The occurrence of violence in long-term care homes, both resident-on-resident and towards care staff, is escalating at an alarming rate. The system is failing to provide a living and working environment that preserves the dignity, well-being, and safety of residents and care staff respectively.
The issue of violence in long-term care homes has recently been brought to media attention. On January 21, 2019, the Ontario Health Coalition released a report called Situation Critical: Planning, Access, Levels of Care and Violence in Ontario’s Long-Term Care. This report draws attention to the alarming statistics. Unfortunately, in the past five years, there have been 27 resident-on-resident homicides in Ontario long-term care homes. The root of this issue can largely be attributed to understaffing in long-term care homes across Ontario. Another key factor playing a role in these alarming statistics is the increase in the acuity of long-term care residents. Put simply, acuity is the measurement of the intensity of nursing care required by a patient. According to the Ontario Health Coalition, long-term care residents today are medically complex and frail, and therefore, require equally complex care. The understaffing, in combination with the increased acuity of long-term care patients, leaves care staff ill-equipped to properly care for all residents, especially those with severe cognitive impairments. When residents are left unattended and/or are not properly monitored, signs of agitation go unnoticed, and often manifest in violent behaviours.
So, how does music play a role in the issue of alleviating the issue of violence in Ontario long-term care homes? Music can be used as a tool to calm and relieve agitated behaviours before they manifest as violence. Moreover, it can be implemented in a way that requires minimal time and effort from care staff. For example, a study conducted by Jan Cioddaer and Ivo L. Abraham titled, Effects of Relaxing Music on Agitation During Meals Among Nursing Home Residents With Severe Cognitive Impairment, found that simply playing relaxing music during the main meal of the day helped significantly reduce agitation among residents with severe cognitive impairments. More importantly, it helped significantly reduce physically aggressive behaviours. Care staff are already stretched thin due to understaffing, however, as previously mentioned, playing prerecorded music requires minimal time and effort and could have some incredible positive implications moving forward in terms of reducing violence.
It is clear that in order to solve this horrifying healthcare issue, it is of the utmost important that policy changes are made, and fast. The Ontario Health Coalition, and various researchers such as Dr. James Brophy and Dr. Margaret Keith have done an amazing job bringing this issue to the forefront. But how long will it be until we see tangible changes? Aligning with the goals of Room 217, it is critical that music is seen as a primary approach to care. Music is something that can be implemented almost immediately, and by almost anyone in the long-term care setting. Moreover, it can be implemented in a way that requires minimal effort. Optimistically, music, in combination with policy changes, will be used to decrease violent behaviours in long-term care homes in order to provide a living and working environment that preserves the dignity, well-being, and safety of residents and care staff respectively.
This article was written by Mara Medeiros, and is part of a series provided by upper year health sciences students at McMaster University.