Aged Care Insite Issue 110 Dec-Jan 2019 | Page 29

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. ■ agedcareinsite.com.au 27