This article was written by Adriana Fedorowycz, and is part of a series provided by upper year health sciences students at McMaster University.
As a result of North America’s increasing aging population, dementia is becoming more common, and is prevalent in the long-term care system. Studies from the U.S. show that residents of long-term care homes experience symptoms of dementia at three times the rate of the senior population outside of the long term care system, and, in the average long term care home, about 50% of residents have dementia. Because there are risks associated with using medications like antipsychotics to treat symptoms of dementia, it is important that studies are done on the effectiveness of treatments that aren’t drug-based.
A study conducted by Thomas et al. found that the use of a program for personalized music in long term care homes was linked to positive effects for residents living with dementia. In particular, it was associated with a decrease in the use of antipsychotic and anti-anxiety medications, as well as fewer behavioural problems among residents.
The “MUSIC & MEMORY” program was created in 2006 to help reduce the symptoms of dementia for long-term care home residents. Through this program, caregivers provide music playlists for the residents that are specific to their personal histories and musical tastes. In order to implement this program in a long-term care home, a minimum of one staff member must undergo training through three 90-minute webinars hosted by MUSIC & MEMORY, Inc. These webinars cover the benefits of personalized music, the legal boundaries of music sharing, how to create personalized music playlists, and how to introduce and expand the program over time. Further support is offered by MUSIC & MEMORY, Inc., in the form of online resources and one-on-one consultation. The 2014 documentary Alive Inside showed how this program encouraged residents to sing and dance along to music; however, the full extent of how it affected the participants’ health was not yet well known.
The Thomas et al. study compared 98 nursing homes that used the MUSIC & MEMORY program between 2012 (the year before the program was used) and 2013 (the year the program was used) with 98 nursing homes that didn’t use the program between 2012 and 2013. About 13,000 residents living with dementia participated in each group.
The study looked at the effect this program had on the use of anti-anxiety and antipsychotic medications, behavioural problems, and resident mood.
Findings showed that, while the use of antipsychotic medication stayed the same for long-term care homes that did not use the MUSIC & MEMORY program, the homes that were involved with the program saw an increase in the number of residents that stopped using antipsychotic medication after the program’s implementation. Specifically, the proportion of residents who stopped taking this form of medication increased from 17.6 per cent in 2012 to 20.1 per cent in 2013.
Similar results were found when researchers looked at the use of anti-anxiety medications from 2012 to 2013. In the long-term care homes involved with the program, the number of residents who stopped taking anti-anxiety medication increased slightly after the program’s implementation (from 23.5 per cent to 24.4 per cent), while the number of residents who stopped taking anti-anxiety medication decreased during that same time in homes that did not use the program (from 24.8 per cent to 20.0 per cent).
Additionally, for homes that were involved with the program, the amount of residents whose behaviour showed improvement increased after the program was implemented (from 50.9 per cent in 2012 to 56.5 per cent in 2013), while the amount of residents whose behaviour improved did not change for homes that were not involved with the program.
However, no significant difference in mood was found between residents of long-term care homes that were involved with the program and the residents of homes that were not involved with the program.
Overall, the use of this personalized music program was found to be connected with fewer residents taking antipsychotic and anti-anxiety medications, as well as a decrease in behavioural problems. This provides some evidence that music-based programs like the MUSIC & MEMORY program could be a practical way to lessen the symptoms of dementia for long term-care residents without relying on the use of drugs.
Room 217 has an extensive collection of articles and webinars about music and health in its reference library. If you want to learn how to incorporate music into your care practice, visit our Music Care Training page. We also have resources for use in a number of care settings.