EFFECTIVENESS OF MUSIC THERAPY ON PATIENTS LIVING WITH DEMENTIA

 

“Exploring the effectiveness of music therapy as part of nursing care for patients living with dementia”

Introduction

People living with dementia undergo various psychological challenges in life. Therefore, it is crucial to make interventions that could make their lives better. Music therapy is perceived as one of the major interventions that can help the patients as part of the nursing care. Therefore, caregivers face various music-based interventions that could fit their patients to deliver the best results. The major options music therapy, forming groups to sing as well as listening to various music genres to boost their psychological well-being (Bunn, Lynch, Goodman, Sharpe, Walshe, Preston and Froggatt, 2018). In this case, music therapy is explored further in this study as a major intervention among dementia patients based on its stimulating aspect.

According to The American Music Therapy Association, it involves a clinical way of using music geared toward achieving a certain goal with the help of a credentialed professional. In this case, dementia patients require the music therapeutic relationship that addresses their needs physically, emotionally, cognitively, and socially (Carrion, Folkvord, Anastasiadou and Aymerich, 2018). The significance of having a professional therapist is to assess the strengths, needs of every dementia patient, and decide the most suitable musical routine or song choice (Weise, Jakob, Töpfer and Wilz, 2018). As a result, the patients can be helped through new and dedicated music creation that addresses their situation. Alternatively, the patients will be required to sing along, make some moves as they listen. As a result, the patients achieve stronger abilities that will help them in daily life through better communication and overcoming difficulties when expressing themselves using words. The effectiveness of music therapy facilitates rehabilitation, motivation, and trigger movement during the treatment sessions (Osman, Tischler and Schneider, 2016). Further, it leads to emotional support to all stakeholders related to the patient as feelings expression is eased.

Studies reveal that music acts as a stimulating medium and it is accessible in various means. Therefore, dementia patients can use it alone, in the company of their family or caregivers (Schneider, 2018). As a result, most care homes hosting dementia patients and families have adopted music listening, singing, and dancing as part of their daily activities. It is also clear that modern societies recognize music as part of life, which makes it a universal language that can be enjoyed by people of all ages and backgrounds (Werner, Wosch, and Gold, 2017). Music tends to stick in mind despite other distractions to cognitive functionality.

Notably, the effectiveness of music therapy has not been exhausted in the current studies because the theoretical framework of dementia care is limited. The available studies have not elaborated strong theoretical frameworks to elaborate on the degree of effectiveness based on the best method and necessity of music therapy towards benefiting the psychological well-being of dementia patients. Therefore, this study will consolidate current studies to determine if the studies have identified a sustainable theoretical model for incorporating music therapy as part of caring for people living with dementia (Henskens, Nauta, st, and Scherder, 2018). The presence of different findings and results from studies is not enough if they cannot address the effectiveness of music therapy as a tool to be used by nursing caregivers dealing with dementia patients.

Therefore, this study will engage people living with dementia and their nursing caregivers directly to understand their social life and how they relate with the people around them. There are many dynamics of life exhibited by these patients, which can be physical, emotional, or social (Smallfield and Heckenlaible, 2017). For example, it will be significant to understand if music therapy can address all these aspects or it should be targeting either personality, physicality, social, or biological healing. In addition, the impact of music has to be targeted to certain patients' such as psychosocial factors.

According to Alzheimer's Research UK (2021), The latest study revealed that people living with dementia in the world are approximately 50 million. This is very saddening and measures should be taken to prevent the prevalence. It is further projected that the population suffering from Dementia may triple by the year 2050. These are not just mere statistics and there is a need to address the issue in totality. The cases of people already living with the problem are important to ensure the society is catered for (Froggatt, Patel, Perez Algorta, Bunn, Burnside, Coast . . . Walshe, 2018). Therefore, the study will be crucial for the people already affected to ensure the damage is reduced significantly, as the patients undergo musical therapy. It will not only help the patients but also the caregivers and the members of their families.

Aims and Objectives

1. To investigate the aspect of music therapy and its value to people living with dementia.
2. To explore the understanding and perspectives of nursing caregivers, families, and professional music therapists on the effectiveness of music to patients living with dementia.
3. To create a comparison and connections found between psychosocial factors and the findings derived from the study findings to determine the suitable music therapy theoretical model that can help patients living with dementia.

Methodology

The secondary sources used in this study were searched systematically using the keywords. The sources used in the literature review revolved around major keywords that made it easy to retrieve the relevant materials. As a result, the keywords yielded a variety of sources that were subject to appraisal. In this study, the keywords included Therapy, Music Therapy, Mental health, Dementia, and Nursing care for Dementia patients. All these terms are readily available in medical databases hence the preferred search engines included, BMJ, Medline, British Nursing Index (BNI), CINAHL, and Google Scholar. Priority was given to BMJ, BMI, and CINAHL. The first two databases are majorly based on the United Kingdom Journals whereas the  CINAHL  was critical in getting specialized peer-reviewed journals in many nursing topics. The studies chosen for this study were limited to 5 years old limit to ensure the contents were up-to-date and relevant to the research topic.  Other factors considered in the search process were the references used in each journal before the appraisal. However, time limitation a problem, and a critical review process was preferred. The table below summarizes the 10 sources used in the study in which most were British journals.

Author/year	Journal	Type of study	Purpose	Sample	Research Design	Data Collection	Key Findings	Strengths	Limitations	Location
Bunn et al. (2018)	BMC Geriatrics	Qualitative	Reviewing Namaste Care and other multisensory interventions	Purposive N= 85 papers And 27  Stakeholders	Descriptive	Literature and stakeholder interviews for a realist review	Intervention triggers feelings of familiarity, reassurance, engagement, and connection	Adequate papers for literature review and interview for firsthand information	The time limit in interviewing the 27 stakeholders	UK
Carrion et al. (2018)	Advances in Mental Health and Intellectual Disabilities	Qualitative	Identify the effects of Music Therapy on patients with both learning difficulties and Dementia	Selective  10-reality orientation 25-skills training 12-mixed trials	Descriptive	Systematic reviews and meta-analyses.	Stimulation of cognitive functions among people with dementia by skills training or a mix of reality orientation and skills training is effective in improving cognitive functioning	The combination of the trials and training yielded some results that can be used in making some correlations.	The findings were inconclusive	UK
Froggatt  et al. (2018)	BMJ open	Qualitative	Evaluating the quality of life, care, and dying experienced by these people is variable	Purposive N=3 participant groups	Controlled randomized trial	Semi-structured interviews	Music Therapy became more accepted the longer staff were exposed to it Music therapy aided patients Staff sometimes struggled to explain Music Therapy	Results are concurrent with similar studies	Aims could be more clearly defined Small sample size The questionnaire included non-nursing staff.	UK
Harmer,  & Orrell, (2008	Aging Ment Health ·           ·           ·           .	Qualitative	To  explore concepts of meaningful activity, as defined by older people with dementia living in care homes, staff and family carers	Selective 17-residents15-staff 8- family carers  3-care homes	Descriptive	focus groups	People with dementia staff and carers had differing views about what made activities meaningful.	Identifies various means of getting data using focus groups.	The sample size was inadequate	UK
Henskens et al. (2018)	Clinical Interventions In Aging	Qualitative	evaluate the effect of three-movement stimulating interventions on QoL and ADL performance in NH residents with dementia	Selective N=87	a parallel randomized controlled trial	Trials	ADL training can improve QoL	Use of the randomized trials reduced bias	Lack of additional data collection methods	UK
Osman et al. (2016)	Dementia (London) ·           ·           ·           .	Qualitative	Identify  suitable psychosocial interventions to help manage the condition, enhance well-being, and to provide support for caregivers	Selective N=20	Descriptive	semi-structured interviews	Social inclusiveness and improvements in relationships, memory, and mood were found to be especially important to participants.	The use of interviews ensured the collection of current first-hand information on the nb topic	20 participants is a small sample size given the topic has been exhausted before.	UK
Schneider (2018)	Int J Environ Res Public Health.	Systematic reviews	Arts as a Medium for Care and Self-Care in Dementia: Arguments and Evidence	Selective N+9 (5 service users, 4 Nurses)	Descriptive	Meta-reviews	There is more recognition of the contribution of the arts to the quality of life of people living with dementia	Use of different studies to review and apply on the topic	Lack of primary research.	Switzerland
Smallfield & Heckenlaible, (2017).	Am J Occup Ther ·           ·           ·           .	Qualitative	To describe the evidence for the effectiveness of interventions for adults with Alzheimer's disease (AD) and related neurocognitive disorders	Random   N= 52	Descriptive	Articles review	Occupational therapy practitioners should integrate daily occupations, physical exercise, and error-reduction technique.	A good	No usage of statistical power to justify findings	US
Weise et al. (2018)	BMC Geriatrics	Quantitative	To determine whether an individualized music intervention can improve the quality of life for PwD living in a nursing home	Selective   N=320 (Staff) N= 194 (Nurse)	Randomized controlled trial	Observations	Listening to individualized music constitutes a promising non-pharmacological intervention for PwD Therapy than MDT staff.	The randomized trials reduced possibilities of bias during the observation	Observing the patients for a long period of the intended 6 weeks follow up.	UK
Werner,  et al. (2017)	Aging & Mental Health	Quantitative	To  determine the effects of music therapy in dementia homes	Selective N= 117	Randomized  interactive groups	Focus groups	The level of depressive symptoms improved significantly more in those assigned to music therapy	Is the only Randomized controlled trial among the apprised articles	The method of assessment was not easily repeatable.	UK

 

 

 

 

 

 

References list

Alzheimer’s Research UK, 2021,  Dementia Statistics hub: Global prevalence, [Online]    Available at: <https://www.dementiastatistics.org/statistics/global-           prevalence/#:~:text=Globally%2C%20the%20numbers%20of%20people,2050%2C%20a            %20204%25%20increase> [Accessed 11 Jan. 2021]

Bunn, F., Lynch, J., Goodman, C., Sharpe, R., Walshe, C., Preston, N., & Froggatt, K., 2018.       Improving living and dying for people with advanced dementia living in care homes: A          realist review of namaste care and other multisensory interventions. BMC       Geriatrics, 18(1), pp. 303-303. doi:10.1186/s12877-018-0995-9

Link: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0995-9

Carrion, C., Folkvord, F., Anastasiadou, D. & Aymerich, M., 2018. Cognitive therapy for             dementia patients: A systematic review. Dementia and Geriatric Cognitive    Disorders, 46(1-2), pp. 1-26. doi:10.1159/000490851

Link: https://www.karger.com/Article/Fulltext/490851

Froggatt, K., Patel, S., Perez Algorta, G., Bunn, F., Burnside, G., Coast, J., . . . Walshe, C.,           2018. Namaste care in nursing care homes for people with advanced dementia: Protocol for a feasibility randomised controlled trial. BMJ Open, 8(11), e026531-e026531.           doi:10.1136/bmjopen-2018-026531

Link: https://bmjopen.bmj.com/content/8/11/e026531

Harmer, B., & Orrell, M., 2008. What is meaningful activity for people with dementia living in    care homes? A comparison of the views of older people with dementia, staff and family             carers. Aging & Mental Health, 12(5), pp.548–558. doi:10.1080/13607860802343019

Link: https://www.tandfonline.com/doi/full/10.1080/13607860802343019?scroll=top&needAccess=true

Henskens, M., Nauta, I. M., st, K. T., & Scherder, E. J. A., 2018. The effects of movement           stimulation on activities of daily living performance and quality of life in nursing home           residents with dementia: A randomized controlled trial. Clinical Interventions in           Aging, 13, pp.805-817. doi:10.2147/CIA.S160031

Link: https://www.dovepress.com/the-effects-of-movement-stimulation-on-activities-of-daily-living-perf-peer-reviewed-fulltext-article-CIA

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 (London, England), 15(6), pp. 1326-1339.        doi:10.1177/1471301214556291

Link: https://journals.sagepub.com/doi/full/10.1177/1471301214556291

Schneider, J., 2018. The arts as a medium for care and self-care in dementia: Arguments and             evidence. International Journal of Environmental Research and Public Health, 15(6),      pp. 1151. doi:10.3390/ijerph15061151

Link: https://www.mdpi.com/1660-4601/15/6/1151/htm

Smallfield, S. & Heckenlaible, C., 2017. Effectiveness of occupational therapy interventions to    enhance occupational performance for adults with alzheimer's disease and related major     neurocognitive disorders: A systematic review. The American Journal of Occupational Therapy, 71(5), 7105180010p1-7105180010p9. doi:10.5014/ajot.2017.024752

Link: https://ajot.aota.org/article.aspx?articleid=2648712

Weise, L., Jakob, E., Töpfer, N. F. & Wilz, G., 2018. Study protocol: Individualized music for     people with dementia - improvement of quality of life and social participation for people          with dementia in institutional care. BMC Geriatrics, 18(1), pp. 313-313.        doi:10.1186/s12877-   018-1000-3

Link: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-1000-3

Werner, J., Wosch, T., & Gold, C., 2017. Effectiveness of group music therapy versus      recreational group singing for depressive symptoms of elderly nursing home residents:            Pragmatic trial. Aging & Mental Health, 21(2), pp. 147-155.    doi:10.1080/13607863.2015.1093599

Link: https://www.tandfonline.com/doi/full/10.1080/13607863.2015.1093599