Talking about the emotional healing power of music may sound like hippie New Age stuff, but it’s scientifically proven fact, says Teppo Särkämö, Professor of Neuropsychology at the University of Helsinki.

“Elements of music such as melody, rhythm, lyrics and emotional content have been shown to help in rehabilitating patients who’ve suffered strokes or have other neurological disorders,” he says. Music is a useful tool in rehabilitation from various forms of cerebrovascular disease, a variety of medical conditions that affect the brain and often cause dementia.

And for those already affected by dementia, hearing beloved old songs can open a brief window of joy, memory and togetherness. That can be dramatic – and it is witnessed regularly by those who bring musical events to old-age nursing homes.

That includes Maria Kalaniemi, one of Finland’s best-known folk musicians, an integrative therapist and a teacher at the Sibelius Academy. She performs as a duo with fellow accordionist Elina Leskelä, a teacher at the Espoo Music Institute.

The two have been playing together for nearly 50 years, and for the past five years performing as HoivaPelimannit (roughly “the caring folk musicians”), making weekly visits to care homes in Espoo.

“Both of our mothers have had Alzheimer’s disease, which gave us the idea of bringing music to those who can’t get out to the concert halls to hear music. We all need music and stimulation.”

Also bringing old-timey sounds to residents of old-age homes is Olli Suutela, a freelance musician whose alter ego is DJ Old Crank, playing songs mainly from the 1920s onward on a hand-cranked gramophone.

“I’ve been DJing with the wind-up gramophone and shellac records since 2018. Early on, it was evident that the machine and the music appealed to elderly people. It didn’t take long before a friend and fellow DJ asked me to play at the nursing home where his mother lives. That’s how it all started,” he explains.

Like HoivaPelimannit, Suutela’s repertoire centres around songs made popular by singers like Olavi Virta and the Harmony Sisters from the 1930s through the 1950s – when most of today’s nursing home residents were kids and teenagers. And like the accordion duo, he sees intense, deeply heartfelt responses to the music. Dear old tunes often inspire nursing home residents to dance, sing along and share long-forgotten memories.

In Särkämö’s view, it’s clear that such relaxed musical gatherings are valuable and therapeutic.

“These accordion and gramophone music sessions are highly useful for people with dementia,” he says. “From the neuroscience perspective, the familiarity of music plays a key role in dementia. Playing songs in the original versions or sounds is important in supporting their recognition and strengthening the emotional response that the songs elicit in the brain. By bringing back memories and facilitating reminiscence, it also serves a valuable purpose of supporting communication and interaction within the care home residents and staff.”

Regularly enjoying music may slow the normal cognitive decline associated with aging, Särkämö says. His research suggests that active playing or singing – especially in a choir – can be helpful, particularly for people in the early stages of Alzheimer’s.

Meanwhile, a study in the UK showed that regular musical hobbies, such as dancing or playing an instrument, reduced the risk of developing dementia.

Brief moments of comfort

Music-related memories can be preserved despite the advance of Alzheimer’s disease. This may be related to the function of the inner parts of the frontal lobe, which process emotions and autobiographical memories.

Brain degeneration does not typically reach the inner parts of the frontal lobe until the final stages of the disease. Therefore even some individuals with severe dementia can experience music-related emotions and memories.

Särkämö says he has seen people with severe memory disorders burst into song when hearing familiar tunes.

“Familiar songs can serve as triggers to remember names and other long-forgotten details about people,” he says.

While such moments don’t slow the progression of the disease, they can be tools for emotional expression and communication. And although these moments may be brief, they can be comforting for patients and their loved ones.

In one of his studies, caregivers and relatives of people with dementia used musical listening and discussion as part of their daily care during a three-month period. During a follow-up period, the patients who listened to music and sang had better cognitive abilities and attentiveness than a control group. They seemed to have clearer access to memories from their youth, with music serving as a link between past and present, says Särkämö.

“Meanwhile, some stroke patients who aren’t able to speak can nevertheless produce words through singing,” says Särkämö. That’s because speech mainly relies on the left hemisphere of the brain, while singing uses both. Therefore, it can help some patients gradually regain the power of speech.

Tailored songs for stroke survivors

Building on that, Särkämö is now working with singer-songwriter Heikki Salo on a research project using tailored songs in an effort to help rehabilitate stroke survivors.

The aim is to create an enjoyable music-based rehabilitation programme that patients can use at home, in parallel with standard speech and physical therapy. If all goes to plan, it should enhance verbal, motor and cognitive functions, including their memory and attention span, while also boosting mood and outlook.

“The programme is implemented mainly by self-training at home using a tablet and training videos but includes also weekly remote sessions with a music therapist,” explains Särkämö. The clinical trial began in February and will continue until 2027.

Salo is best known as lead singer of the rock band Miljoonasade, which he started nearly 40 years ago. He has also penned songs for many other musicians and released solo albums, collaborations with pianist Iiro Rantala and songs for children, including a musical preschool material and book. Salo also teaches songwriting courses, including for people with disabilities.

Salo drew on this background as he crafted songs for the project, focusing on themes that are central to stroke survivors and using target words that aphasic patients – who have little or no ability to speak – can train through singing and melodic intonation therapy.

“I aimed to write so many songs that there would definitely be enough relevant tunes among them. I felt like a duck hunter standing in the middle of tall reeds who can’t see properly around him. Sometimes it’s best to shoot in all directions and then collect the catch at the end of the evening, or maybe the next morning in daylight,” says Salo with a chuckle.

“I prepared for the project by carefully studying the subject for about half a year. Then I sent Teppo some ideas for songs. He and his team picked the most suitable ideas, and then I really got to work,” recalls Salo. He included key words identified through research as being crucial for rehabilitees, which in turn suggested song themes.

“In the lyrics, I tried in some way to touch the person who would sing the songs, including the rehabilitees and their loved ones,” says Salo.

Better than antidepressants

Kalaniemi and Leskelä clearly touch the residents of the old-age homes, inviting them to sing along and dance to chestnuts from the 1930s like Tulipunaruusut (“Fire-Red Roses”) and Satumaa (“Fairyland”).

“There’s something incredibly moving when the residents help each other get up to dance and the nurses are watching in the background, wondering if they’ll stay upright. But they’ve always stayed upright and had such joy from dancing and being together. Moments like this can be the equivalent of many antidepressant pills,” says Kalaniemi.

Kalaniemi’s mother suffered from Alzheimer’s for 10 years, during which time she became frustrated with the lack of social or other stimulation on offer for nursing home residents, especially during the pandemic years.

In these budget-cutting days, such facilities cannot afford to pay for such performances. Suutela’s visits are on a voluntary basis, while HoivaPelimannit get a minimal support from the city of Espoo, playing almost every Friday atone of the city’s old-age care homes.

“If I could, I’d be happy to quit all my other jobs and do just this,” says Kalaniemi, who has played around the world since the 1990s and is artistic director of Espoo’s JuuriJuhla festival.

“Many students of mine at the Sibelius Academy are also interested about this kind of work. Not everybody wants to perform onstage or to be a star. This is also a way to do music and help society at the same time, so I’m really happy about that. Elena’s students at the Espoo music school are also interested in going to play at nursing homes.”

Meanwhile, the idea is spreading. Kalaniemi has heard of similar projects in the cities of Turku and Savonlinna, and has hopes for a book or film to share the duo’s experiences. She also urges more collaboration between musicians and researchers.

“These stories need to be heard”

“When you go to these nursing homes, you never really know what’s going to happen. It’s such a human moment and we learn a lot. Each of the people in these homes has their own story, wonderful or not so wonderful, but we hear them during these visits. Many of them were children during the wars, so there are some traumas,” says Kalaniemi.

“There’s one wonderful resident who always tells us how she used to climb out of her window to go to dances, even though it was forbidden. Her mother was very strict, but she had such a terrible passion for dancing. These stories always thrill us, and these stories need to be heard.”

“Sometimes we get asked to play songs that we’ve never played. But if you can remember even a few parts of a song, that can be really important to someone. Even if it’s incomplete, it can be a really big moment,” she says, adding that that the duo makes an effort to learn such lost songs afterwards so they can play them properly on a return visit.

“There’s a wonderful old waltz called Rantakoivun alla (“Under the Shore Birch”) that always makes me think of one resident in a care home who couldn’t speak. But when we asked for their favourite songs, we figured out from the way she moved her mouth that she meant Rantakoivun alla. When we started playing it, her eyes brightened up. It really touched her, and us.”

Onni Laihanen composed 'Rantakoivun alla' in 1938 and recorded it in 1947.

“Play it louder, play it faster!”

Suutela, too, has often experienced such moments.

“It’s a magnificent moment when someone who has lost the ability to speak suddenly starts to hum a melody or sing all the lyrics of a song along with the records. Sometimes just seeing the gramophone makes their eyes open. You can see that something is happening inside. The music does get their hands and feet moving. I cherish the moment when I put on Four Brothers by Woody Herman from 1948 and a gal in her tender 90s started banging her walker and shouting 'Play it louder, play it faster!'.”

“We listen, drink coffee and sometimes take long breaks to chat,” he explains. “Often, they spontaneously tell stories or memories, like when someone’s father brought home their first 'His Master’s' – that was a common term for gramophones. Someone said: ‘I remember that we ran out of needles during the war, so we used hawthorn spikes,’ while another said: ‘we only had two records, and we played them over and over again’ or ‘I remember seeing that singer at a dance hall; he wore the most stylish suit I’ve ever seen…’ I’ve heard so many great stories.”

Playing songs through a gramophone makes for quite a different musical experience, he says.

“It starts with the visual effect of seeing the shiny technology under the lid. Many of them spot the His Master’s Voice logo with Nipper the dog. Winding it up and changing the needle for each song is part of the show. And the sound is so different from today’s heavily compressed music. Even if an old record has cracks and pops, it feels like the music is truly present, as if Enrico Caruso is singing an aria in your living room or Olavi Virta interpreting tangos at your summer house.”

“I’m no scientist, but when I see someone open up their eyes and smile, or maybe a tear runs down their cheek, I know that something good is happening.”

As the population ages, more and more of us will fill care homes as the public health burden of cerebrovascular disease will grow and new care models will be needed. When we’re in our dotage, we may ask our carers to play us some nostalgic oldies. Whether they’re techno, punk, Afrobeats or gangster rap, those lifelong sounds could throw us a lifeline.

Featured photo: David Gartmann