Abstract
BackgroundPrevious research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients’ care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes.Methods17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents’ symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers’ feedback through semi-structured interviews, programme evaluations and track records of the study.ResultsThe music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (−0.74, 95 % CI: [−1.15 to −0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme.ConclusionThe data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size.Trial registrationClinicaltrials.gov, number NCT01744600.
Highlights
Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia
At Home 2, 5 residents and 5 carers recruited for the intervention group, and 5 residents and 2 carers recruited for the control group
9 residents and 7 carers were allocated to the music therapy group, and 8 residents and 3 carers were allocated to the standard care group
Summary
Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Neuropsychiatric symptoms of dementia such as agitation, depression, apathy and anxiety are reported to affect approximately 80 % of people with dementia living in care homes [2, 3]. These symptoms are chronically present and in need of long-term support to reduce the impact on care home residents’ quality of life and caregiver stress [4]. Kitwood’s work in particular has placed importance on the quality of relationships with caregivers as key to well-being [7] His concept of ‘person-centred care’ initiated a shift away from the more medical approach and emphasised the importance of considering the individual and their unique psychosocial needs
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