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The Contribution of Music to Positive Aging: A

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Terrence Hays,1,3 Ruth Bright,2 and Victor Minichiello2

The Contribution of Music to Positive Aging:

A Review

LY

C 2002)
Journal of Aging and Identity, Vol. 7, No. 3, September 2002 (

FR

EA

IN

Many people value music as an important part of their everyday lives. The published literature reveals that the role of music in life is varied: it can be recreational,
educational, social, emotional, therapeutic, and spiritual. The importance and relevance of music depend on the life needs and interests of the individual and the
social group within which he/she lives. It is now widely recognized that music for
many older people is crucial in supporting a sense of well-being. The article reviews the evidence on the role of music in promoting health and well-being, and how
it can produce positive psychological and physiological benefits for individuals.
The aim of this article is to increase awareness among health professionals of the
importance of music and discuss how it can be used to add to older peoples lives.

PR
O

KEY WORDS: music; aging; well-being; health; emotions.

INTRODUCTION

FO

From preliterate times to today, music has been associated with the maintenance of physical and mental well-being. Historical evidence shows that, since
the first appearance of civilizations as far back as 5000 B.C., music has been used
to serve communal purposes, for example, religious ritual, warfare, and healing
(Davis, Gfeller, & Thaut, 1992; Storr, 1992). From China to Egypt to India and
to the golden age of Greece, there was a common belief that there was something immensely fundamental about the power of music. These civilizations believed that music could heal, entertain, control emotions, maintain social order, or
degrade the individuals psyche (Tame, 1984), and to this day music continues to

1 School

of Education, University of New England, Armidale, New South Wales, Australia.

of Health, University of New England, Armidale, New South Wales, Australia.
should be directed to Terrence Hays, School of Education, University of New
England, Armidale, New South Wales 2350, Australia.

2 School

3 Correspondence

165
C 2002 Human Sciences Press, Inc.
1087-3732/02/0900-0165/0 

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be used as an adjunct to important social activities and rites of passage (Bright,

1997; Slobada, 1989; Storr, 1992).
An important reason for exploring the meaning of music in the lives of older
people is that music is the most social of all the arts. Interestingly, the literature
shows that it is the social aspects of life that can be most affected by old age
or mental illness (Slobada, 1989). For example, people who are frail, mentally
incapacitated, or have limited mobility often may be excluded from interactions
with other people, participation in recreational and social activities, or from simply
being able to make personal choices regarding their lives. Yet loneliness and depression often can be lessened when people engage in musical activities, whether
it be solitary listening, group listening, music making, dancing, or singing (Bright,
1997; McClosky, 1985; Wylie, 1990). Music also has the potential to fill our lives
with beauty, which Kenny (1989) states, provides us with the fullest potential of
what one can be in the world (p. 77). It is this beauty that has the ability to move
us, open our hearts, and help us achieve wholeness because it connects people with
the subjective experience of meaning (Levine & Levine, 1999).
Music therapy has been shown to have a role in the care and support of older
people whose lives are adversely affected by illness and marginalization (Clair,
1996; Clair & Hanser, 1995; Storr, 1992). There is some commonality between
music therapy and everyday music for recreation, for example, emphasizing the
positive aspects of life (which remain despite frailty or illness), helping people to
build relationships with those who have similar interests, and enhancing relaxation
Publisher: Delete or physical exercise. However, these quasi-therapeutic aspects of everyday music
and close-up?
listening do not represent music therapy in its totality. The purpose of this article
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is to review the role of music in the lives of older people and highlight how music
throughout?
can contribute significantly to positive aging.
THE ROLE OF MUSIC IN HEALTH AND WELL-BEING
According to Campbell (1995), we are just beginning to realize the deep
and profound scientific, medical, psychological, and spiritual questions involved
in the power of music. It is only in the twenty-first century that there have been
extensive scientific studies regarding the potential of sound as an agent of healing
and cure. These include music as an anesthetic, and the influence of music on, for
example, synchronizing brain waves, modifying behavior, and stimulating physical responses (Campbell, 1995; Clair, 1996; Jourdain, 1997; Storr, 1992; Thaut,
Prassas, & Rice, 1992).
For most people, pain is a common by-product of illness and is reduced by
intrusive medical intervention. Maranto (1993), in outlining the utility of music in
medicine, states that it can be used to reduce stress and anxiety, pain, depression,
helplessness, low self-esteem, and to enhance immune functioning with minimal
intrusion. The outcome of the intervention of music is the enhancement of quality

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of life and possibly the facilitation of a faster recovery period. For this reason,
Maranto states that music can be successfully used in medicine because it elicits
physiological, psychological, and cognitive responses, evokes imagery and associations, and may cause physiological and psychological entrainment.
One of the most important benefits of music on personal health is that it
simultaneously affects the biomedical and psychosocial aspects of treatment (Clair,
1996; Maranto, 1993; Merritt, 1990; Ortiz, 1997; Rider, 1987). It is painless, nonintrusive, easily accessible, and cost effective. Moreover, it has few side effects and
incorporates participation as well as a sense of personal responsibility for ones own
treatment. Phillip (1994) argues that the concept of creative expression through the
arts provides health-promoting opportunities for individuals to improve their wellbeing and self-esteem. He suggests, for example, that when peoples self-esteem
is enhanced, they are more likely to live a healthier lifestyle, and this potentially
can lead to reduced dependence, fewer prescriptions, fewer repeat visits to health
clinics, and more constructive leisure-time pursuits.
THE PSYCHOLOGICAL CONTEXT OF MUSIC
Music for most people is experienced as a sense of pleasure, whether they
listen to it intently or participate in the making of it. Our appeal for music is
primarily emotional and psychological. As Anthony Storr (1990) states, music
more aptly symbolizes human processes because music, like life, is in constant
motion (p. 11). Music can excite us, move us, entertain us, soothe us and thrill us
more than most other stimuli (Scarantino, 1987).
Radocy and Boyle (1979) suggest that there are eight types of affective responses to music. Some of these relate to an innate sensory perception of sound,
while others are associated with images, past experiences, and the emotional context of these experiences. These responses may include simple feelings; negative
and positive organic feelings; activity feelings; moral, religious and aesthetic feelings; and emotions and temperaments. Although music is not physically invasive,
for many people it is psychologically the most invasive of all stimuli because it
gets into the mind, whether we want it to or not. Because of this, quality music
often can help people confront issues which they have not dealt with earlier in their
lives. This is largely because of the association between the events of the past with
a particular piece of music (Bright, 1993; Levine & Levine, 1999; Ortiz, 1997).
Under the right circumstances, music is an effective therapeutic agent because it
can align patterns of emotions, structures of consciousness and/or psychic energy (Stewart, 1990, p. 62). It does not need to appeal to logic and rarely meets
with intellectual resistance to initiate its action (Guzzetta, 1995).
Music can help us to initiate psychological movement by modifying our mental state and cuing us towards more positive affirmations, such as sad to cheerful,
discouraged to hopeful, gloomy to sunny, or tormented to peaceful. To do this

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successfully in music therapy, Ortiz (1997, p. 317) refers to the concept of entrainment, whereby music is matched to moods. Bright (1993), from her work as
a therapist, states that it is essential to gradually change the mood of the music
with the state of the individual. It must first match the individuals state and can
then be changed to allow movement.
Blacking (1990) suggests the essential quality of music is in its ability to create
another world of virtual time. The composer Stravinsky (1936) expressed the same
concept when he said music is given to us with the sole purpose of establishing
an order in things, including, and particularly, the coordination between man and
time (p. 83). Menuhin (1972) goes further when he states that music creates
order out of chaos, for rhythm imposes unanimity upon the divergent, melody
imposes continuity upon the disjointed, and harmony imposes compatibility upon
the incongruous (p. 3). Listening to music can mean creating and expanding our
internal space where we can retreat from the norms and reality of the world. This
is achieved by creating an internal imaginative world of sound which is rich in
symbolism and personal meaning, and allowing us to revisit the emotional context
of particular memories (Bunt, 1996).
Music as a medium for channeling our emotional being is trans-cultural,
given that all known cultures had/have music. This reflects peoples attraction
to organized sound, though it is the human mind that assigns meaning to sounds.
According to Slobada (1989), the reason most of us take part in music activities (be
it listening, composing, or playing music) is that music is capable of arousing in us
deep and significant emotions. These range from the pure aesthetic delight in sound
construction, through emotions such as joy or sorrow which music sometimes
evokes or enhances, to simple relief from monotony, boredom, or depression.
Blacking (1995) notes that music can transport people in a variety of ways,
such as tapping their feet or hands, falling into a trance-like state, or giving vent to
anger. However, such physical states have no meaning unless people relate them to
particular personal associations or events in their lives. For instance, such a physical
state may be linked to an erotic or joyful situation. The music itself cannot have
extra musical meaning unless the experience to which it refers already exists in
the mind of the listener. When music has such associations, it can make people more
aware of feelings they experienced by intensifying and underlining the emotion.
While Storr (1992) believes that music causes arousal only in those who desire
pleasure and meaning from it, the converse effect is true for some people. Particular
music can evoke reminiscence of painful memories or issues that they have not dealt
with in their lives. Storr refers to this arousal as being a condition of heightened
alertness, awareness, interest, and excitement. Thus it can be an enhanced state
of being (p. 4) for many, and a natural non-chemical way of altering mood. He
also claims that there is a closer relation between hearing and emotional arousal
than there is between seeing and emotional arousal.
Boyd and Campbell (1992) observe that when we communicate with the
emotional centers of our being, such as through the use of music, we can reduce

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stress and achieve a sense of well-being. And it is through our emotions that we
can create a feeling of being bonded with other people and safe within ourselves.
Music also can help achieve a sense of peace and relaxation (Ortiz, 1997). This is
because music can trigger endorphins in the human body that help the mind create
sound images, allowing people to escape into a painless world sheltered by their
imagination. Ortiz (1997) suggests that music energizes people, and such a state can
be instrumental in altering thoughts both by reprogramming old and dysfunctional
messages that may have a negative effect on their lives and by releasing guilt
feelings and unresolved angers.
Bright (1997) comments that words are often inadequate in describing our
inner responses to the music we hear. Ironically, it is music that often can help us
to express through words the problems we may be experiencing and previously
considered inexpressible. Music at times provides a long-awaited catharsis through
laughter, joy, or tears. People who have been isolated from others may open up
to share their feelings after hearing music that triggers joy, sorrow, happiness, or
pleasant memories (Kaye & Blee, 1997).

THE PHYSIOLOGICAL IMPACT OF MUSIC ON THE BODY

The literature shows that whenever we are within audible range of music, its
influence constantly plays upon us, by speeding or slowing, regularizing or irregularizing our heartbeat, relaxing or jarring the nerves, affecting the blood pressure,
the digestion and the rate of respiration (Tame, 1984, p. 14). This suggests that the
effects of music upon the emotions and desires of people are potentially vast, and
that the extent of its influence over even the purely intellectual, mental processes
is only beginning to be suspected by researchers.
The ear is the first sensory organ to develop, at about the fifth month of
gestation (Tomatis, 1991), and interestingly, the last sense to go at the end of ones
life. Some people still can hear when under a general anesthetic. It is, therefore,
hardly surprising that at birth we hear before we see (Campbell, 1995). According
to Ansdell (1995), we make and experience music because our bodies are made up
of cells, organs, and muscles that have pulses and tone, tensions and resolutions.
Emotions share with music the qualities of speed, force, attack, and intensity.
It is now acknowledged that our bodies are affected by sound in the form
of music and that this easily can be assessed by an electro-encephalogram, which
measures the changes in the amplitude and frequency of brain waves (Felten, 1991;
Rider, 1987). The effect of music on the body also can be observed by the tingling
of the skin surface, the dilating of pupils, increased muscular tone, and change
in respiratory rate (Slobada, 1989; Storr, 1992). Campbell (1995) cites published
studies in 1830 by J. Dogiel that describe how music can influence human blood
circulation by causing blood pressure to rise or fall because of variations in pitch,
intensity, and the timbre of particular sounds.

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OLDER PEOPLE WITH SPECIAL NEEDS

A number of clinicians have shown how music can help older people with
special needs to develop a sense of intimacy and connection between themselves
and others. For example, older frail people with special needs find it more difficult to
maintain friendships as they become less able to visit or communicate with others,
especially if they are institutionalized (Clair, 1996; Clair, Tebb, & Bernstein, 1993).
Friendship and companionship are a great loss if we accept that they provide us
with happiness, strength, and contentment (Bright, 1997). It has been shown that
music can facilitate friendship by providing people with opportunities to interact
and share their life experiences with others (Bright, 1997; Bunt, 1996; Colt, 1996;
Cozier, 1997). For example, Storr (1992) describes how some people who stammer
can sing sentences that they normally cannot speak because of reduced anxiety
about speech. This is largely because stammering is encoded in the left-brain
hemisphere, while singing is predominantly a right-brain activity. This may also
explain why people suffering from dementia or dominant hemisphere brain damage
are able to remember and participate in musical activities, but find other daily
activities difficult. The concept of remembering tends to be procedural rather
than a declarative memory, such as knowing the words and tune or the factual
details about the music (Mollon, 1998; Squire, 1992).
History provides us with many examples of how music helps people to maintain some sense of normal functioning. The philosopher Friedrich Nietzsche, who
in his latter years was mentally ill and died of paresis in 1900, was unable to
communicate in words, but would sit at the piano and improvise for hours (Storr,
1992). Sacks (1985) cites the case of a musician who suffered from a brain lesion
and was unable to recognize most objects. The only way he could bathe, dress or
eat a meal was to do so while singing. Beatty, Zavadil, and Bailly (1988) refer to
a woman who had severe impairments including aphasia, memory dysfunction,
and apraxia, yet was able to sight read and play an unfamiliar song. Another case
is that of an elderly musician who could play from memory but no longer could
recall the name of the composer or the piece (Crystal, Grober, & Masur, 1989).
Music has also been found to facilitate communication and create a sense of
normality for people who suffer from dementia, Alzheimers disease or acute memory loss. Music can help dementia sufferers identify with people, recall important
events, and evoke associations with emotions, visual images, or other sensory information, including perception of flavors, odors, textures, temperatures, etc. (Clair,
1996; Clair & Hanser, 1995). This connection can be as simple as singing a song,
listening to music, or getting the patients to dance to music that has had some form
of meaning in their lives. For example, Clair (1990; 1994; 1996) found that planned
recorded music and participation in music activities had a beneficial effect on the
behavior of older persons with dementia, especially those living in residential care.
Residents became less aggressive, engaged in less verbal and physical reaction to
hallucination, experienced reduced frequency in incontinence, developed greater

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interest in group activities, and improved their attention to personal appearance

and hygiene.
For people who suffer from Parkinsons disease, daily routines such as bathing,
dressing, eating, or exercising can be better managed with the use of music. When
Parkinson sufferers internalize the rhythmic stimulus of the music they often can
move, walk, or perform consecutive tasks that previously they had been unable
to do (Tomaino, 2000). Music therapy also can be used to help improve walking,
moving, balance, voice control, and movement synchronization. Music can be a
stimulant to help people who are frail get involved in simple movement exercises.
In a study investigating the effects of music therapy on elderly people who were
mentally ill, Odell-Miller (1988) found that patients improved and maintained levels of engagement when they participated in music sessions. All the subjects in
the study were significantly more engaged and showed higher levels of awareness,
interaction, and communication.

MUSIC AS A CONTRIBUTOR TO HEALTH AND WELL-BEING

The proposition that music can contribute to health and quality of life stems
largely from health professionals in the latter part of the twentieth century adopting
a more holistic approach to health. Holistic health is linked with the concept of
an equilibrium state, in which body, mind, and spirit are in harmony (Gibson,
1998; Jamieson, 1997). This social model of health puts the emphasis on the
individuals interaction with the social and physical environment rather than on
decline and decay (Kendig, 1996; Lerner, 1994). Wellness is a product of healthy
body/mind/spirit interactions, and, as a result, music can be an important asset in
creating the appropriate environment for healing (Stewart, 1990). Diamond (1979)
suggests that music can be an important part of primary preventative health care at a
psycho-social level, and cites the longevity of many conductors such as Stokowski,
Tocannini, Fiedler, Ormandy, as examples.
Bunt (1996) shows how music can be used to assist people in releasing their
feelings, transcending their everyday experience, resolving hurt and pain, and reviewing significant life events. Music also can evoke memories of the emotional
context of past events and times, and aid people to explore issues from a different
perspective and re-access events and emotions. For older people, music is a way of
feeling connected to their past, and also feeling valued and needed (1992). The connection with the past via long-term memory happens because the brain remembers
things by categorizing them rather than by viewing them as discreet photographs.
Jourdain (1997) explains this, stating, whatever the brain encounters, whether a
sight or sound, smell or sensation, it dissects for its deepest relations, and it is
this network of relations that the brain retains (p. 164). Memories, therefore, are
recreated rather than being retrieved from the database of the brain. The imagery
occurs in parts of the brain when stimulated by perception, that is, the visual cortex

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is stimulated by visual imagery along with auditory imagery. Thus people can be
transported emotionally and aurally back in time via music (assuming the individual is an active participant who is engaged in the listening process, as opposed to
being passive with music only serving as background noise).
Music evokes not only memories of past times, events, and experiences but
also the emotional context of those times (Bunt, 1996). When we listen to music
in a therapeutic environment, we are able to bring to the surface feelings that are
associated with particular experiences. These memories can be images of states
of being which are not always outwardly tangible. Stevens (1993) states that the
outward emotional expression, whether through the words of a song or the musical
sounds alone, is the manifestation of these images, and this in particular reflects the
perceived reality of these images (p. 91). Culture and personal associations with a
particular piece of music profoundly influence peoples emotional response to the
music (Bright, 1993). Music can offer satisfaction and pleasure because it mirrors
life, including its daily happenings, joys, sorrows, and frustrations (Diamond,
1979). Not surprisingly, it has been reported that music is an activity that the
healthy, impaired, talented, and interested enjoy because it provides them with a
relief from stress, anxiety, bereavement, and depression (Blacking, 1995).
Brewer and Campbell (1992), along with Bright (1997), state that music
has two main roles in the lives of older people. First, it has evocative powers,
and second, it provides scope for people to enjoy shared interests and activities,
thus justifiably allowing music to be regarded as a branch of preventive medicine.
Music is an easy and convenient way of encouraging social interaction by removing
the barriers that divide people. Isolation and loneliness are common phenomena
among older people, and often lead to depression and withdrawal from social
contacts. Music has been shown to provide excellent motivation for patients in
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people, who may be lacking interest and self-expression, to become animated. An
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example of this is Miss D in Awakenings (Sacks, 1973). This is especially so
throughout?
for people suffering from dementia (Bright, 1997; Coulson & Ronaldson, 1997).
Music, coupled with personal attention and care from other people, can provide
gratification and restore a sense of worth to older people who may be experiencing
depression or low self-esteem (Crystal, Grober, & Masur, 1989).
CONCLUSION
Since the 1960s, the importance of music as a therapeutic tool in aged care has
become better understood and researched (Hanser, 1985; Hanser, 1990; Kartman,
1980; Kurz, 1960; McClosky, 1985; Olderog & Smith, 1989; Sacks, 1973). Bunt
(1996) states that the essence of our humanity can be captured by the music in our
lives. Acknowledging the potency and potential of the use of music as a therapeutic
device makes it possible to integrate people of different backgrounds, cultures, and

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experiences. Music therapy and holistic medicine share the same perspective as the
arts therapies in that they are largely concerned with the maintenance of wellness.
Music has the potential of extending the boundaries of all personswhether ill or
healthy, disadvantaged or not (Bright, 1997).
A growing literature explores how music is used as a therapeutic tool that can
influence the psychological and physiological processes in the body to promote
health and well-being (Ansdell, 1995; Bunt, 1996; Jonas, 1991; Olderog & Smith,
1989; Sacks, 1992). However, there is still a lack of research that shows how older
people use music to facilitate positive aging. Although the literature discusses the
use of music as a therapeutic tool, health care practitioners need a broader approach
that advocates and more clearly demonstrates the role and use of music by older
persons to promote personhood and positive aging.
Positive aging is a debatable topic and depends on individual interpretation,
but there is no doubt that participation in activities, such as the use of music,
contributes to an older persons quality of life (Kendig, 1996). Music can be
incorporated into social programs that assist older people in maintaining selfesteem, building bridges between people, providing an opportunity for working
together, aiding in the sharing of memories, and fostering social interests, to name
but a few of the benefits (Bright, 1997).
Further research might include mapping the meaning and role that music
has for older persons, understanding how music assists older persons in later life
to enhance quality of life, identifying how music can be an indicator of positive
health and well-being, and describing the specific circumstances under which
health professionals can best apply music in their practices and what health benefits
are achieved. As Christie (1992) reminds us, if the maintenance of a persons
cognitive, emotional, and physical skill level for as long as possible is an important
goal in the care of the elderly then health professionals need to be more acutely
aware of how music can contribute to older peoples quality of life, health and
well-being (p. 71).
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