Country music legend Glen Campbell spent the last years of his life at a world-renowned memory care center in Nashville, often strumming his red Ovation guitar from a sunlit corner of a community room. Eventually, the four- time Grammy winner − known for hits such as “Rhinestone Cowboy” and “Gentle on My Mind” − could no longer play as his Alzheimer’s disease progressed. His fingers still mimicked the movement as he listened to familiar recordings or tunes his friends played during their visits to Abe’s Garden Community.
Seven years later, staff still call this area the “Glen Campbell corner.”
“It’s a place of love and comfort,” his widow, Kim Campbell, said during a recent trip to the facility.
During one of the roughest periods of her life, she felt warmth and a sense of understanding at the Belle Meade center, which cares for the entire family and offers support services for caregivers. She still maintains friendships made there years ago over a shared bond watching a spouse slip away.
Campbell, who toured with the Beach Boys in the 1960’s and is one of the first country crossover superstars, was among the first memory care residents at Abe’s when it opened in 2015. Nashville entrepreneur Mike Shmerling co-founded the nonprofit center after finding a gap in the availability of quality care after his late father, Dr. Abram C. “Abe” Shmerling, was diagnosed with Alzheimer’s.
Now, Abe’s Garden Community is at the intersection of two booming Nashville industries: music and health care. The center offers both individual and group music therapy for residents in independent living, assisted living or memory care housing. But more than that, it has teamed with a leading Vanderbilt University Medical Center researcher— and classically trained pianist — on using music to help those with dementia. Its staff also has traveled as far away as Poland to present about the benefits of music to an international conference of Alzheimer’s experts.
Mike Shmerling had searched the country for “the Mayo Clinic or the MD Anderson for Alzheimer’s.” When he didn’t find it, he decided to create it, developing evidence-based gold standards of care. Many residents can’t afford the center and beds are limited, with 50 families currently waiting for space. Part of Abe’s mission is to freely share best practices in dementia care with rural and urban senior communities across the state and country as well as those in Europe and beyond.
“I want to impact the quality of care with people with dementia globally,” he said.
The center has received several local, national and international accolades over the years, including recognition as a dementia design “groundbreaker” in the 2020 World Alzheimer Report by Alzheimer’s Disease International, billed as the global voice on dementia. The report included the Nashville facility in its “Design, Dignity, Dementia” report, saying others could “learn significant design and operational lessons.”
Center officials teamed with Vanderbilt University Medical Center to develop standardized protocols for assessing residents and training staff.
The residential buildings or themed housing pods encircle an expansive garden and are divided by residents’ interests in nature, learning, art and music. The nature household features a greenhouse and a live bird exhibit. Painting classes are taught in the art household and the music area has a large space to accommodate keyboards and dancing to everything from Frank Sinatra to Little Richard and Elvis. Sing-a-longs to Doris Day tunes and hits from Disney’s “Mary Poppins” and “The Sound of Music” also are house favorites.
The Shmerlings announced a $20 million campaign in September to add 38,000 square feet, increasing assisted living and memory care suites from 130 to nearly 170 apartments, building an outdoor deck and fireplace, a cafe and adding a nondenominational chapel.
The highlight of the expansion is a new Music Therapy Lab, which will be named in Glen Campbell’s honor and will offer performances and streamed shows to entertain residents.
The center is teaming with Dr. Joe Schlesinger, a classically trained pianist and professor of anesthesiology at Vanderbilt University Medical Center. At the hospital, he’s also studying the use of music with intensive care patients with Vanderbilt’s Blair School of Music student performances from vocalists, pianists, saxophonists. He also plans to conduct groundbreaking research in Abe’s new music lab, analyzing how music affects the mood and behavior of those living with Alzheimer’s disease and other forms of dementia.
“We are very pioneering in this field,” he said during a recent interview on his break from a shift in the intensive care burn unit. “We have to pave our own way. Occasionally, it has been an uphill battle.”
Sometimes people have a misconception that the most music can do is lift someone’s mood and maybe inspire a knee slap or a toe tap. In contrast, Schlesinger and other researchers are looking for scientific ways to quantify success, including charting changes through repeated electroencephalograms, known as EEGs, which measures the brain’s electrical activity. He believes music can be a powerful tool to reduce stress, agitation and delirium and improve mood, sleep and cardiovascular health − ultimately reduce the length of hospital stays.
The physician is combining his two passions of music and health to help drive an international trend to use music therapy to treat a variety of conditions, including improving mood and health for women and men with dementia. The more he can arm himself with measurable results, the better his chances at getting buy-in from other physicians, hospital administrators and, perhaps, even insurance companies.
Schlesinger’s career path was partly influenced by his grandfather, who had a degree in chemistry and also played the saxophone. His grandfather suffered significant cognitive decline before dying at the Mayo Clinic from multiple myeloma when Schlesinger was a sophomore in college. The doctor now serves as the vice president of the International Association for Music and Medicine, founded in 2009 to promote the use of music in the health care system as well as research into its benefits. He spoke about his research on music therapy at a conference in Berlin.
Thailand physician Patravoot Vatanasapt, an otolaryngologist specializing in head and neck cancer, said the Nashville doctor is a leading expert known for his research on music uses in intensive care or critical care settings.
“More and more evidence, along with better understanding through neuroscience, have supported the benefits of music on dementia patients,” said Vatanasapt, director of Khon Kaen University, who has used music in cancer care settings.
Gracie Ault, a new music therapist at Abe’s, has seen the impact music therapy can have with residents.
“Listening to music engages several parts of the brain,” said Ault, a recent graduate of Belmont University. “Sometimes it kind of gets them awake and in a good mood.”
During a recent one-on-one session with a memory care resident at Abe’s, Ault invited a resident with dementia who had been sitting in silence at a table to join her near the greenhouse to make music together. She played several songs from the Memphis native’s era, including “Rhinestone Cowboy.”
The man’s blue eyes lit up as he recognized the tune. Ault kept the beat with a red tambourine while the man shook a wooded maraca near his ear.
“Very good,” Ault said, encouraging him as he shook a wooden maraca near his ear.
When she asked the man his opinion of the song, he replied: “What do I think about it? It’s great.” When Ault played the 1951 hit “Hey, Good Lookin,’ ” in which singer Hank Williams asks “What you got cookin’? How’s about cookin’ something up with me?” a cook who happened to be strolling down the hall swung her hips to the beat and smiled while carrying a silver tray of brownies.
The memory care resident tends to wander the halls, so Ault’s goal is to keep him engaged. She notices if he smiles, hums, taps his foot or plays an instrument, participation she charts and measures over time.
Ault said her grandfather, John, loved to hear her play guitar or oboe. He developed dementia and eventually died, influencing her decision to switch her major at Belmont University from classical oboe performance to music therapy, learning how to use her musical gifts to help other people’s grandpas and grandmas in memory care.
She’s now one of more than 10,000 board certified music therapists credentialed through the Certification Board for Music Therapists, the only board of its kind in the U.S.
“I just like listening and I like learning from them, learning about their life experiences,” Ault said of working with seniors. “They all have a background and they all have a story.”
Belmont created its Music Therapy program 11 years ago to teach evidence-based and ethical practices, including working with clients and their families to develop individual goals and objectives and collect data to gauge efficacy, said Alejandra Ferrer, an associate professor and coordinator of Belmont’s program.
Sometimes individuals may be overstimulated or even agitated by a certain genre of music, considering it noise, so music therapy isn’t for everyone, she said. Still, she expects the field to grow as research shows it often can improve outcomes in a variety of healthcare settings, from soothing children during painful procedures to calming psychiatric patients.
“People think music therapy is just like bringing your guitar and singing for someone and they feel better
and then you go home,” Ault said.
“It’s much more. There’s planning, there’s assessing, documenting. Measurable progress is an important part of it.”
It’s Different By Design
When his father needed memory care, Mike Shmerling didn’t know where to turn. He’d never stepped foot in a nursing home.
He and his family saw their father suffer from boredom while living in four or five different senior communities in the Nashville area over an 11-year period. They’d find him asleep in front of the television or participating in a mundane activity like stringing macaroni.
When Mike decided to open a Nashville center, he kept his father in mind, displaying Abe’s white doctor’s coat in the lobby with a plaque in the late doctor’s honor.
He knew so many families were grappling with how to care for their loved ones suffering from dementia. It’s listed as the underlying cause of death for more than 279,000 women and men in 2021, the most recent statistics from the Centers for Disease Control and Prevention.
This includes nearly 119,400 deaths blamed on Alzheimer’s disease nationally. In Tennessee, the death toll reached 2,879.
Alzheimer’s was the No. 7 leading cause of death in the U.S. in 2021, claiming nearly 119,400 lives, according to the national 2024 report by the Alzheimer’s Association.
Abe’s death inspired his family to create a center he would have enjoyed.
Abe’s Garden Community uses an engagement-focused approach to dementia care that provides a sense of purpose and encourages learning. It also keeps in mind individual preferences.
Abe’s leaders work to create pioneering best practices that range from design of the building to healthy farm-to- table meals, to resident programs to the training of its staff.
Residents are free to move about and can help tend to the outdoor vegetable and flower gardens, linger on a bench, visit with other residents or take a nap inside in an oversized chair. Visitors are encouraged to drop in and can share meals, cookout on the outdoor grills and join in the activities or find a quiet corner to sit and chat, said Judy Shmerling Given, Abe’s daughter and the center’s senior director of campus development.
“We have evidence to support that we’ve been able to decrease the symptoms of depression and anxiety and agitation and because of that, we’ve been able to decrease medications,” she said. “And, now we have longer, better retention of staff because they’re not constantly putting out those fires.”
Given joined two other center officials to give a presentation at the global conference of Alzheimer’s Disease International in Krakow, Poland earlier this year. Leaders in the senior care industry have sought guidance from the Nashville center from across Tennessee and the nation as well as from other countries, including Australia, she said.
Because the Nashville center has a waiting list for families looking for a home for a loved one, Given encourages early interaction, long before a bed is needed. Women and men with early stages of dementia can participate in certain daytime club activities, including lunch.
“When we’ve been working with a family, we can help them recognize when they’re at those transitional points to increase in-home care, or to look at a day program or when it’s time to look at residential,” Given said. “They know our staff and the routines and it makes a very smooth transition.”
‘Heartbreaking and Also Dangerous’
Glen and Kim Campbell knew something was wrong long before his diagnosis.
In early 2011, Glen Campbell had been searching for something in their home of 10 years in Phoenix and when his wife told him to look in the garage.
“What’s a garage?” he responded.
They sought help from a neurologist, who diagnosed him with Alzheimer’s disease.
With his wife by his side, the country star openly discussed his diagnosis in August 2011 with a USA TODAY reporter, saying both had noticed gaps in his short-term memory for some time.
“That’s just something I didn’t want to say to anybody,” he said at the time.
With his wife’s support, he learned to accept his diagnosis and even laugh about it.
“There’s a lot of things I didn’t want to remember anyway,” he quipped. “So just shuck it out and start over.”
They discussed his upcoming farewell tour, with the musician asking his wife to remind him of their planned tour stops, which included several U.S. cities as well as venues in England, Ireland and Scotland.
When he took to the stage for the last time in 2012, he candidly sang about his diagnosis in the song, “I’m Not Gonna Miss You.”
A year later, Kim Campbell remembers cleaning the kitchen in their Malibu home, while her husband watched golf on television.
“He asked who I was,” she said. “It broke my heart.” “I’m Kim,” she responded. “I’m your wife, darling.”
She took him by the hand and led him to the staircase to guide him to their bedroom and he studied her face and said, “Oh, you’re my darling!”
“When we hugged, I wondered if he would recognize me the next day,” she said. Kim Campbell cared for her husband at home for years, but when he wandered at night and became combative, she realized she needed help. “He was a big strong man,” and she is petite.
“That was heart breaking and also dangerous,” she said. They relocated to Nashville to be near their three adult children, all of whom are singers and songwriters and to seek treatment from a neurologist at Vanderbilt. The doctor suggested they try a memory care facility, pointing out that she needed to take care of herself, too.
The family tried a few centers in the Nashville area. She was nervous, fearing her husband would grow angry. He didn’t.
He strummed a guitar he had bought in Ireland and played three songs. “He just lit up,” his widow recalled. “He was so happy. He thought he was closing a show.”
He thanked the other memory care residents for coming to his concert and took a bow. Then, he plopped on a community room couch and took a long nap.
She drove home and sobbed. Relief washed over her but so did sadness. She would have help caring for her husband, but their happy life together would never be the same.
They tried other memory care facilities and were excited to be among the first to move into Abe’s Garden Community when it opened in 2015. Here, the couple shared meals and good times chatting with others. Nearly every day, she drove to the facility to have lunch with him. Sometimes, she’d return for dinner, too. If she couldn’t make it, their children or one of his friends would visit.
“I never said I put my husband in a home,” she said. “I say our family joined a memory care community.”
Article published in The Tennessean on Sunday, December 1st, 2024 Beth Warren covers health care and can be reached at bwarren@tennessean.com.