Does music therapy help to moderate the agitated behavior of people with dementia?
Music intervention is non-invasive and enjoyable. During the past two decades, the health care field has seen an increased interest in and exploration of the therapeutic potential of music in the restoration, maintenance and improvement of mental and physical health.
Koger, Chapin, & Brotons (1999) conducted a meta-analysis of 21 empirical studies, testing the hypothesis that music or music therapy would be an effective intervention for use with people with dementia. Statistical analyses revealed that the overall effect of music or music therapy was significant, although the effect sizes were not consistent across all studies. A qualitative study of 10 people with severe dementia showed that in the presence of background music, caregivers decreased their verbal instructing and narrating while the patient communicated with an increased understanding of the situation, both verbally and behaviorally. During caregiver singing, despite an evident reduction in the amount of verbal narration and description by the caregiver, the patient implicitly understood what was happening (Gotell, Brown, & Ekman, 2002). Another study by Remington (2002) illustrated that exposing people with dementia to calming music for 10 minutes decreased physically nonaggressive behaviors. One hour later, verbally agitated behaviors were also reduced. Ragneskog et al. (1996) suggested using music at dinner time, particularly soothing music to reduce irritability, fear-panic and depressed mood, and as a result to increase food intake. Clark, Lipe and Bilbrey (1998) revealed that when recorded music was played during bathing, the aggressive behavior of people with Alzheimer's disease was significantly reduced. Some studies (Gerdner, 2000; Ragneskog, Asplundh, Kihlgren, & Norberg, 2001) even suggested using individualized music over classical relaxation music to produce the best results in reducing agitation. It was explained that experiences associated with music are not embodied in its content, but the latter is reflective of emotions, memories, and private images that have a learned association with music stimuli (Thaut, 1990). The findings of these studies provide some evidence that music interventions assist in managing agitated behavior in those with dementia. Issue Contributor:Daphne Cheung Sze-ki, RN, MSc, BN
Registered Nurse
PhD student, School of Nursing, The Hong Kong Polytechnic University of Hong Kong. References:
Clark, M.E., Lipe, A.W., & Bilbrey, M. (1998). Use of music to decrease aggressive behaviors in people with dementia. Journal of Gerontological Nursing, 24(7), 10-17.
Gerdner, L.A. (2000). Effects of individualized versus classical "relaxation"music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders. International Psychogeriatric, 12(1), 49-65.
Gotell, E., Brown, S., Ekman, S.L. (2002). Caregiver singing and background music in dementia care. Western Journal of Nursing Research, 24(2), 195-216.
Koger, S.M., Chapkin, K., & Brotons, M. (1999). Is music therapy an effective intervention for dementia? A meta-analytic review of literature. Journal of Music Therapy, 36(1), 2-15.
Ragneskog, H., Asplund, K., Kihlgren, M., Norberg, A. (2001). Individualized music played for agitated patients with dementia: analysis of video-recorded sessions. International Journal of Nursing Practice, 7, 146-155.
Ragneskog, H., Brane, G., Karlsson, I., & Kihlgren, M. (1996). Influence of dinner music on food intake and symptoms common in dementia. Scandinavian Journal of Caring Science, 10(1), 11-17.
Remington, R. (2002). Calming music and hand massage with agitated elderly. Nursing Research, 51(5), 317-323.
Thaut, M.H. (1990). Neurophysiological processes in music perception and their relevance in music therapy. In R.F. Unkefer (Ed.), Music therapy in the treatment of adults with mental disorders. (pp. 3-32). New York: Schimer Books.
TAG: Issue January