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Alive Inside

aka Personal Song

D: Michael Rossato-Bennett / 78m

With: Dan Cohen, Oliver Sacks, Gregory Petsko, Samite Mulando, Bobby McFerrin, William Thomas, Michael Rossato-Bennett

It’s estimated that as many as 5.1 million Americans may have Alzheimer’s disease. If this figure is correct then the US healthcare system is in for a rocky ride in the decades to come, as that figure rises in line with a rapidly aging – and longer living – population, and the cost of medication to treat the condition rises right alongside it. But what if there was an alternative to the use of drugs such as NAMENDA XR®, or Aricept, an alternative that was also cheaper to implement?

Step forward Dan Cohen, founder of Music & Memory, “a non-profit organization that brings personalized music into the lives of the elderly or infirm through digital music technology”. Michael Rossato-Bennett’s inspiring documentary introduces us to the former consultant/trainer for the U.S. Department of Education as he attempts to convince healthcare professionals and pretty much anyone who will take notice, of the beneficial effects of music on the memories and cognisance of Alzheimer’s sufferers. Originally, Rossato-Bennett was meant to follow Cohen around for one day only, filming his attendance at a care home and recording the effects – if any – on the residents there. Using iPods and music choices that reflected the eras when these people were young, Cohen was able to prove that music could “reawaken” Alzheimer’s sufferers, and retrieve memories long believed lost.

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Cohen found a perfect example in Henry, a ninety-four year old who was withdrawn and barely able to speak. Within moments of Henry’s being fitted with headphones and music from his youth played for him, he reacted with spontaneous enthusiasm. Henry responded in a way that amazed everyone, and the longer he listened the more articulate he became. He was able to tell Cohen how the music made him feel, and soon he was able to sing independently of the iPod, revealing a deep melodic voice almost unaffected by the passing of the years. (At this point, Rossato-Bennett decided one day of filming Cohen wasn’t enough: he followed him for the next three years.)

Other patients benefitted from Cohen’s approach to palliative care. While the drugs they were taking each day did little to alleviate their isolation, Cohen’s iPods brought people out of their lethargy. Families could reconnect with their loved ones again, and those sufferers who were still able to understand what the disease was doing to them were able to appreciate the renewed lease of life this music therapy afforded them. People like Denise, a bipolar schizophrenic who felt every emotion so intensely that her life was like being on an emotional rollercoaster. Cohen’s “intervention” saw her do away with the walking frame she’d been using constantly for the previous two years, and dance. And for the first time in a long time, she could honestly say she was happy.

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With such dramatic but telling effects on a range of Alzheimer’s sufferers, it would seem absurd for the US healthcare system to ignore Cohen’s work. But you’d be wrong (if unsurprised). As Gregory Petsko, Professor of Bio-Chemistry and Chemistry at Brandeis University puts it so tellingly, he could write a prescription for a thousand dollar drug and no one would bat an eyelid. But if he wanted to prescribe a forty dollar iPod, then questions would be asked. It’s at this point that Cohen begins to encounter all manner of excuses from doctors and care providers unwilling to adopt his unique methods. (It’s not mainstream enough for them.)

Cohen perseveres though, focusing on the US care home system, but he makes a limited amount of headway, despite continued, and incontrovertible, evidence that his idea works. When the uptake of iPods ends up being less than one per cent, an exasperated Cohen throws in the towel. But the story doesn’t end there. Some time later, footage of Henry is posted on Reddit, and it goes viral, and now Cohen is appearing on television and promoting his use of iPods…

There’s a great deal of joy to be had from Alive Inside. Joy at seeing Alzheimer’s sufferers regain a semblance of their old selves, joy at knowing that this particular form of therapy works independently of any drugs, joy at seeing the relief and happiness it brings to families and loved ones, and joy that Cohen’s efforts haven’t all been for nothing. There’s something incredibly powerful and uplifting in seeing someone who is withdrawn – mentally, emotionally and physically – emerge as if from a deep sleep and re-engage with their past and their present surroundings. There are several of these moments in the movie, and rather than become expected or commonplace, each is a moment to be thankful for, a transformation that reinstates identity and awareness.

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In between these powerful moments, Rossato-Bennett is astute enough to provide viewers with historical, social, medical and political contexts for the current state of care home facilities, particularly in light of the introduction in 1965 of Medicare and Medicaid. By treating Alzheimer’s sufferers as patients, the elder care programme has effectively mistreated millions of people in the forty-plus years since; they’ve been victims of a system that has failed to do anything other than make them physically comfortable for as long as possible. As one esteemed physician and researcher puts it, he’s worked in the field of dementia for thirty-eight years and he’s not been able to do anything as productive for dementia sufferers as Cohen has with his iPods. It’s admissions like these that add to the emotional impact of seeing the effect of music on so many people, especially when you have someone as authoritative as Oliver Sacks confirming that musical memories are able to withstand the ravages of Alzheimer’s far better than other kinds of memory. (If this is the case then why the hesitation in adopting Cohen’s idea?)

Cohen himself comes across as a committed, dedicated individual with a great deal of empathy for the people he meets, be they Alzheimer’s sufferers, care providers such as nurses, or the families struggling to come to terms with the premature “loss” of a loved one. As the movie follows him on his quest to improve the lives of so many “lost souls”, his approach and consideration of others serves as a reminder that we should cherish our time with our elders, and recognise their value as individuals, even if they are distant or unresponsive. It’s an important message, and one that shouldn’t be diluted or allowed to fade away. Thanks to Cohen and his efforts, and the reawakening of a man named Henry, that’s unlikely to happen anytime in the near future.

Rating: 8/10 – an impressive, solidly mounted documentary, Alive Inside skimps on statistics in its attempt to put across its feelgood story, but that’s a minor quibble when there’s so much that’s delightful to be had; Rossato-Bennett should be congratulated for his efforts, as his movie tells what could have been a remarkable if dour story with careful consideration and passion.

For further information about Dan Cohen and his work, visit http://musicandmemory.org