Manlio is 88 years old. He spent his life teaching music—the trumpet, to be precise. He has a wife, two children, three grandchildren, and a beautiful home. But somewhere along the way, everyone and everything that once grounded him has become a source of fear and anguish. His wife is no longer his wife. His house is no longer his home. Every day he searches desperately for the certainties that have vanished. Only music remains faithful to him—a true friend. Alzheimer's has claimed him. Stage two on a scale that runs from zero to seven. His family wants to help, to manage his care, but the institutions responsible for such cases offer no support. "When they reach this level, you need to keep them at home and organize shifts among yourselves," his children were told. And so they did.
For two months now, they have not slept in their own beds. They have not taken a walk. They have not gone out to dinner. They have not read a book.
No one should face a crisis like this alone.
Professor V. Marigliano, director of the Department of Aging Sciences, said in an interview: "An Alzheimer's patient who has lost language is still a person. If you hold his hand, if you play music with him, if you activate his soul with yours, he will return to being one of us. Inside, like the core of a tree, he wants to feel the warmth of love, of understanding, of acceptance. He is not different from us. The only difference is that he does not speak our language." Connection is possible through language, yes—but it is equally possible through the simple touch of a hand.
The absence of words often makes people blind to the person trapped inside the disease. Those afflicted with Alzheimer's have anatomical differences, but only some centers recognize this. Others do not. Their desperation is often mistaken for madness. The only way out of the depression of being misunderstood is to cry out—and no one hears.
We are the disabled ones. We are the ones who cannot understand those struggling to express their feelings.
The Alzheimer's patient is painfully aware of losing cognitive abilities day after day. That awareness is the source of the despair—and the despair itself becomes depression. What is our task? To stand beside them. To hold their hand. Depression takes root where hope dies. They cannot make themselves understood. We cannot understand them. When a child cries, we recognize the signal at once and our hearts soften. When an elderly person cries, we grow agitated. We understand nothing. We grow angry.
Even a flower that is old and sick can still bear beautiful fruit. "Those who no longer have their minds among us—their minds rest in God's arms."
Even a flower that is old and sick can still bear beautiful fruit. "Those who no longer have their minds among us—their minds rest in God's arms."
The Alzheimer's patient sees only fragments of the world, and that fragmentation terrifies him. Respecting his space becomes crucial. He reaches out with open arms to embrace everything he sees, as if in one vast hug. This is why we must ask permission before entering his space—we must not force our way in. And then there are the hallucinations. They make everything feel dangerous, threatening. He cannot distinguish them from reality. So he becomes agitated. He dreams with his eyes wide open. Behavioral disturbances emerge. They escalate into aggression, and we interpret them as such. But in truth, he is afraid. We must try to understand this not by sedating him, but by listening to him, observing him. We must learn—and teach him—the language that needs no words, a language present until the very last moment of life.
A remarkable discovery has come to light: through music, we can teach them to speak again. Inside our bodies, a rhythm beats. A racing heart is a frightened heart. A calm heart is a heart at peace, a heart that loves. This is a profoundly complex form of expression—almost sacred. Everything can be organized in musical intervals and rhythms. Plato said that music shapes the human soul. Music can lift anyone, even those who can no longer speak to us. Just as a blind person has not lost touch or hearing, an Alzheimer's patient has not lost the ability to FEEL music, to read it, to play it.
A music therapist can communicate without words and enter into contact with the patient, restoring the joy of being alive.
I know an Alzheimer's patient who was once a musician. He no longer recognizes his family, his home, his own clothes. He despairs like a child because others cannot see the animals filling his room. He cries because he cannot bring "that friend" he sees reflected in the mirror into the room with him. But place a musical score in front of him, and his hands—suddenly sure again, just as they were in his youth—cannot help but begin conducting an imaginary orchestra. And that makes him smile again. Truly smile.
His name is Manlio. He is 88 years old. He has Alzheimer's disease.
Laura Cattaneo, 2006
