Music therapy can benefit older adults with developmental disabilities in multiple ways. It can improve skills, bring joy, and aid in self-expression for non-verbal individuals. Music is processed in both brain hemispheres and engages multiple senses. It can also help manage behaviors, reduce stress and agitation, and facilitate emotional closeness between caregivers and patients with conditions like Alzheimer's. New Horizons, a California-based organization, offers various programs and services to meet the needs of older adults with developmental disabilities, including those with Down syndrome who are at high risk for early-onset Alzheimer's. They are opening a new residential home specialized for caring for this population.

1. Active Aging I/DD
Offering Information, Strategies and Networking Resources
To Support Older Adults with I/Developmental Disabilities
Summer 2015 Volume 1 Issue 2
Editor’s Note:
Music Therapy is an effective therapeutic and educational tool for older adults
with developmental disabilities. Music therapy strategies can effect changes in
skill areas cognitively, physically, and socially. Older Adults with DD do so well in
music therapy because it captivates attention, motivates action and brings joy
and success. Music can be beneficial in so many ways because it is processed in
both the left and right hemispheres of the brain. It is also a multi-sensory activity that
incorporates the visual, kinesthetic, auditory and tactile systems. This is especially
true when moving to music or playing instruments such as drums, tambourines or
shakers. In addition, music is non-verbal so for those who struggle with language,
music can be a wonderful way to connect with others and express oneself. Hans
Christian Anderson once said, “Where words fail, music speaks.”
Social Worker Dan Cohen, founder of the nonprofit organization Music & Memory,
fights against a broken healthcare system to demonstrate music’s ability to combat
memory loss and restore a deep sense of self to those suffering from it. He is the
topic of the award winning film Alive Inside by Filmmaker Michael Rossato-Bennett
who chronicles the astonishing experiences of individuals around the country who
have been revitalized through the simple experience of listening to music. His
camera reveals the uniquely human connection we find in music and how its
healing power can triumph where prescription medication falls short.
Music is magic… especially for individuals with Alzheimer’s disease and
related dementias. It can generate significant and meaningful outcomes
even in the later stages of the disease.
These outcomes
documented include
reduction in falls and
behavior restrictions
as well as the obvious
related to increase
memory of one’s
life. The Alzheimer’s
Foundation of America
(AFA) reports when
used appropriately,
music can shift mood, mange stress induced agitation and stimulate
Best Practice
New Horizons: Meeting the needs
of the Older Adult with DD
New Horizons (North Hills, California)
strives to meet every need to
include the older adult with DD. For
the past 61 years, New Horizons has
served families and individuals in
the San Fernando Valley through
programs such as Supported
Employment, Independent Living,
the Achievement Center, and
Facility based Employment and
now specialized services for those
individuals aging with DD.
Roschell Ashley, Vice President
Program Operations, has identified
and implemented a number of
aging services programs for older
adults currently being served as
well as for those waiting for ser-
vices. These programs include a
Senior Center Integration Program
whereby typical seniors and older
adults with DD come together at
New Horizons for senior activities.
Also, L.A. Care, a three year Pilot
Project, offering affordable health
care coverage. In addition, the
Monarch Day Program, a mobile
service without walls, providing
transition services in the home and
medically related services prior to
day services at New Horizons. Their
newest endeavor is establishing a
residential home for individuals with
symptoms related to Alzheimer
and other Dementia concerns.
Alzheimer’s Care: More than 50
years ago, New Horizons began
serving the needs of children with
Down Syndrome. Now, these
continuedpage4continuedpage2
The Music and Memory Project
for Individuals with Alzheimer
and other related Dementia.

2. positive interactions, facilitate cognitive function and coordinate motor
movements.
Desire to awaken the person served to what they were and who they
are accompanied by music engagement has brought about significant
improvements and responses for the person with dementia. Alzheimer
attacks the area of the brain where music processes last. Therefore it is the
first to be awaken when music is used. The individual is able to reflect on
the melody, words and time when he/she experienced it.
The AFA explains that this happens because rhythmic and other well-
rehearsed responses require little to no cognitive or mental processing.
They are influenced by the motor center of the brain that responds directly
to auditory rhythmic cues. A person’s ability to engage in music, partic-
ularly rhythm playing and singing, remains intact late into the disease
process because, again, these activities do not mandate cognitive
functioning for success. Music Associations. Most people associate music
with important events and a wide array of emotions. The connection can
be so strong that hearing a tune long after the occurrence evokes a
memory of it.
Prior experience with the piece is the greatest indicator of an individu-
al’s likely response. A melody that is soothing for one person may remind
another of the loss of a loved one and be tragically sad. If the links with
the music are unknown, it is difficult to predict an individual’s response.
Therefore, observe a person’s reaction to a particular arrangement and
discontinue it if it evokes distress, such as agitation, facial grimaces or
increasing muscular tension.
Top Ten Picks. Selections from the individual’s young adult years—ages
18 to 25—are most likely to have the strongest responses and the most
potential for engagement.
Unfamiliar music can also be beneficial because it carries no memories or
emotions. This may be the best choice when developing new responses,
such as physical relaxation designed to manage stress or enhance sleep.
As individuals progress into late-stage dementia, music from their child-
hood, such as folk songs, work well. Singing these songs in the language
in which they were learned sparks the greatest involvement.
Sound of Music. Typically, “stimulative music” activates, while “sedative
music” quiets. Stimulative music, with percussive sounds and fairly quick
tempos, tends to naturally promote movement, such as toe taps. Look to
dance tunes of any era for examples. Slightly stimulative music can assist
with activities of daily living: for example, at mealtime to rouse individuals
who tend to fall asleep at the table or during bathing to facilitate move-
ment from one room to another.
On the other hand, the characteristics of sedative music—ballads and
lullabies—include unaccented beats, no syncopation, slow tempos, and
little percussive sound. This is the best choice when preparing for bed or
any change in routine that might cause agitation.
Responses that are opposite of those expected can occur and are likely
due to a person’s specific associations with the piece or style of music.
Agitation Management. Non-verbal individuals in late dementia often
become agitated out of frustration and sensory overload from the inability
How-to of
music therapy:
Early stage—
♦ Go out dancing or dance in the
house.
♦ Listen to music that the person
liked in the past—whether swing
or Sinatra or salsa. Recognize that
perceptual changes can alter
the way individuals with dementia
hear music. If they say it sounds
horrible, turn it off; it may to them.
♦ Experiment with various types
of concerts and venues, giving
consideration to endurance and
temperament.
♦ Encourage an individual who
played an instrument to try it
again.
♦ Compile a musical history of
favorite recordings, which can be
used to help in reminiscence and
memory recall.
Early and middle stages—
♦ Use song sheets or a karaoke
player so the individual can sing
along with old-time favorites.
Middle stage—
♦ Play music or sing as the individual
is walking to improve balance or
gait.
♦ Use background music to
enhance mood.
♦ Opt for relaxing music—a familiar,
non-rhythmic song—to reduce
sundowning, or behavior prob-
lems at nighttime.
Late stage—
♦ Utilize the music collection of old
favorites that you made earlier.
♦ Do sing-alongs, with “When the
Saints Go Marching In” or other
tunes sung by rote in that person’s
generation.
♦ Play soothing music to provide a
sense of comfort.
♦ Exercise to music.
♦ Do drumming or other rhythm-
based activities.
♦ Use facial expressions to commu-
nicate feelings when involved in
these activities.
Music is Magic —continuedfrompage1
continuedpage3
2

3. to process environmental
stimuli. Engaging them in sing-
ing, rhythm playing, dancing,
physical exercise, and other
structured music activities
can diffuse this behavior and
redirect their attention.
For best outcomes, carefully
observe an individual’s pat-
terns in order to use music
therapies just prior to the
time of day when disruptive
behaviors usually occur.
Emotional Closeness. As dementia progresses, individuals typically lose the
ability to share thoughts and gestures of affection with their loved ones.
However, they retain their ability to move with the beat until very late in
the disease process.
Ambulatory individuals can be easily directed to couple dance, which
may evoke hugs, kisses or caresses; those who are no longer walking can
follow cues to rhythmically swing their arms. They often allow gentle rocking
or patting in beat to the music and may reciprocate with affection.
An alternative to moving or touching is singing, which is associated with
safety and security from early life. Any reciprocal engagement provides an
opportunity for caregivers and care receivers to connect with one another,
even when the disease has deprived them of traditional forms of closeness.
Contributed by Alicia Ann Clair, Ph.D., MT-BC, professor and director of the Division of Music
Education and Music at the University of Kansas in Lawrence. “How-to” section contributed
by Concetta M. Tomaino, DA, MT-BC, vice president for music therapy and director of the
Institute for Music and Neurologic Function at Beth Abraham Family of Health Services, Bronx, NY.
For more information, connect with the Alzheimer’s Foundation of America’s
licensed social workers. Click here or call 866.232.8484. Real People. Real Care.
Music —continuedformpage2
Older Adult I/DD
Survey Results
At the Community Employment
Services Conferences held in
April 2015 by CARF.
Three questions were presented
to the surveyors in attendance.
1. How does your organization serve older
adults with I/DD and their families?
• 40% served this population
through Specialized Services/
Supports individualized to the
needs and interests of the older
adult by their organization
directly.
• 40% had no specific services
provided at the time of survey.
• 20% combined to serve the
older adult through Contracted
Services by Aging Network
providers or others
2. What type of training is provided to
staff serving the older adult I/DD and their
families?
• 55% of the respondents did not
have specialized training in this
area
• 30% offered training in the
Aging Process/Basic Aspects of
Aging and /or Characteristics of
Older Adults with I/DD and / or
Community Resources specific
to the service provided by the
Aging network of providers
• 15% provided training on the
topic of Caregiver Supports
3. Please, describe the specific type of
supports and services provided by the
organization to the older adult with I/DD
and their families. These included:
• Residential Housing/
Supported Living
• Community Integration
• Pre-Retirement planning
• Medical Services and Equipment
• Case management/
Service Coordination
• Dementia Training
• Aging in Place
• Home Accommodations
and Accessibility Design
• Employment
• Respite Services
• Community Collaborations/
Senior Coalition
• Therapy (Art, Music, Pet)
• Wellness Programs
3
Stay Informed! Sign up for our Newsletter today.
Send us your email.
ActiveAgingI/DD@gmail.com
http://activeagingdd.org
Active Aging I/DD
Paul M. Herrera, Editor
2350 Nottingham St NW
Massillon, Ohio 44646
Mail Inquiries and Submissions Welcomed.
Contact Active Aging DD for All Your STAFF TRAINING Needs
Provided on-site and/or electronically
EMAIL: activeagingidd@gmail.com • Pherohio@sssnet.com
Go to: http://activeagingdd.org • Call: 330.244.6327
► Implementing Programs
and Activities
► Aging Networks
and Collaborations
► Specialized Training Topics
available upon request
• Dementia
► Characteristics of the
Older Adult with DD
► ISP
• Assessment
• Development
• Coordination

4. Best Practice —continuedfrompage1
4
adults have aged and some are
developing complications arising
from the onset of dementia. New
Horizons is committed to provid-
ing residential housing in order for
these adults to remain in the com-
munity for as long as they choose.
Ms. Ashley states “in efforts to
meet the current needs of these
adults, New Horizons will soon con-
struct and open a residential home
that will specialize in caring for
adults with Down Syndrome and/
or other developmental disabilities.
The home is designed specifically
for this population”.
When New Horizons was founded
in 1954 by eight families, their com-
mon bond was that they all had a
child with Down Syndrome. At that
time, the average life expectancy
for their children was their early
20s. Today, the life expectancy is
much greater. Medical advances
and care have increased life
expectancy and continue to have
a positive impact. Even with the
advanced aging process accom-
panying Down Syndrome, today
approximately 70% of individuals
now live beyond their 50th birth-
day. This has presented a new life
challenge for adults with Down
Syndrome. Through New Horizon’s
collaborations with the Alzheimer’s
Association, it is known that indi-
viduals over 40, who have Down
Syndrome and who have a family
member with Alzheimer’s disease,
are at a greater risk of developing
Alzheimer’s disease. In addition,
nearly all individuals with Down
Syndrome over the age of 40
will begin to exhibit early onset
dementia. In contrast, most adults
with developmental disabilities are
at the same risk for developing
dementia and Alzheimer’s disease,
as are individuals in the general
population. The brain markings
of Alzheimer’s disease are pres-
ent in the brains of all adults with
Down Syndrome by the age of 40
which suggests a shared genetic
susceptibility to Down Syndrome
and Alzheimer’s disease. Nearly all
individuals with Down Syndrome
will develop Alzheimer’s disease or
dementia. Some of the symptoms
family members and care providers
may see in a person with Down
Syndrome at the onset are:
• Personality changes, irritability
or apathy Down Syndrome and
Alzheimer’s Disease
• Loss of speech or change in
language skills
• Disorientation to time and place
• Decline in self-care skills; this is
important because it reflects a
person’s level of functioning and
it is here that a care provider or
family can observe over time, a
subtle or sudden decline
• Abrupt onset of seizure activity
when there had been none in
the past
• Incontinence, when an individual
has always been independent in
toileting
• Short-term memory loss may
depend upon the previous
level of memory demands and
reliance on memory in everyday
life
• Sleep/wake cycle disruptions
Families and individuals are
advised that if they are notic-
ing these symptoms over time
contact the primary care doctor
and begin discussing the appro-
priate testing to help determine
the best course of action.
Ms. Ashley continues “when New
Horizons began 57 years ago it
was unimaginable that our clients
would live into their 50s, 60s, and
beyond. Today our clients can
age in place in the continuum of
programs that New Horizons offers.
It is our goal to have programs
that assist in the management of
life with this dual diagnosis. She
stresses to help individuals and
their families manage with this dual
diagnosis resources are available
from the Alzheimer’s Association,
our care providers, and many
others. Seek out the information
and supportive care you need and
advocate on behalf of your loved
one”.
Roschell Ashley, Chief Operating Officer.
Ms. Ashley joined New Horizons nearly 10
years ago working in Residential. Under
her direction, the program has become
noted for operating some of the high-
est-rated home care facilities in the State
of California. Roschell originated from
Cleveland, Ohio before she joined New
Horizons executive leadership team
…average life expectancy for their children was their early 20s.
Today, the life expectancy is much greater.
Medical advances and care have increased life expectancy
and continue to have a positive impact.
Active Aging DD
is now on the web
http://activeagingdd.org
in your web browser

5. 5
The Association on Aging with Developmental Disabilities (AADD)
supports and serves aging adults with developmental disabilities to
promote their dignity and independence, in the greater St Louis Area
to include St. Louis and St Charles Counties.
Annually, for the past 25 years, the AADD has held a conference on
the topic of Aging with Developmental Disabilities. Local, regional
and national speakers have presented to audiences attending from
across the country. This year’s conference held in May 2015 featured
topics on Aging in Place, Dementia and Grief Support. Keynote speak-
ers were Joseph H. Flaherty, MD, Assistant Program Director Geriatric
Medicine Fellowship Program, St. Louis University Division of Geriatric
Medicine and Sheli Reynolds, PhD, Director, Individual Advocacy and
Family Support, UMKC Institute for Human Development.
The 26th Annual Aging with
Developmental Disabilities
Conference will be Monday, May
16th & Tuesday, May 17th, 2016 at
the St Charles Convention Center,
#1 Convention Center Plaza, St
Charles, MO 63303. Sessions are
designed to support caregivers
and professionals in enhancing
the lives of people with devel-
opmental disabilities who are
aging. Sample topics will include:
Home & Community Engagement,
Adaptive Equipment, Cognitive
Stimulation Therapy, Dementia,
Mental Illness, and lots more,
all directly related to the aging
population with developmental
disabilities.
The intent of the AADD
Conference is to bring individuals
with developmental disabilities,
their families, support personnel,
and managerial staff together to
network, learn about the latest
information on aging with develop-
mental disabilities, bridge the gap
between the aging and devel-
opmental disability worlds and
provide usable tools and strategies
to better support individuals with
developmental disabilities who are
aging. This conference provides
information, that when used, will
enable consumers and families to
make informed decisions about
home and community based
supports, health related issues,
bereavement issues, housing, and
family support as well as many
other topics.
We will again be offering
Continuing Education Units pend-
ing approval from Illinois, St Louis
University School of Nursing, &
NASW- Missouri. Hotel accom-
modations will be available at
a discount through the Embassy
Suites, attached to the Convention
Center. (Registration will also be
available online again, but will not
go live until after the first of the
year, so we do not have the link as
of now.)
At our Spring 2015 Conference,
we had 364 attendees, including
self-advocates, families, and sup-
port personnel, which is testimony
to both the need for education
about, and interest in, the older
adults with developmental dis-
abilities population. We expect
the number of attendees to grow
beyond this year’s attendance,
as that was our first year at a new
location.
If any staff person, family member,
administrator, etc. who cares for
a person with a developmental
disability who is aging is interested
in our conference or our company,
please visit us at:
www.agingwithdd.org
or check us out on FaceBook at:
www.facebook.com/agingwithdd
to join our mailing list, or call (314)
647-8100 for more information.
Thank you!
Joseph H. Flaherty, MD Sheli Reynolds, PhD
Turn to the
Active Aging eNewsletter
—for—
• News • Tips • Practical Tools
—on—
Servicing and Supporting the Older Adult I/DD
To sign up email
ActiveAgingIDD@gmail.com
25th Annual Conference held by AADD

6. State of Ohio disabilities budget
increased by $306 million
Ohioans with developmental disabilities got a $306 mil-
lion boost — the largest one-time increase in program
history — and thousands more individual-service waiv-
ers in the new state budget. This budget is historic in its
support for Department of Developmental Disabilities
services,” said Zach Haughawout, deputy director
of legislative affairs for the agency. He said 3,000
new waivers, accounting for the bulk of the funding
increase, will allow the agency to continue pushing
for money to follow the individual when it comes to
providing services. Kristen Henry, an attorney with
Disabilities Rights Ohio, an advocate for people with
developmental and other disabilities, said the bud-
get also sets up a statewide information system in the
Adult Protective Services program to report on and
investigate abuse of older adults and the disabled.
But she said there’s barely any money for it. Columbus
Dispatch August 16 2015.
Community Living getting almost
$400,000 to create a hub of supports
Campbellford-Community Living, Ontario. Canada
will receive close to $400,000 over the next two
years to create, in collaboration with Campbellford
Memorial Hospital, a centralized hub of supports for
aging individuals with developmental disabilities that
will allow them to continue living independently in rural
areas. www.insidebelleville.com/ Aug 13, 2015.
U.S. Senate approves
PACE expansion bill
The Senate has approved a bill that would expand the
Programs of All-Inclusive Care for the Elderly for testing
in other populations.
PACE was designed to keep frail seniors in the com-
munity, rather than a skilled nursing facility. Currently,
only people over the age of 55 who require a nursing
home level of care are PACE eligible. The Senate bill
would waive requirements for PACE demonstration
projects, allowing the model to be tested with younger
populations. Possible test populations include people
with physical disabilities, intellectual or developmental
disabilities or behavioral health challenges, or older
adults who aren't yet nursing home eligible. McKnight's
Long-Term Care News August 2015.
Medicaid Waiver funding cuts to impact
agencies providing developmental
disability and aging services
Oklahoma State cuts and a loss of matching federal
funds will total $8.7 million. Area agencies are scram-
bling to provide the same level of care with less
money after a 3.5 percent cut to state Medicaid
waiver reimbursements for home and community-
based developmental disability and aging services.
Tulsaworld.com July 31, 2015. Mike Averill
State of Washington creates Silver
Alerts for Missing and Vulnerable
Adults
OLYMPIA (AP) — Gov. Jay Inslee on June 10, 2015,
signed a measure that creates a new alert for high-
way signs and traffic advisories when older adults
who may be suffering from Alzheimer’s, dementia
or developmental disabilities go missing.
The bill creates a “Silver Alert” that will use Washington
State’s current missing person alert system that acti-
vates electronic highway signs and radio traffic
advisories. It will be aimed at locating adults age
60 and older.
Museum of Modern Art Launches
New‘Prime Time’Initiative, Offering
Programs to New Yorkers Ages 65+
Community and Access Programs at MoMA serve a
diverse array of New Yorkers through partnerships with
community-based organizations as well as visitors with
disabilities, including individuals with developmental
disabilities, visitors who are blind or have low vision,
individuals who are deaf or have hearing loss, individ-
uals with learning and developmental disabilities, and
people with Alzheimer’s disease. More information is
available at MoMA.org/learn/disabilities.
6
News and Alerts