Dementia: Holistic Approaches to Memory Care

Dementia is an expansive term that includes a few degenerative conditions that are characterized by critical mental debilitation. Loss of memory, changes in the dialect, conduct, and judgment prompts significant hindrance of daily activities in an individual. While progression in quality of life has been effective in extending life expectancy, this has prompted a checked increment in the number of individuals most helpless to memory loss. Dementia is referred as a clinical syndrome of cognitive decline. Global estimates reflect that 44.4 million people have dementia, which will increase to 75.6 million by 2020 (Boltz, Capezuti, Fulmer, & Zwicker, 2016).

The increasing number of the elderly population in the United States is due to population trend on the US Baby Boom between 1946-1964, which affects about 11% of people between 65 years and above (Ray & Mittelman, 2017). Dementia prevalence grows exponentially with age, increasing to almost 32% in individuals 85 years and above (Ray & Mittelman, 2017). Over 4.7 million people in the United States have the most common form of dementia, and this number is projected to increase to 13.8 million by 2050 (Boltz et al., 2016). Agitation can be portrayed as anxious conduct or ill-advised physical and verbal activities that may cause inconvenience for relatives, nursing staff and caregivers (Ray & Mittelman, 2017). The symptoms of agitation include irritability, anxiety, restlessness, pacing, and anger.

The elderly are the vulnerable group of most cases of the disease. Pharmacological treatment is effective in controlling the side effects of dementia, however, the related reactions led patients and suppliers to desire elective strategies for treatment. Music interventions offer an inexpensive alternative to medication to reduce behavioral disruptions. Although music therapy has been under underutilized, it has been reported to improve behaviors and brighten morale of caregivers by decreasing the overall stress level. When individuals with dementia presents difficult behavior such as noncompliance with care or medication, holistic approaches that promote communication skills, interpersonal relationships, physical and cognitive health become significant (Ray & Mittelman, 2017). Thus, the research will explore the effects of music therapy interventions on patients with dementia. The focus will be on reducing agitation.

Literature Review

Chu et al. (2014), examined the adequacy of group music treatment for enhancing wretchedness and deferring the disintegration of subjective capacities in elderly people with dementia. The authors conducted the research using a planned and cumulative outline with permuted-square randomization. As a result, the sample population got 12 sessions of musical treatment and the control cohort got regular treatment. Based on the outcome, the authors suggested that group music treatment diminished dejection in people with dementia. Changes in gloom occurred after musical treatment and were obvious throughout the course of treatment. Thus, the authors concluded that music mediation is a noninvasive and reasonable treatment, which can decrease dementia effects in the elderly. It additionally postponed the weakening of intellectual capacities, especially memory loss. Thus, group music treatment might be a proper intercession among elderly people with dementia.

With the increasing number of the aged in the UK, reports show they are defenseless against long- term uneasiness, wretchedness, torment, and dementia. Elles (2014), emphasized that these conditions can be alleviated by curative method, however, this has variable antagonistic impacts. Thus, elderly people regularly lean toward choices, for example, unwinding, and diversion, including music or singing sessions. This survey of applicable examinations suggested that the utilization of music as a substantial nursing intercession could ease nervousness and memory loss. The author concluded that non-pharmacological approaches ease memory loss and enhance personal satisfaction.

In the study of non-pharmacological approaches, Gallego and Garcia (2017), tested the clinical change profile of Alzheimer patients who have experienced musical treatment. The sample populations were patients with mild Alzheimer disease (AD). Changes were seen in memory loss, coordination, dejection, and uneasiness in patients suffering from mild dementia, hallucination, tumult, fractiousness, and dialect issue. The impact on cognitive measures was obvious after the music treatment sessions. The authors concluded that music therapy enhanced some intellectual, mental, and conduct changes in patients with AD. Consolidating music therapy with dance sessions to enhance motor and brain debilitation would be an intriguing line of study.

Dementia is a staggering and dynamic disease that causes the loss of feeling of self and sentiments. For example, disappointment, despondency, tension, and memory loss are effects of dementia. Goldstein-Levitas (2016), believe dance therapy is a valuable, non-pharmacological intervention for dementia, as it improves personal satisfaction, lessen intellectual decay, and cost effective. Thus, dance and movement therapy connects with tangible frameworks and empowers physical, passionate, and cognitive reasoning. This article confirms that tactile incitement in dance and movement therapy is an inclusive, sparing, and a holistic approach for dementia treatment.

Another survey by Janzen, Zecevic, Klosec, and Orange (2013), revealed that about 36 million individuals have Alzheimer’s illness globally, and numerous behavioral challenges. As a result, the authors explored the views of caregivers concerning non-pharmacological approaches to dementia. The authors also studied the facilitators and hindrances that guide non-pharmacological interventions in the treatment of dementia and its effects. Qualitative techniques were utilized to assemble information from meetings and group gatherings. The discoveries demonstrated that both medications and non-pharmacological approaches are utilized for the administration of agitation and memory loss. The utilization of non-pharmacological intervention was encouraged by consistency and efficiency in quality care. The authors listed the absence of time, low staff-to-patient proportions, and short-enduring adequacy of non-pharmacological approaches as constraints of the research. This examination offers understanding into elements that affect the use and effectiveness of non-pharmacological interventions.

Li et al. (2015), revealed that music treatment (MT) surveys have discovered valuable consequences for practices, social association with Alzheimer’s disease (AD) and conflicting consequences on cognition. The reason for the investigation was to assess the impact of long term and locally situated music therapy in Alzheimer’s disease in AD patients undergoing pharmacological treatment. The authors revealed there were no significant benefits of musical treatment on daily cognitive functioning of Alzheimer’s patients. McDermott, Orreli, and Ridden (2014), carried out a qualitative study to advance further into musical encounters of patients with dementia and investigate the importance of music in their lives. The authors developed a psychological model of music and uncovered the significance of music to help the cognitive research of individuals with dementia and the social psychology of the healing facility. The authors concluded that impacts of music exceed the mitigation of behavioral conduct and mental indications. Preference of music is protected during the curative sessions of dementia.

Onieva-Zafra, Hernandez-Garcia, Gonzalez-del-Valle, and Fernandez- Mariez (2018), conducted a survey to examine the impact music and memory treatment with the utilization of effective orientation methods. The authors suggested that listening to familiar music associated with the memory of past occasions would invigorate memory affiliations leading to a constructive outcome of misery and nervousness. The outcome affirmed the impact of music sessions with orientation procedures on patients with moderate Alzheimer disease. The survey makes up a critical phase for future studies on the nursing intercession of music and orientation methods.

Vink, Zuidersma, Boersma, Zuidema, and Slaets (2013), compared the impact of music treatment and recreational exercises in lessening anxiety in individuals with dementia. The findings revealed that music treatment and recreational exercises improved the cognitive reasoning. However, there was no gainful impact of musical treatment on general exercises. Further research is required to give knowledge on the impacts of music treatment in decreasing anxiety in demented patients.

Project Idea/Research Question

There is a growing need for the use of non-pharmacological methods such as music therapy because it is a cost-effective intervention of promoting sensory, cognition, and motor stimulation for residents with dementia. Music is an enjoyable stimulus capable of stimulating positive emotion and increasing the tolerance threshold toward stressful stimuli (Onieva-Zafra et al., 2018). As more patients burdened with dementia are admitted to healing centers, caregivers solve complex issues associated with dementia-related practices and dealing with those practices. This research provides a framework for understanding the influence of music therapy as a holistic approach to dementia.

Research Question

What is the benefit of music therapy interventions to demented patients that experience agitation?

Patient- Patients with dementia

Interventions- Agitation, music therapy interventions, non-pharmacological activity

Comparison- Standard medical care, randomized controlled group

Outcomes- Decreased agitation, enhanced personal satisfaction, decreased discouragement

Research Site/Strategy

The reason for this examination is to explore a profound comprehension on how music affects elderly patients with dementia. Specifically, this investigation means to acquire information on how music oversees conduct issues in individuals experiencing dementia. Based on these assumptions, the paper adopts two theories of planned behavior and social cognitive theory. The theories have been used in different research settings, which account for its general acceptance. Change theories predict individual conduct as elements agreeable to change and they incorporate non-volitional parts that recognize that people do not have thorough control over their activities. The research will be a four-week therapy session administered on seven residents. Participants will be randomly selected from the sample population.

The inclusion criteria include patients 65 years and above. Consequently, the patients should have mild or moderate dementia, with specific interest in agitation. However, patients with a poor educational background and hearing impairment will be excluded from the experiment. In accordance with research ethics, the participants will sign a voluntary consent form before participating in the program. As a result, the details of the research will remain confidential and private. Data collected will be recorded and analyzed using appropriate analysis. The research will adopt the formal interview method and observation technique as its data collection method. The data collected will be analyzed using inductive code patterns. Thus, a methodological log of daily activities will be analyzed.

SWOT Analysis

Strength of the Site

Participants will be selected from Fraser Healthcare Center. By implication, residents will be accessible throughout the research timeline. The nursing staff will form the research team. Thus, the research will be cost efficient due to limited cost of logistics. Data collection will be guaranteed because residents and the nursing staff can be observed simultaneously.

Weakness

The planned research will be carried out in facilities not specific to dementia issues. Sorting will be a challenge for the research team because of the patient’s treatment routine. Since participants are not confined to a specific location, it would be difficult to monitor and control their activities.

Opportunities

The nursing homes may exploit the project to its advantage by incorporating it in its operations. The program can be offered to the outside community to reduce cases of dementia in the elderly. Based on the subjective report, the nursing homes can adopt the research measures and findings, which will be a holistic approach to memory care.

Threats

Some participants could be discharged before completion of the program. Delays in obtaining consent form will affect the data collection process. There is the possibility of participants withdrawing from the experiment for personal or family induced reasons. The treatment routine of participants could affect the timing and daily observations

Project Overview/Timeline/Outcome

As more patients burdened with dementia are admitted to healing centers, caregivers solve complex issues associated with dementia-related practices and dealing with those practices. While it is typical for antipsychotic solutions to be utilized as a part of these circumstances, it is vital to instruct caregivers about the perilous impacts these drugs can have on dementia patients. It will be similarly as vital to instruct them about non-pharmacological approaches, and their advantages, in the administration of testing dementia-related practices. Thus, this research provides a framework for understanding the influence of music therapy as a holistic approach to dementia. The project will be a four-week session administered on seven residents in Fraser Healthcare Center.

References

Boltz, M., Capezuti, L., Fulmer, T., & Zwicker, D. (2016). Evidence-based geriatric nursing protocols for best practice (5th ed.). New York, NY: Springer Publishing Company.

Chu, H., Yang, C., Lin, Y., Ou, K., Lee, T., O’Brien, A., & Chou, K. (2014). The impact of group music therapy on depression and cognition in elderly persons with dementia. American Journal of Alzheimer’s and Other Dementias, 16(2), 209-217.

Eells, K. (2014). The use of music and singing to help manage anxiety in older adults. Mental Health Practice, 17(5), 10-17.

Gallego, M. G., & Garcia, J. G. (2017). Music therapy and Alzheimer’s disease: Cognitive, psychological, and behavioral effects. Neurologia, 32(5), 300-308.

Goldstein-Levitas, N. (2016). Dance/movement therapy and sensory stimulation: A holistic approach to dementia care. American Journal of Dance Therapy, 38(2), 429-436.

Janzen, S., Zecevic, A. A., Klosec, M., & Orange, J. B. (2013). Managing agitation using nonpharmacological interventions for seniors with dementia. American Journal of Alzheimer’s and Other Dementias, 28(5), 524-532.

Li, C., Liu, C., Yang, Y., Chou, M., Chen, C., & Lai, C. (2015). Adjunct effect of music therapy on cognition in Alzheimer’s disease in Taiwan: A pilot study. Neuropsychiatric Disease and Treatment, 1(1), 291-296.

McDermott, O., Orreli, M., & Ridden, H. M. (2014). The importance of music for people with dementia: The perspectives of people with dementia, family carers, staff and music therapists. Aging and Mental Health, 18(6), 706-716.

Onieva-Zafra, M. D., Hernandez-Garcia, L., Gonzalez-del-Valle, M. T., & Fernandez-Mariez, E. (2018). Music intervention with reminiscence therapy and reality orientation for elderly people with Alzheimer’s disease living in a nursing home: A pilot study. Holistic Nursing Practice, 32(1), 43-50.

Ray, K. D., & Mittelman, M. S. (2017). Music therapy: A non-pharmacological approach to the care of agitation and depressive symptoms for nursing home resident with dementia. Dementia, 16(6), 689-710.

Vink, A. C., Zuidersma, M., Boersma, F., Zuidema, S. U., & Slaets, J. P. (2013). The effects of music therapy compared with general recreational activities in reducing agitation in people with dementia. International Journal of Geriatric Psychiatry, 28(10), 1031-1038.