was the oldest in a large Irish family, South Boston, just spitfire, one of the first women in her family to become educated, college education. She was a nurse. She was stationed out at Fort Williams where she met my grandfather. And so to lose that person and lose that woman and then even to not be able to introduce that woman to my children and it was so insidious. You know, you didn't really know that one day you would have Nana and then the next day she wouldn't be there anymore. You didn't even know when it was time to say goodbye. And I'm wondering if music or some of these other therapies that you're describing can somehow be of comfort, somehow be soothing.

William Kirkpatrick:

I think they can. It's certainly a way for children or grandchildren or others to stay connected or have that connection and see the impact, the positive impact on the person with dementia. But that loss that you described is something that is pervasive, is insidious. And I think that it's a process that takes place throughout the progression of the disease. So it's not something that happens sort of at a moment in time and then it's gone. It's sort of a continual process. So that there is that theme of loss and so anyway, that we are able to help families, including children and teens from staying connected with their parents or their grandparents who are living with the disease is very powerful and very therapeutic for them as well. So we would be available to help families, including families with younger children, to find ways to maintain that communication or stay connected with the person living with dementia and deal with the loss and depression and concerns that they're feeling.

Dr. Lisa Belisle:

That sounds like a very valuable resource. I'm also thinking about this early detection that you've described because I know that patients who come in to see me who have a family member with Alzheimer's, they will often say, I just can't find my keys, or I can't find the name of a person that I have met once before on the street. And we're not talking about that kind of memory loss. We're not talking about you can't find your keys. I mean, most of us have those moments. It's if you don't remember that you had keys, you know, it's much bigger things than that.

William Kirkpatrick:

Exactly.

Dr. Lisa Belisle:

To be afraid to bring this up to your doctor, I think is. Well, just. I would like people who are listening to know that we can maybe help with some of those fears.

William Kirkpatrick:

Exactly. One of our signature education programs is part of our early detection alliance or initiative across the country. And that's know the 10 signs early detection matters. And in that program, and also through our helpline, as we talk to people who are calling who might have some worry about their memory or talking about those signs, we want to differentiate those kinds of things that happen to all of us as a result of normal aging and the signs of a potential to dementia that is not part of normal aging. So it's a great example. Misplacing an item or forgetting a name happens to all of us. We're all slower cognitively and physically as we grow older. But it's really those changes that occur that begin to interrupt daily life and interrupt the person's ability to live their life normally. So the early detection part of that is there are lots of reasons why memory might be impaired. Not necessarily Alzheimer's disease. There are lots of medical conditions that are life threatening that can cause some of the symptoms that we see. So please go to your physician and check it out and be able to get the help and find out whether in fact it is something that's momentary or normal aging or sort of a red flag of something else. We also advise family members to go with them, particularly because if we're talking about a memory impairment, it's important that the practitioner, the physician or other practitioner get the whole story, the whole history. And there may be gaps in that person's ability or knowledge or memory of being able to share with them what's been happening and how long it's been happening. So folks usually start with their primary care physician or practitioner and then move on to other diagnostic workups if necessary.

Dr. Lisa Belisle:

So what are some of the 10 things for people to be paying attention to? And I'll just send people over to your website to learn all of them. But what are some of the signs?

William Kirkpatrick:

Well, memory loss is sort of the signature sign of Alzheimer's disease. And that's because the part of the brain that is responsible for taking in newly learned information is first affected by the disease. It's changes in the ability to plan or organize, some language problems, some, some word finding problems, and eventually some difficulty in writing. Visual spatial changes in relationships. It's always important to check out our vision, but what I'm referring to is the part of the brain that's responsible for taking in input and sort of interpreting it in terms of vision that begins to be affected. Balance and equilibrium, difficulty with calculation. So balancing the checkbook, for instance, may be impacted. Judgment and reasoning are impacted. Mood and personality are impacted. So there are a number of these that can be again, red flags for another condition, maybe dementia may not be. But we urge people to check it out and not be afraid to, to talk about it and go see their physician.

Dr. Lisa Belisle:

And as you've pointed out, there are some things, some medical things that can cause memory or other issues. And in fact, some of them may be reversible. I mean, there is something called delirium. People can come in and have a urinary tract infection if they're older or some other type of infection and actually be delirious. And we can actually fix that.

William Kirkpatrick:

Absolutely.

Dr. Lisa Belisle:

And they aren't going to progress to dementia. So that sort of thing should always be checked out.

William Kirkpatrick:

Absolutely.

Dr. Lisa Belisle:

Tell me how people can find out more about the main chapter of the Alzheimer's Association.

William Kirkpatrick:

We have a toll free number for immediate Access and that's 1-800-272-3900 and our website is alz.org Maine and that'll get everyone to the chapter. But calling that 800 number 24 hours a day gets people immediate access to master's prepared clinicians who can provide information, referral resources, but also care consultation, which is just spending the time to talk about their respective situation and help them begin to plan. It's a free service it's an unlimited service. We don't bill anybody. We're voluntary healthcare organization and so it's here for people in Maine to get access to right now.

Dr. Lisa Belisle:

Well, I've actually learned quite a bit today, so it's really wonderful that you were able to come in and speak with us. I've been having a conversation with Bill Kirkpatrick, who is the program director for the Maine Chapter of the Alzheimer's Association. Thank you so much for all the good work you're doing for people here in Maine. This is a tough, tough thing that you're working on and I'm sure that what your organization is doing is very important.

William Kirkpatrick:

Thank you very much. Thanks for this opportunity to talk about it.

Dr. Lisa Belisle:

You have been listening to Love Maine Radio show number one 99 Music and Memory. Our guests have included Andrea Gration and Bill Kirkpatrick. We love to hear from you, so please let us know what you think of Love Maine Radio. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring Love Maine Radio to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed our Music and Memory show. Thank you for allowing me to be a part of your day. May you have a bountiful life.