Observing Music Therapy in Dementia: Repeated Single-case Studies Assessing Well-being and Sociable Interaction

Kristine Gustavsen Madsø,Helge Molde,Kia Minna Hynninen,Inger Hilde Nordhus

doi:10.1080/07317115.2021.1978121

Kristine Gustavsen Madsø, Helge Molde + Show 2 more

Open Access

https://doi.org/10.1080/07317115.2021.1978121

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Journal: Clinical Gerontologist	Publication Date: Sep 29, 2021
Citations: 6	License type: open-access

Affiliation: University of Bergen, University of Oslo

Abstract

ABSTRACT Objectives This study compared behavioral expressions of momentary well-being and sociable behavior toward significant others during music therapy and regular social interaction. Methods A 10-week active music therapy intervention was provided for people living with dementia and family caregivers. A bi-phasic AB single-case design was replicated for three sessions per dyad and coded using the Observable Well-being in Living with Dementia-Scale (OWLS) and the Verbal and Nonverbal Sociable Interaction Scale-Care Receiver (VNVIS-CR). Effect sizes (Log Response Ratio) were calculated for each session and analyzed with robust cluster meta-analysis. Results Eleven dyads were included, and 32 sessions analyzed (2102 observations). Within sessions we found a 48% increase in well-being, and a 32% increase in sociable interaction during music therapy. Heterogeneity was high. Dementia severity predicted an increase in nonverbal sociable interaction (93% for moderate dementia). Depression and time did not predict any change. Conclusion The potential of music therapy to increase well-being and sociable interactions toward significant others calls for further investigation of heterogeneity and covariates. Single-case designs are demonstrated to be feasible for these investigations. Clinical implications Preference-based music therapy may alleviate some of the individual and relational consequences of living with dementia, facilitating positive emotions and connection to significant others.

Highlights

An increasing attention toward living well with dementia is present in dementia research and care (Dröes et al, 2017), public action plans, and guide lines (i.e. National Institute for Healt and Care Excellence, 2018; World Health Organization [WHO], 2017)
To investigate the sources of heterogeneity, sepa rate meta-regression analyses were conducted for the moderators “dementia severity” and “depression.” Using dementia severity as a factor (CDR, “very mild,” “mild,” and “moderately severe”), we found a larger change in the nonverbal sociable interactionsubscale in the group with “moderately severe dementia” (80% change, LRR = 0.59, 95% CI = [0.05– 1.12], SE = 0.19, t(4) = 3.05 p
For the well-being measure, the results indicated that dementia severity could predict the effect of music therapy as well, but the reliability of the results were too low to be trustworthy (Tipton & Pustejovsky, 2015)

Summary

Introduction

Personalized and active music interventions may be beneficial for several of these objectives for multi ple reasons (Brancatisano, Baird, & Thompson, 2020). Music is a strong trigger of positive emotions G., Juslin, 2013), and familiar music may trigger pleasant memories and maintain a sense of identity and coherence in the individual living with dementia (Baird & Thompson, 2018; Särkämö, 2018). Music is an engaging and inherently social activity (Brancatisano et al, 2020). Active music interventions may posi tively affect cognition (Fusar-Poli, Bieleninik, Brondino, Chen, & Gold, 2018), and meet current recommendations of individualizing interventions for this group (Dowson, McDermott, & Schneider, 2019; WHO, 2017)

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