Singing: a golden instrument of hope for dementia care

A dementia diagnosis is heartbreaking for everyone involved and inevitably hard to face. So how do you hang onto hope?
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​There is a strong body of evidence to show that singing delivers benefits for people living with dementia and their carers. This article will demonstrate the potential for singing to reduce agitation, improve mood, and promote positive social interaction. ​Further is the possibility to boost cognitive and motor function in the short-term improving quality of life overall.

Singing can increase amiability and reciprocity, and reduce difficult behavioural presentation such as aggression and resistance (Ridder et al. 2013). Hammar et al. (2014) found particularly good results for carers who introduced singing to showering and dressing, noting a significant reduction in agitation and aggression at what can often be a difficult period in the daily routine. It could reasonably follow that singing would help to soothe and calm people with dementia during “sundowning”, a phenomenon that typically occurs later in the day when people experience confusion, restlessness and anxiety.

Music, particularly favourite songs, can trigger positive emotions and memories. Singing has been shown to reduce depression and enhance mood to promote well-being (Thompson et al. 2021). Group singing in particular fosters social support, and a sense of belonging and community (Osman et al. 2016). Singing also promotes social interaction and communication, even when verbal communication skills are reduced. One study by Lesta and Petocz (2006) found a decrease in mumbling, touching clothes/face, and sitting alone, and an increase in eye contact, smiling and talking which remained high after the singing session.

Singing and movement preserves and improves motor coordination and balance. A small study of nine late-stage dementia patients carried out by Götell et al. (2003) saw improvement in dementia patient presentation after carer singing. Initial presentations included slumped posture, slow and asymmetric movement, listlessness, and low level spatial awareness in relation to the physical environment. After caregiver singing patients exhibited straightened posture, more movement symmetry, and increased cognisance of themselves in relation to their environment.

Singing has shown limited promise in slowing cognitive decline and improving cognitive function. One study by Scott & Kidd (2016) found that singing engages the function of memory and recall, strengthening this capacity in dementia patients. Tragantzopoulou & Giannouli (2025) found a small increase in psychomotor processing speed and a small reduction in neuropsychiatric dementia symptoms at the conclusion of 6 months of weekly singing sessions, though noted that the sample size was too small to be conclusive. Maguire et al. (2015), implemented a singing program for dementia patients which led to improvement in cognitive ability. The study showed that singers achieved significantly higher scores than music listeners. Specifically, the study fostered cognitive engagement through melodic structures, music arrangement, and developing the musical story.

Osman et al. (2016), found that singing supported people with dementia and their carers to accept the dementia diagnosis. This outcome may reasonably lead people to access appropriate support sooner after a dementia diagnosis, slowing decline.

Incorporating singing into dementia care supports improved quality of life and sense of connectedness for people living with dementia. This assists with accepting and coping with dementia. Participating in singing activities can also provide valuable benefit to carers in the form of improvement in mood and reduced stress levels.

How I work with dementia clients
Importantly, I tailor the approach according to the individual. To support comfortable participation, I create a space that is safe and encouraging. The focus of activities is on engagement over performance. I sing along with clients to foster collaboration and interaction. Some of the specific ways I work include:
Singing together
Singing in harmony
Improvising to live piano and pre-recorded music in a variety of musical styles
Song writing, this may be as simple as singing the client’s name/names of their loved ones
Rhythmic activities: marching, clapping, leg patting and hands together clapping between client and therapist to music and/or while singing

Things you can try at home
Create a play-list of familiar songs - listen, sing along and/or dance
Remember loved songs to stimulate conversation about events and experiences from the past
Play music during meals, bath time, or other daily activities to create a stimulating and more enjoyable environment. 

References
Hammar, L. M., Lovenmark, A., & Small, A. (2024). The benefits of caregiver signing and receptive music in dementia care: a qualitative study of professional caregivers’ experiences. Arts & Health, 17(2), 132-146. https://doi.org/10.1080/17533015.2024.2320248
Lesta, B., & Petocz, P. (2006). Familiar group singing: Addressing mood and social behaviour of residents with dementia displaying sundowning. Australian Journal of Music Therapy, 17, 2-17.
Maguire, L.E., Wanschura, P.B., Battaglia, M.M., Howell, S.N. and Flinn, J.M. (2015), Participation in Active Singing Leads to Cognitive Improvements in Individuals with Dementia. J Am Geriatr Soc, 63: 815-816. https://doi.org/10.1111/jgs.13366
Osman, S. E., Tischler, V., & Schneider, J. (2016). ‘Singing for the Brain’: a qualitative study exploring the health and well-being benefits of singing for people with dementia and their carers. Dementia, 15(6), 1326-1339.
Ridder, H. M., Stige, B., Qvale, L. G., & Gold, C. (2013). Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & mental health, 17(6), 667–678. https://doi.org/10.1080/13607863.2013.790926
Scott, S. & Kidd, A. (2016), A scoping review of music and anxiety, depression and agitation in older people with dementia in residential facilities and specialist care units, European Geriatric Medicine, 7(5), 488-491. doi.org/10.1016/j.eurger.2016.07.007
Thompson Z., Baker F. A., Tamplin J., Clark I. N., (2021). How Singing can help people with dementia and their family care-partners: A mixed studies systematic review with narrative synthesis, thematic synthesis, and meta-integration. Front Psychology. 11;12:764372.
Tragantzopoulou, P., & Giannouli, V. (2025). A Song for the Mind: A Literature Review on Singing and Cognitive Health in Aging Populations. Brain sciences, 15(3), 227. https://doi.org/10.3390/brainsci15030227