With 32 years of caring for people with dementia, Barbara Kalt is constantly scouting for new ways to get through to the clients who come to her program each day.
Inspired by the award-winning 2014 documentary "Alive Inside," she's now adding "personalized music" via iPods and individual playlists to the array of activities offered at Rosener House, the Menlo Park day program for adults of which she has been executive director for two decades.
The house at the edge of the city's Arbor Road Park provides daytime activities for about 100 people the youngest in his late 40s aimed at reducing the social isolation of people in various stages of Alzheimer's disease or other forms of memory impairment.
"This will be another tool for us to learn about them," Kalt said in a recent interview at Rosener House, where volunteer Steve Marchick was busy creating playlists for clients that include everything from traditional Episcopalian music to the heavy metal band Metallica.
"We can talk about Big Band music or Cat Stevens. There are so many musicians that people really love, and that's a great topic for conversation," she said.
The use of music therapy is nothing new for Rosener House or similar programs, which for decades have employed professional musicians to reach out to memory-impaired adults.
But the ability to match songs with individual preferences offers the possibility of penetrating the fog of dementia at a deeper level.
"This music is so personal it just strikes right to your heart and your emotions all those things you remember about that music," Kalt said.
In the movie "Alive Inside," a bedridden patient, non-communicative for two years, begins to move her feet and head after being fitted with headphones that played music her family said she had loved.
"Music has more ability to activate more parts of the brain than any other stimulus," neurologist and author Oliver Sacks says in the movie. "For the patient with Alzheimer's it has to be music which has a meaning for them and is correlated with memory and feeling."
Social worker Dan Cohen, who is featured in the movie, began creating personalized playlists in 2006 for residents of the New York-area nursing home where he was a volunteer. Excited by the results, he mounted a larger effort through a nonprofit called Music & Memory, which he created in 2010. Cohen is on a quest to make personalized music part of the standard of care in the nation's 16,000 nursing homes.
"Alive Inside," which documents his work, won the Audience Award at the 2014 Sundance Film Festival.
Academic researchers in Wisconsin are examining the impact of personalized music on the behavior of nursing home residents, including their levels of use of anti-psychotic and anti-anxiety drugs. The Wisconsin Department of Health Services has funded the Music & Memory program in hundreds of nursing homes across the state.
Locally, Kalt and her staff moved to add personalized music to their offerings after seeing "Alive Inside" at the Fox Theatre in Redwood City last year. Rosener House, a project of Peninsula Volunteers, Inc. recently became the first adult day program on the Peninsula to be certified as a Music & Memory provider.
Volunteer Marchick is building playlists based on questionnaires that have been returned by clients and their families, which asked for things like favorite songs, genres, performers, Broadway musicals, hymns, military music and dancing styles.
Requests so far include swing and ballroom music, Elton John, Joan Baez, Aretha Franklin, Episcopalian service music, Lionel Ritchie, Mahalia Jackson, the Honolulu Symphony, Glenn Miller, "I Love Lucy" music, Beethoven, Metallica and World War II marching bands.
"We've had a lot of CDs given to us and we'll also download directly from iTunes for genres we might not have, like marching band," Marchick said.
Rosener House will continue to offer professional music therapy in addition to other activities, such as exercise, discussion groups, a therapy dog, art and physical therapy.
On a recent Thursday morning, music therapist Maggie Grady sat with her guitar and a circle of 15 clients. She quizzed them on ideas for snow-themed activities as she began improvising "our favorite things about winter" to the tune of the familiar Rodgers and Hammerstein song.
Rosener House regulars also sing along in groups to standby favorites "Let Me Call You Sweetheart," "You Are My Sunshine," "This Little Light of Mine" and "Jingle Bells."
Kalt expects the iPods and personal playlists to find their niche as calming tools.
"Some people have a certain time of day when we know they're going to get a little anxious," she said. "They'll start walking around, trying the doors, saying, 'Well, I think it's time to go home now.'
"We can talk with them and redirect them but this (music) would be a pre-emptive kind of thing to prevent that kind of behavior and keep them happy, engaged and soothed in a certain way that they'd be content to be here rather than think it's time to go home."
In many cases, a nursing home is the next step for people who leave Rosener House. "We're really hopeful this will help keep people in the (day) program longer and avoid that kind of (nursing home) placement," she said.
Contributing Writer Chris Kenrick can be emailed at firstname.lastname@example.org.