Music Therapy in Dementia Care

Introduction

Music therapy does not treat dementia. The use of music therapy is founded on the beneficial effects it may have on symptoms regarding cognitive, social, and emotional skills (Aparecida, et al., 2017). Music therapy is also believed to reduce behavioral problems of people who have dementia (Pedersen, et al., 2017). Since the disease is incurable, the principal treatment goal is quality of life. Individuals with dementia usually report reduced quality of life as a result of changing family relationships, decreased ability in performing daily living tasks, and social isolation (Pedersen, et al., 2017). The changes often lead to depression, anxiety, and agitation. Marsh (2016) posits that clinically significant depressive disturbance occurs in 40 to 50 percent of patients with dementia.

According to Garrido, et al., (2017), approaches that are non-pharmacological are desirable in tackling the behavioral changes that are associated with dementia because pharmacological treatments have high rates of adverse effects. If non-pharmacological treatments like music therapy were implemented in hospitals for people with dementia, their wellbeing would be improved (Garrido, et al., 2017). Music can be a useful tool for changing the moods of patients with dementia, especially during personal care (Dementia UK, 2017). Leading research has also shown that the use of music therapy in the management of dementia can reduce medication use (Dementia UK, 2017). Although various reports have emphasized the need for further research into the effectiveness of non-pharmacological methods in the treatment of dementia in the UK, music therapy is recommended as a psychosocial intervention in the National Dementia Strategy (Department of Health, 2017). However, documentation and quantification of the evidence of this effect are essential.

Literature Review

Bibliographic searches for this paper will include MEDLINE and the Cochrane Central Register of Controlled Trials. Additional databases that will be searched include CINAHL, EMBASE, and PsychINFO. Both controlled and uncontrolled vocabulary will be used and search will be tailored for each database. Also, bibliographies existing eligible studies and reviews will be scanned. Assessment of literature for this study will be done checking the credentials of the authors, ensure that the arguments are supported by evidence, and objectivity. It will also be critical to determine whether the conclusions and arguments are convincing. The arguments and the conclusions in the literature should significantly contribute to an understanding of the research topic. Regarding risk bias assessment, risk of bias categories that are appropriate for the topic of this study and the design will be selected. Instruments of risk bias that are based on established measurement properties, epidemiological study design, and empirical evidence will be chosen. Finally, instruments that include items that assess specific concerns associated with each of the bias risk categories that present threats to the accuracy of the effect estimate will be selected.

In a paper that reviewed studies that used pre-recorded music to treat people with dementia, Garrido, et al., (2017) revealed that the use of pre-recorded music can be useful in dealing with the symptoms of dementia such as agitation and other behavioral symptoms even in the absence of a trained music therapist. However, the results of the study are not universally positive suggesting the necessity to clarify the protocols for the use of music and further exploration of variables that affect individual response to music therapy (Garrido et al., 2017). Osman et al., (2016) also found that music therapy is vital to both caregivers and dementia patients, and helped in coping with and accepting dementia.

The importance of music therapy in managing dementia patients is also suggested by Ahn & Ashida (2012). Ahn & Ashida (2012) assert that music can be used to facilitate positive interactions and evoke reactions that are positive hence reducing agitation, restlessness, and depression. Although there are positive responses to music among dementia patients, Ahn & Ashida (2012) warn that there are research gaps in the use of music therapy to manage dementia. This hinders the confidence to say that music therapy is evidence-based. Therefore, ascertaining the effectiveness of music therapy requires more attention using meticulous research (Ahn & Ashida, 2012).

According to Clark & Shoemark (2015), music can help in the engagement in communicative dialogues and address the psychosocial needs for patients who have dementia. Clark & Shoemark (2015) opine that the use of music in the management if patients with dementia is well researched, and music is well preserved in people with dementia, even when other cognitive functions have deteriorated. Music and singing trigger language functioning (Moussard et al., 2012), memory function (Finkel & Burns, 2013), reduce anxiety and pain (Korhan et al., 2014), and lead to positive emotions and reducing agitation (Livingston et al., 2014).

The results of this literature review confirm that there is a clear relationship between improved cognitive skills and memory and music therapy. Research into the use of music therapy lacks the methodology design vigor (Garrido et al., 2017). However, from this literature review, it is clear that there is sufficient evidence on which to justify an in-depth investigation into the use of music in the management of patients with dementia. Further, the reviewed literature does not provide enough empirical evidence that can be used to justify the use of music therapy in the treatment of dementia. However, evidence strongly suggests that music therapy is beneficial in the management or treatment of symptoms of dementia, and the main conclusion of this literature review is that there is a need for studies that are better designed to establish the use of music therapy as an intervention in the management of dementia.

Methodology

This study will be quantitative research. Quantitative research is essential because the researcher will compare the results of music therapy in wards and the results of no music for a period of six months. The patients will be observed for six months with music and six months without music. when a researcher seeks to establish the meaning of a phenomenon through description (Al-Busaidi, 2015). The research philosophy a researcher chooses impacts the quality and design of the study. This research will adopt interpretivism as a research philosophy, as it is concerned with people’s behaviors (Howell, 2014).

This study will also use the inductive approach because previous research has only partially explained the use of music therapy in the management of dementia. Also, since this is a study of human behavior, an inductive approach will be appropriate. Further, the data that will be used in this research will be collected through interviews and observation. Archival data will also be used. Finally, the study will make use of thematic analysis. Thematic analysis to present patterns or themes that are associated with the collected data (Castleberrya & Nolen, 2018). Thematic analysis helps in illustrating collected data in detail and tackles varied subjects through interpretations (Castleberrya & Nolen, 2018).

References

Ahn, S. & Ashida, S., 2012. Music therapy for dementia. Psychology Journal, IV(2), pp. 6-7.

Al-Busaidi, Z. Q., 2015. Qualitative Research and its Uses in Health Care. International Journal of Medicine, X(6), pp. 45-53.

Castleberry, A. & Nolen, A., 2018. Thematic analysis of qualitative research data: Is it as easy as it sounds?. Currents in Pharmacy Teaching and Learning, X(6), pp. 807-815.

Clark, I. & Shoemark, H., 2015. Music Therapy and Aging Well. Australian Journal of Therapy, V(2), pp. 74-85.

Department of Health, 2017. Living well with dementia: London: Department of Health.

Finkel, S. I. & Burns, A., 2013. Behavioral and Psychological Symptoms of Dementia: A Clinical and Research Update. International Psychogeriatrics, IX(1), pp. 9-12.

Garrido, S. et al., 2017. The Use of Music Playlists for People with Dementia: A Critical Synthesis. Journal of Alzheimer's Disease, LX(3), pp. 1129-1142.

Korhan, E. et al., 2014. The effects of music therapy on pain in patients with neuropathic pain. Pain Management Nursing, XV(1), pp. 304-314.

Livingston, G. et al., 2014. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technology Assessment, XXV(39), pp. 96-124.

Moussard, A., Bigand, E., Belleville, S. & Peretz, I., 2012. Music as an Aid to Learn New Verbal Information in Alzheimer's Disease. Music Perception: An Interdisciplinary Journal, XXIX(5), pp. 521-531.

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. SAGE Journals, XV(6), pp. 1326-1329.