A session with an early Alzheimer’s study group

The presenters were one staff member and one musician.

Before we identified what we would do for this group, we asked the organizers for information about the participants. So this is what we knew:

They hadn’t done movement to music.

They really respond to rounds, becoming more aware of the group and interacting more, which makes them feel more connected and less isolated.

They like recognizing songs.

They have trouble putting responses into words, similar to those with dementia.

They respond well to reassuring songs, music in three, and marching or other movement to Irish/fiddle/ dance music.

If you ask, they may not say they know a song, but if you play it they can hum along and some know the words.

They may need visual cues to remember what they are supposed to do.

They respond well to activities that reduce stress and anxiety.

They are glad when you give them attainable tasks and where they can be successful.

Some may have trouble following directions due to processing or hearing issues, but will be able to follow you if you model the action you want.


So here is the script for what we did:

Our focus for this presentation was the use of breath to enhance resilience and reduce stress

Setup: Give each participant a handout and sterilized one-inch PVC pipe. Have a side table for viola and violin cases. Bring a music stand and stand light if needed. All the participants need chairs, with space between them to allow for standing and arm movements.

 We are introduced.

Hello everyone, and welcome! You should have a handout [hold it up] and one of these little pieces of tube [Hold it up in your left hand] that we will be using to practice a new type of breathing to get you more air with little effort. [Check to see if everyone has these things]

Our main topics will be body posture and breathing.

Have you ever practiced different types of breathing in your yoga classes? Have you ever done Alexander technique? Pilates?

[ Attention to breathing can offer a stable point of focus, and keep you in the present moment. Sometimes staying in the present moment, particularly when you are stressed, is the only way to find rest. It helps to clear your head, quieting your mind so you are ready to do your best. It helps you to take in what is occurring around you. It enables you to handle whatever comes your way.]

  • Let’s start by making a self-assessment. Without changing anything in your breathing, I want you to notice how you are breathing at this moment. Do you feel expansion in your lungs? Where? Notice your posture: how are you sitting? Is your back resting on the back of the chair? Is your spine curved? How are your legs positioned: are your legs crossed or are your feet on the floor? Don’t change, just observe and make a mental note of it. Now count how many beats you take as you inhale, how many beats as you exhale. How many counts in? how many counts out? Look up when you are done. This is your everyday way of breathing and sitting.

Now let’s work on increasing our breath capacity and our efficiency in how we use the breath. We’ll go through a 4-minute exercise on breathing, and then pause for another self-assessment. Ready? Let’s begin.

  1. Put both feet on the floor. If you can, sit away from the back of your chair, straightening your spine and lengthening your neck, as if you are a puppet and your body, from the crown of your head, is suspended on a string.[like this]
  2. [Hold up ocean drum] Do you know what this is? [Listen to the sound of the ocean drum for a few minutes.] Imagine you are feeling the cool breeze, watching the waves build and build, crest and rush to the shore, then hissing as the cold water reaches the hot sand, ssssssss, going and going until the wave runs out of energy and begins to fall back, the water gathering and gathering, adding to the next wave as it builds and builds, crests, and rushes to the shore.[demonstrate with gestures]

Now with our breath let’s create the sound of the wave as it whooshes to the shore and hisses on the hot sand, like this: whhhhuhhhssssssss……., whhhuhhhsssssss……whhhuhhhhsssssss….I’m stopping after 3 times so you don’t get dizzy.

Now let’s give a big sigh, with the pitch going way down: \ huuuuuuuu. Again: \ huuuuuu.

Now you’re going to sing on this pitch [on violin, give a low A. Can add E] my colleague will be singing your pitch, so follow him! OK when I take a step you’re going to go down in pitch, to a G [and D] [demonstrate]. And when I step back, go back to the A [and E]. Got it? OK, keep singing. Can you sing louder? [Louder?] Now I’m going to play a tune over the pitch you are singing. Remember, when I step, change the pitch. If at any time you begin to feel dizzy, stop! Follow my colleague if you aren’t sure what to do!

  • OK now do your next self-assessment. Are you breathing through your nose? Mouth? How many counts in? Out? How are you sitting? Spine? Feet? Make a mental note of what you notice. Look up when you are done.
  1. Let’s do some singing, now that we’ve warmed up a bit.

Sing Rounds: Are You Sleeping combined with Row Row Row your Boat. High Ho, Shalom Haverim, Dona Nobis Pacem.  End with Take Me Out to the Ball Game

  1. Now let’s talk about two different types of breathing:

The Warming Breath: How would you warm your hands? [Breathing is with wide open mouth, short fast breaths]

The Cooling Breath: Now try cooling soup. How would you do this?  Try breathing with pursing of the lips controlling the airflow. The cooling breath has less volume but lasts longer than the warming breath. Imagine holding up a lit candle at a distance in front of you, and try to make the flame move.

Open Airway:  Hold the tube in your left hand and pretend you are about to drink something. Feel the cool air in the back of your throat? This gives you the sense of the open airway. And you do it automatically. Now place the tube between your teeth, with your tongue underneath. Breathe in and out through the tube. What do you notice? Listen to the sound the air makes. In, out. In, out. Can you make it quieter?  Let’s stop after three cycles so you don’t get dizzy! You automatically open up the back of your throat, so the device helps you practice and reinforce this.

Breathe through the tube. Listen to the sound of the air going in and out. Now try to get the sound to match going in and out. Now count to three going in, then three out.  Again, stop after three cycles so you don’t get dizzy!

  1. Now let’s try this when you are walking. Time to stand up! Hold the tube up to your mouth, between your teeth, tongue below the tube. Got it? Walk in place, breath and count three in, three out. Follow my colleague if you aren’t sure what we are supposed to be doing! Keep going!

Play increasingly fast music in 2 or 4.

 Breathe in 2, out 2. Now let’s try something in three to see if that works better for you. Is that better?


Have a seat now. Any questions?

Thanks for your good work!

End with Skye Boat Song or something else peaceful

 Questions for reflection:

What would be your goals for a session with this group?

What activities would you do, and what music would you play?

Who could help you with planning?



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