clinical focus
Source: The University of Melbourne
different to that small group music
therapy intervention, because the music
therapy intervention is delivered by a
registered music therapist, someone with
master’s level training who has expertise
specifically for this population, whereas
the community musician could be just
somebody who’s been a performer, who
comes into the home. That’s the second
condition, the recreational choir singing.
Then we have a third condition, which
actually has a combination of both. There
will be two sessions of group music
therapy each week, as well as two sessions
of this kind of choir singing, twice a week
for the first three months, and then they
drop down to one time each for the
second three months.
Why is music therapy important?
symptoms of dementia as well as
levels of depression. We’ve got these
four conditions. As usual in a big trial
like this, we have standard care as the
control condition.
Then we have another condition, which
we’re calling small group music therapy,
where we take small groups of people with
dementia who are exhibiting depression,
and we have a tailored program where we
design musical activities to meet the needs
of these people. The music therapist will
work with them to match their emotional
level and attune to their emotional state
using music, preferably music that they are
connected to and have a long history with.
We work with them twice a week for the
first three months, and then once a week
for the following three months. That’s our
first condition.
Our second condition is what we’re
calling recreational choir singing, where
we’re taking larger groups of people
living with dementia in care and running
a kind of singalong that’s directed by
a community musician. This is quite
People who are living with dementia have
a lot of challenges with ongoing memory.
The confusion they sometimes experience
in the residential care setting can be quite
distressing for them. The wonderful thing
about music therapy is that people who
have dementia connect with music from
their past, and it helps them to feel safer and
more calm. Once they’re more calm, they’re
more able to interpret their environment and
therefore be less stressed by it. It impacts
their degree of stress and anxiety.
Then it has a ripple effect throughout the
whole home. If these people are responding
to music, and they’re feeling more calm
and less disruptive to others around them,
then other people get less distressed as well.
We’re looking really at a care home level, as
well as looking at individuals.
Music is important because it connects
with people’s emotions. Given that
we’re looking at depression specifically,
we’re trying to use the music as a way of
enhancing people’s wellbeing through
altering their mood, so making their mood
more positive by helping them to connect
with positive memories through music.
Music often evokes specific moments
in time, doesn’t it?
That’s right. One of the things we know
is that people living with dementia have
what they call the reminiscence bump.
This is a period of time when they’re in
their late teens to their mid to late 20s,
where they are laying down memories that
are really important to them. It’s usually
when they find their first love, when
they start a family. It also happens to be
a period in time where music becomes
really important as well. We know that
that’s why, even with teenagers, that
they’re really hooked on music at that
period in their life when they’re forming
their identity.
When we use music with older people
who have memory issues, it evokes these
memories that are connected to that same
period in their life, when they’re having all
these really positive experiences. When
they listen to that music, it connects them
emotionally as well as cognitively to that
feeling they had when they were younger.
What are the anticipated outcomes
from this type of therapy for people
living with dementia?
Our research is looking at a number of
different outcomes. For people living with
dementia, we’re anticipating that the small
group music therapy will actually reduce
their level of depression and help them to
have a better quality of life, and to be more
socially connected with people within
the home. We’re looking at how it impacts
care staff as well.
We’re also looking at a health economic
analysis, what the economic benefit is for a
care home and for people who are paying
to be in the care home. We’re looking at
staff stress levels. For people living with
dementia, we’re looking at whether they
need less medication. We’re looking at
medication data. We’re looking at the
number of falls they might have. We’re
looking at, not just in the moment, but
what happens more long-term.
What’s the relevance, considering
Australia’s ageing population?
As you can imagine, the number of people
entering care homes is increasing as
our population increases, but also the
number of people living to be 100 years
of age is also increasing. We know that
the percentage of people over 80 who
are living with dementia is much higher
than those over 60, so we’re expecting
more and more people to be living with
dementia in care homes in the future.
We’re hoping that our research will
show that if music is able to manage
people’s emotional state and allow them
to have a better quality of life, then that’s
a great thing for society, because we have
a responsibility to look after our older
generation, and having a better quality of
life is a key component of that. ■
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