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Monroe P, Halaki M, Luscombe G, Kumfor F, Ballard KJ. Phase I trial of the MuSic to CONnect (MuSiCON) protocol: feasibility and effect of choir participation for individuals with cognitive impairment. BRAIN IMPAIR 2023; 24:732-749. [PMID: 38167370 DOI: 10.1017/brimp.2022.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Individuals living in residential aged care facilities with cognitive decline are at risk of social isolation and decreased wellbeing. These risks may be exacerbated by decline in communication skills. There is growing awareness that group singing may improve sense of wellbeing for individuals with dementia. However, to date few studies have examined broader rehabilitative effects on skills such as communication of individuals with dementia. AIMS To determine the feasibility and acceptability of the MuSic to Connect (MuSiCON) choir and language/communication assessment protocol in people with cognitive impairment living in non-high-care wards of a residential facility. METHODS Six individuals with mild-moderate cognitive impairment participated (age range 55-91 years, five female, one male). A mixed method approach was used. Quantitative outcomes included attendance rates, quality of life and communication measures. The qualitative measure was a brief survey of experience completed by participants and carers post-intervention. RESULTS Overall, MuSiCON was perceived as positive and beneficial, with high attendance, perception of improved daily functioning and high therapeutic benefit without harmful effects. While there was no reliable change in communication skills over the course of the six-week intervention, most participants successfully engaged in the conversational task, suggesting it is a suitable and ecologically valid method for data collection. CONCLUSIONS The MuSiCON protocol demonstrated feasibility and was well received by participants and staff at the residential facility. A co-design approach is recommended to improve upon feasibility, acceptability and validity of the assessment protocol prior to Phase II testing.
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Affiliation(s)
- Penelope Monroe
- Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, 53 Broadway, Burringbar, NSW 2483, Australia
| | - Mark Halaki
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Georgina Luscombe
- School of Rural Health (Orange/Dubbo), The University of Sydney, Sydney, Australia
| | - Fiona Kumfor
- School of Psychology, The University of Sydney, Sydney, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, Australia
| | - Kirrie J Ballard
- Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, 53 Broadway, Burringbar, NSW 2483, Australia
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2
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Shirsat A, Jha RK, Verma P. Music Therapy in the Treatment of Dementia: A Review Article. Cureus 2023; 15:e36954. [PMID: 37139292 PMCID: PMC10151115 DOI: 10.7759/cureus.36954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
The etiology of depression is the degeneration of the brain cells involved in cognitive function before the other brain cells. It is characterized by a neurological condition that causes a reduction in terms of physical, social, and cognitive impairment and has no cure presently. These nonpharmacological approaches, such as music therapy, enhance living outcomes for those dealing with dementia and also reduce behavioral incidence. Among these strategies is music therapy, and individual or gap-time psychological and educational counseling. Many scientists believe in the advantages of music for the brain. The brain is affected by music function and enhances some cognitive abilities, including the mechanism of speech, alteration, memory, and learning. Music can activate the limbic system, subcortical circuits, and emotionally related systems, inducing the sensation of well-being. The music itself is quite effective at increasing cerebral plasticity. Music therapy has powerful stimulation for neuroplastic alterations in the adult and developing brain. Dementia can be cured by music therapy and music-based intervention (nonpharmacological intervention) rather than by medication. This study highlights dementia therapy utilizing the music therapy method.
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3
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Ridder HM, Krøier JK, Anderson-Ingstrup J, McDermott O. Person-attuned musical interactions (PAMI) in dementia care. Complex intervention research for constructing a training manual. Front Med (Lausanne) 2023; 10:1160588. [PMID: 37200965 PMCID: PMC10185798 DOI: 10.3389/fmed.2023.1160588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/10/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the "caring culture" but often lack professional training in verbal and non-verbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in non-verbal communication with persons with late-stage dementia in residential care home contexts. Research process With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centered dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation. Results The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory. Discussion With increased knowledge about caring values and non-verbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed.
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Affiliation(s)
- Hanne Mette Ridder
- Centre for Documentation and Research in Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
- *Correspondence: Hanne Mette Ridder
| | - Julie Kolbe Krøier
- Centre for Documentation and Research in Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Jens Anderson-Ingstrup
- Centre for Documentation and Research in Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Orii McDermott
- Centre for Documentation and Research in Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
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Yous ML, Boamah SA, Hunter PV, Coker E, Hadjistavropoulos T, Sussman T, Kaasalainen S. Exploring the factors influencing meaningful engagement of persons living with advanced dementia through the Namaste Care Program: a qualitative descriptive study. Palliat Care Soc Pract 2023; 17:26323524231165319. [PMID: 37025503 PMCID: PMC10071147 DOI: 10.1177/26323524231165319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/07/2023] [Indexed: 04/04/2023] Open
Abstract
Background: Meaningful engagement has been described as active participation based on a person’s interests, preferences, personhood, or perceived value. It has many benefits for persons living with dementia in long-term care (LTC) homes, including improvement in physical and cognitive function, and mental health. People with advanced dementia continue to need and benefit from inclusion and social contact in LTC, yet there is not a well-developed understanding of how to support this. A tailored intervention called Namaste Care has been shown to be an effective approach to meaningfully engage residents in LTC, decrease behavioral symptoms, and improve their comfort and quality of life. There is a need to consider how best to deliver this intervention. Objective: The aim of this study was to describe environmental, social, and sensory factors influencing meaningful engagement of persons with advanced dementia during Namaste Care implementation in LTC. Methods: In this qualitative descriptive study, focus groups and interviews were conducted with families, volunteers, staff, and managers at two LTC homes. Directed content analysis was conducted. The Comprehensive Process Model of Engagement was used as a coding framework. Results: With respect to environmental attributes, participants emphasized that a designated quiet space and a small group format were helpful for engagement. In terms of social attributes, participants emphasized Namaste Care staff capacity to deliver individualized care. Regarding sensorial factors, familiarity with the activities delivered in the program was emphasized. Conclusion: Findings reveal the need to offer small group programs that include adapted recreational and stimulating activities, such as Namaste Care, for residents at the end of life in LTC. Such programs facilitate meaningful engagement for persons with dementia as they focus on individual preferences, comfort, and inclusion while recognizing changing needs and abilities of residents.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Paulette V. Hunter
- Department of Psychology, St. Thomas More College, University of Saskatchewan, Saskatoon, SK, Canada
| | - Esther Coker
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- St. Peter’s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Sharon Kaasalainen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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5
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Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2022; 6:150. [PMID: 35243005 PMCID: PMC8864187.3 DOI: 10.12688/wellcomeopenres.16856.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve wellbeing for people with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate using simulation modelling analysis. Results: In study 1, the singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster tempos. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during singing compared to a baseline control. In study 2 EDA (p < 0.0001 for 14/18 data points [3 music conditions across 6 participants]) and ST (p < 0.001 for 10/18 data points) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 data points). EDA was higher during slower music (p < 0.0001 for 13/18 data points), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different music genre. Conclusions: Physiological measures provide valuable information about the experiences of people with dementia participating in musical activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures. video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
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Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
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6
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Dorris JL, Chang K, McLaughlin DJ, Murray SS, Schaumburg S, Rodakowski J. Project Unmute: A Digital Music Program Delivered by Adolescent Musicians to Older Adults with Cognitive Decline. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2022; 20:493-501. [PMID: 36642997 PMCID: PMC9838787 DOI: 10.1080/15350770.2022.2086958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Effective intergenerational music programming has the power to positively influence the current lives of the millions of older adults who are experiencing Alzheimer's disease and dementia, as well as to support the confidence of the newest generation of young musicians. To explore this potential, we designed a digital, intergenerational music program delivered by adolescent musicians to older adults with cognitive decline. This program utilized songs preferred by the older adults and an interactive activity that engaged the two generations. We believe this type of easily scalable programming could support older adults and young musicians, as well as promote new intergenerational relationships.
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Affiliation(s)
- Jennie L. Dorris
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, USA,School of Music, Carnegie Mellon University, Pittsburgh, USA
| | - Kyle Chang
- School of Medicine, California University of Science and Medicine, Colton, USA
| | | | - Shaun S. Murray
- School of Music, Carnegie Mellon University, Pittsburgh, USA
| | | | - Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, USA
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7
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Lorusso L, Bosch S, Park NK, Shorr R, Conroy M, Ahrentzen S, Freytes M. Investigating the Feasibility of Multisensory Environments to Improve the Assisted Bathing Experience for Veterans With Dementia: A Clinical Trial. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:180-195. [PMID: 34763558 DOI: 10.1177/19375867211053861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This evidence-based design clinical trial assessed the feasibility of a multisensory environment (MSE) using aromatherapy, color-changing lights, and music as a behavioral intervention to calm Veterans with dementia during assisted bathing to improve the patient experience. BACKGROUND The number of Veterans with dementia is growing rapidly, along with the associated debilitating behavior challenges. The severity of these distressed behaviors that predominantly occur at bath time often necessitates costly, dangerous sedatives. Feasibility studies of nonpharmacological behavioral interventions during bathing for people with dementia are urgently needed, and research supports MSE as a viable solution. METHOD Using an A-B, multiple baselines across participants design, this study tracked operational behaviors of four Veterans with dementia during bathing without and with an MSE intervention. Sessions were provided and recorded by a dedicated team of five nurses, so the study team could analyze the Veterans' operational behaviors to understand the impact of individualized MSE during both baseline and intervention phases. RESULTS The results support the feasibility of MSE as a helpful, nonpharmacological behavioral intervention for Veterans with dementia during bathing. All participants experienced an overall increase in duration of positive operational behaviors and an overall decrease in duration of negative operational behaviors. CONCLUSIONS Healthcare environments are integral components in dementia care and the use of MSE within the bathing setting appears to improve not only operational behaviors but the overall bathing experience.
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Affiliation(s)
| | | | | | - Ronald Shorr
- Geriatric Research Education and Clinical Center, University of Florida, Gainesville, FL, USA
| | | | | | - Magaly Freytes
- Center of Innovation on Disability & Rehabilitation Research, Gainesville, FL, USA
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8
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Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2021; 6:150. [PMID: 35243005 PMCID: PMC8864187.2 DOI: 10.12688/wellcomeopenres.16856.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
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Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
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9
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Strohmaier S, Homans KM, Hulbert S, Crutch SJ, Brotherhood EV, Harding E, Camic PM. Arts-based interventions for people living with dementia: Measuring 'in the moment' wellbeing with the Canterbury Wellbeing Scales. Wellcome Open Res 2021; 6:59. [PMID: 34458586 PMCID: PMC8370129 DOI: 10.12688/wellcomeopenres.16596.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is growing acknowledgement for the need to move beyond exclusive biomedical understandings of dementia and also focus on how to improve the lives and wellbeing of people living with dementia. A mounting body of research advocates for the benefits of arts-based interventions for this population. The purpose of this study was to explore the links between multiple components of arts-based interventions and subjective wellbeing in order to help assess if these activities might contribute to meaningful community-based dementia care initiatives. Methods: Using previously collected data across different intervention sites, a within- and between- participants design was used that assessed wellbeing through the Canterbury Wellbeing Scales (CWS) in people with mild-to-moderate dementias (N = 201) who participated in various community arts-based interventions (ABI). Data were analysed using non-parametric statistical analyses and bootstrapped moderation models. Results: Increases in subjective wellbeing were associated with all forms of ABI. Co-creative sessions significantly strengthened the relationship between number of sessions attended and overall wellbeing as well as optimism. No significant moderating effect was observed between number of sessions attended and carer presence. Conclusions: In the largest study of its kind to date to assess wellbeing using arts activities in a community-based dementia sample, findings support the use and acceptability of the CWS as a measurement tool for people with early-to-middle stages of dementia and suggest that the CWS can reliably measure wellbeing in this population. In addition, the positive effect of arts-based interactions on specific aspects of wellbeing were found, which provide a better understanding of the conditions under which these effects can be prolonged and sustained. Further research is needed to better understand the environmental, social, and psychological mechanisms through which these improvements operate.
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Affiliation(s)
- Sarah Strohmaier
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Karl M. Homans
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sabina Hulbert
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
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10
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Daniel Lai LL, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L L Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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11
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 08/08/2023] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L.L. Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J. Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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12
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Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2021; 6:150. [PMID: 35243005 PMCID: PMC8864187 DOI: 10.12688/wellcomeopenres.16856.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
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Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [DOI: 10.12688/wellcomeopenres.16189.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Music Connects Us: Development of a Music-Based Group Activity Intervention to Engage People Living with Dementia and Address Loneliness. Healthcare (Basel) 2021; 9:healthcare9050570. [PMID: 34066004 PMCID: PMC8151914 DOI: 10.3390/healthcare9050570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/05/2022] Open
Abstract
There is a need for intervention research to understand how music-based group activities foster engagement in social interactions and relationship-building among care home residents living with moderate to severe dementia. The purpose of this conceptual paper is to describe the design of ‘Music Connects Us’, a music-based group activity intervention. Music Connects Us primarily aims to promote social connectedness and quality of life among care home residents living with moderate to severe dementia through engagement in music-making, supporting positive social interactions to develop intimate connections with others. To develop Music Connects Us, we adapted the ‘Music for Life’ program offered by Wigmore Hall in the United Kingdom, applying an intervention mapping framework and principles of engaged scholarship. This paper describes in detail the Music Connects Us program, our adaptation approach, and key adaptations made, which included: framing the project to focus on the engagement of the person living with dementia to ameliorate loneliness; inclusion of student and other community-based musicians; reduced requirements for care staff participation; and the development of a detailed musician training approach to prepare musicians to deliver the program in Canada. Description of the development, features, and rationale for Music Connects Us will support its replication in future research aimed to tests its effects and its use in clinical practice.
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Strohmaier S, Homans KM, Hulbert S, Crutch SJ, Brotherhood EV, Harding E, Camic PM. Arts-based interventions for people living with dementia: Measuring 'in the moment' wellbeing with the Canterbury Wellbeing Scales. Wellcome Open Res 2021; 6:59. [PMID: 34458586 PMCID: PMC8370129 DOI: 10.12688/wellcomeopenres.16596.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 09/22/2023] Open
Abstract
Background: There is growing acknowledgement for the need to move beyond exclusive biomedical understandings of dementia and also focus on how to improve the lives and wellbeing of people living with dementia. A mounting body of research advocates for the benefits of arts-based interventions for this population. The purpose of this study was to explore the links between multiple components of arts-based interventions and subjective wellbeing in order to help assess if these activities might contribute to meaningful community-based dementia care initiatives. Methods: Using previously collected data across different intervention sites, a within- and between- participants design was used that assessed wellbeing through the Canterbury Wellbeing Scales (CWS) in people with mild-to-moderate dementias (N = 201) who participated in various community arts-based interventions (ABI). Data were analysed using non-parametric statistical analyses and bootstrapped moderation models. Results: Increases in subjective wellbeing were associated with all forms of ABI. Co-creative sessions significantly strengthened the relationship between number of sessions attended and overall wellbeing as well as optimism. No significant moderating effect was observed between number of sessions attended and carer presence. Conclusions: In the largest study of its kind to date to assess wellbeing using arts activities in a community-based dementia sample, findings support the use and acceptability of the CWS as a measurement tool for people with early-to-middle stages of dementia and suggest that the CWS can reliably measure wellbeing in this population. In addition, the positive effect of arts-based interactions on specific aspects of wellbeing were found, which provide a better understanding of the conditions under which these effects can be prolonged and sustained. Further research is needed to better understand the environmental, social, and psychological mechanisms through which these improvements operate.
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Affiliation(s)
- Sarah Strohmaier
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Karl M. Homans
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sabina Hulbert
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
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Strohmaier S, Homans KM, Hulbert S, Crutch SJ, Brotherhood EV, Harding E, Camic PM. Arts-based interventions for people living with dementia: Measuring 'in the moment' wellbeing with the Canterbury Wellbeing Scales. Wellcome Open Res 2021; 6:59. [PMID: 34458586 PMCID: PMC8370129 DOI: 10.12688/wellcomeopenres.16596.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 09/22/2023] Open
Abstract
Background: There is growing acknowledgement for the need to move beyond exclusive biomedical understandings of dementia and also focus on how to improve the lives and wellbeing of people living with dementia. A mounting body of research advocates for the benefits of arts-based interventions for this population. The purpose of this study was to explore the links between multiple components of arts-based interventions and subjective wellbeing in order to help assess if these activities might contribute to meaningful community-based dementia care initiatives. Methods: Using previously collected data across different intervention sites, a within- and between- participants design was used that assessed wellbeing through the Canterbury Wellbeing Scales (CWS) in people with mild-to-moderate dementias (N = 201) who participated in various community arts-based interventions (ABI). Data were analysed using non-parametric statistical analyses and bootstrapped moderation models. Results: Increases in subjective wellbeing were associated with all forms of ABI. Co-creative sessions significantly strengthened the relationship between number of sessions attended and overall wellbeing as well as optimism. No significant moderating effect was observed between number of sessions attended and carer presence. Conclusions: In the largest study of its kind to date to assess wellbeing using arts activities in a community-based dementia sample, findings support the use and acceptability of the CWS as a measurement tool for people with early-to-middle stages of dementia and suggest that the CWS can reliably measure wellbeing in this population. In addition, the positive effect of arts-based interactions on specific aspects of wellbeing were found, which provide a better understanding of the conditions under which these effects can be prolonged and sustained. Further research is needed to better understand the environmental, social, and psychological mechanisms through which these improvements operate.
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Affiliation(s)
- Sarah Strohmaier
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Karl M. Homans
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sabina Hulbert
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
- Dementia Research Centre, Department of Neurodegeneration, UCL Queen Square Institute of Neurology, University College London, London, UK
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Abstract
PURPOSE OF REVIEW The WHO updated concept of health includes social health alongside physical and mental health. No existing reviews have examined the evidence for preserving or enhancing social health in people living with neurocognitive disorders, such as mild cognitive impairment and dementia. The present review examines recent epidemiological studies and interventions with social health outcome measures, including interventions across multiple modalities and settings, from communities to assisted living facilities. RECENT FINDINGS Epidemiological evidence shows that neurocognitive disorders are associated with poorer social support, and greater social isolation and loneliness. This highlights the importance of maintaining and enhancing social health in people living with neurocognitive disorders. Group activities involving dance or music have emerging evidence indicating improvements in social health in communities and assisted living facilities. More quantitative research is required on the social health benefits of cognitive/multicomponent interventions, community social groups, exercise groups and other interventions. Several socially assistive robots are being developed to help foster social participation and require further research. SUMMARY There is evidence that group music or dance interventions can improve social health for people living with neurocognitive disorders. Larger trials with multiple social health outcome measures are required to investigate the social health benefits of exercise, cognitive/multicomponent and community social group interventions.
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Crutch S, Herron D, Pickett J, Rosser S, Rossor M. Inspired by chance: valuing patients' informal contributions to research. BMJ 2020; 371:m4478. [PMID: 33318028 DOI: 10.1136/bmj.m4478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Sebastian Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | | | | | - Martin Rossor
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- NIHR UCLH Biomedical Research Centre, London, UK
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