"Follow the Musical Road": Selecting Appropriate Music Experiences for People with Dementia Living in the Community

There are many music experiences for people with dementia and their caregivers including but not limited to individualized playlists, music and singing groups, dementia-inclusive choirs and concerts, and music therapy. While the benefits of these music experiences have been well documented, an understanding of the differences between them is often absent. However, knowledge of and distinction between these experiences are crucial to people with dementia and their family members, caregivers, and health practitioners to ensure a comprehensive music approach to dementia care is provided. Considering the array of music experiences available, choosing the most appropriate music experience can be challenging. This is an exploratory phenomenological study with significant Public and Patient Involvement (PPI). Through consultation with PPI contributors with dementia via an online focus group and senior music therapists working in dementia care via online semi-structured interviews, this paper aims to identify these distinctions and to address this challenge by providing a visual step-by-step guide. This guide can be consulted when choosing an appropriate music experience for a person with dementia living in the community.

Therapy-based allied health delivery in residential aged care, trends, factors, and outcomes: a systematic review

Background

Allied health professionals in residential aged care facilities (RACFs) make important contributions to the physical and mental wellbeing of residents. Yet to date, health services research in RACFs has focused almost exclusively on nursing disciplines. This review aims to synthesise the current evidence on allied health services in RACF; specifically, how therapy-based allied health is delivered, what factors impact the quantity delivered, and the impact of services on resident outcomes and care quality.

Methods

Empirical peer-reviewed and grey literature focusing on allied health service delivery in RACFs from the past decade was identified through systematic searches of four databases and over 200 targeted website searches. Information on how allied health delivered, factors impacting service delivery, and impact on resident outcomes were extracted. The quality of included studies was appraised using the Mixed Methods Appraisal Tool (MMAT) and the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) checklist.

Results

Twenty-eight unique studies were included in this review; 26 peer-reviewed and two grey literature studies. Sixteen studies discussed occupational therapy and 15 discussed physiotherapy, less commonly studied professional groups included dieticians (n = 9), allied health assistants (n = 9), and social workers (n = 6). Thirteen studies were assigned a 100% quality rating. Levels of allied health service provision were generally low and varied. Five studies examined the association between system level factors and allied health service provision, and seven studies examined facility level factors and service provision. Higher levels of allied health provision or access to allied health services, specifically physiotherapy, occupational therapy, and nutrition, were associated with reduced falls with injury, improved care quality, activities of daily living scores, nutritional status, and meal satisfaction in five studies.

Conclusion

Evidence on how allied health is delivered in RACFs, and its impact on resident health outcomes, is lacking globally. While there are some indications of positive associations between allied health staffing and resident outcomes and experiences, health systems and researchers will need commitment to consistent allied health data collection and health services research funding in the future to accurately determine how allied health is delivered in RACFs and its impact on resident wellbeing.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03386-9.

Music therapy in the hospital-at-home: A practice for children in palliative care

This pilot research study investigated music therapy in a hospital-at-home setting for children in palliative care, focusing on parental and nurses experiences of music therapy. Nine families included in the study were interviewed after receiving a maximum of five individual music therapy sessions at home with a Music Therapist. In addition, a focus group interview with allied health professionals involved in the patients’ care was conducted investigating the multidisciplinary team’s experiences with music therapy. Results revealed that the families drew attention to the feeling of being isolated–yet connected due to music therapy. All the families reported the importance of the relationship to the Music Therapist, while emphasizing flexibility and joint music-making. Music therapy within hospital-at-home treatment was reported as a meaningful and much appreciated form of therapy, while the multidisciplinary teamwork was highly valued by both the health personnel and the families. The results showed the need for a highly skilled Music Therapist to support the families’ complex and dynamic needs within a hospital-at-home setting. The results demonstrated the need for, and the possibilities of, a dynamic music therapy programme adapting not only to the patients’ individual needs but additionally providing family-centred care that considered shifting locations.

Music Therapy Interventions in Palliative Care: A Systematic Review

BACKGROUND

Palliative care is an interdisciplinary medical approach for people with illnesses that are unresponsive to curative treatment. Music therapy has been gaining ground in this field since the 1970s, with a not-always-standardized range of interventions and musical techniques.

OBJECTIVE

The purpose of this systematic review is to analyze interventions with music therapy and new developments in this area in the field of palliative care.

METHODS

The primary source of data for this review was the online database Web of Science (WOS). We also used other databases such as Medline and Scopus. A systematic search was performed of the past 6 years following the PRISMA criteria.

RESULTS

From a selection of 310 documents, we reviewed 54 completed articles and included 19 studies in the review. The percentage of agreement in the selection of articles was 87.5% and the Cohen Kappa index of inter-rater reliability was 0.727. In 5 of the articles, the musical interventions were not specified. However, in the remaining 14 they were, including new developments such as use of the monochord and the body tambura, and adaptation of the RBL (Rhythm, Breath & Lullaby) method.

CONCLUSIONS

There has been notable improvement in the specification of musical interventions during music therapy sessions in palliative care. However, articles in this field need to describe how these techniques are carried out and any new developments. All this without forgetting that the patient's musical preferences are a fundamental aspect when performing music therapy sessions.

Positive physical and mental outcomes for residents in nursing facilities using music: a systematic review

Objectives

The objective of this study was to investigate the applicability and effectiveness of the use of music in providing for positive physical and mental outcomes in nursing facilities.

Problem

Lack of quality of life (QOL) has been a significant issue within nursing facilities. With the rise in census due to Baby Boomers, it has become imperative to find ways to increase overall QOL.

Methods

The research team participants conducted a literature review via Cumulative Index of Nursing and Allied Health Literature, PubMed (MEDLINE), and Academic Search Ultimate to collect data regarding the use of music to provide for positive physical and mental outcomes in nursing facilities.

Results

The most common facilitator mentioned was increased socialization or communication (18%), followed by reduced depression (12%), improved physical health (11%), and reduced agitation or behavior problems (9%). The most common barriers were as follows: cannot isolate effects of music (26%), cost prohibitive (11%), difficult to implement (11%), and no significant improvements in QOL or well-being (11%).

Conclusion

The use of music showed positive outcomes for residents in nursing facilities and should be considered for implementation as part of the normal culture within such facilities.

Music therapy for palliative care: A realist review

OBJECTIVE

Music therapy has experienced a rising demand as an adjunct therapy for symptom management among palliative care patients. We conducted a realist review of the literature to develop a greater understanding of how music therapy might benefit palliative care patients and the contextual mechanisms that promote or inhibit its successful implementation.

METHOD

We searched electronic databases (CINAHL, Embase, Medline, and PsychINFO) for literature containing information on music therapy for palliative care. In keeping with the realist approach, we examined all relevant literature to develop theories that could explain how music therapy works.

RESULTS

A total of 51 articles were included in the review. Music therapy was found to have a therapeutic effect on the physical, psychological, emotional, and spiritual suffering of palliative care patients. We also identified program mechanisms that help explain music therapy's therapeutic effects, along with facilitating contexts for implementation.

SIGNIFICANCE OF RESULTS

Music therapy may be an effective nonpharmacological approach to managing distressing symptoms in palliative care patients. The findings also suggest that group music therapy may be a cost-efficient and effective way to support staff caring for palliative care patients. We encourage others to continue developing the evidence base in order to expand our understanding of how music therapy works, with the aim of informing and improving the provision of music therapy for palliative care patients.