Sunday, November 29, 2015

Individualized Music in Preventing and Soothing Agitation in Dementia

They say that music is the soundtrack of our lives. Most probably, this strikes a chord with you. Do you ever hear a song on the radio or television that for a moment transports you back to a distant place and time? Perhaps the memory is pleasant and reminds you of event like courting your spouse or your wedding.  A song may also bring back a painful memory such as a bad relationship or breakup. It could even be bittersweet, reminding you of a loved one who is no longer physically in your life. This blog post will tell you how music can create Peace with Dementia. As always, I offer some action steps if you are committed making Peace.

Music is a powerful thing.  According to Professor Linda A. Gerdner at the Stanford Geriatric Education Center, music can be used to sooth persons with dementia when they are agitated.  Agitation is a term used to describe "inappropriate verbal, vocal, or motor activity that is not explained by needs or confusion per se" (Cohen-Mansfield & Billig, 1986, p.712) as documented in Dr. Gerdner's presentation mentioned in the next paragraph.  When someone has a dementia, their "stress threshold" is lower, meaning that it takes even less distraction and disruption to become agitated (Richards-Hall & Buckwalter, 1987) as documented in Dr. Gerdner's presentation. Where you and I today may have a strong ability to keep our cool,  we will generally be set off more easily if we have dementia.  Using music in the proper way can help prevent agitation and also help calm someone down when agitated.

Dr. Gerdner has been studying the benefits of music for persons with dementia for 25 years. In 1996, she published her original evidence based guidelines which is in its 5th edition. In early 2015, Stanford uploaded this Dr. Gerdner presentation that you will enjoy.  I highly recommend viewing the presentation and focusing on these key points from Dr. Gerdner's research:

  • It is important to know this a "music intervention" that can be used by family members and staff who follow Dr. Gerdner's evidence-based guidelines. This is not "music therapy" that is offered by therapists. 
  • For music to effectively create peace, select songs and artists that you know are special to the person with dementia.
  • Dr. Gerdner has developed two (2) assessments to assist you in exploring song selection.
    • One (1) assessment is for persons in the early stages of dementia - Page 16 of the guidelines
    • One (1) assessment is for a family care partner and/or professional care partner- Page 18 of the guidelines.
  • Prevention of agitation is optimal. Dr. Gerdner recommends playing music 30 minutes prior to the time of day when it appears.  This takes looking for patterns and sources of agitation. 
  • The only way to know if this will work for your loved one or a client is to try the selected songs and takes notes on progress.  When a songs works, write that down. When a song does not work, write that down. Discontinue songs that create more agitation.  The person with dementia is the expert from whom we take our cues.
  • If music from a music player bothers other people, try comfortable headphones with a safe volume. Remember the person will like have different hearing ability as you, and not necessarily worse if they have a hearing device.
  • Dr. Gerdner's research also discuss ethnic music that can be very powerful if they have not heard it in a very long time. Her above presentation includes two powerful examples of this.
  • Naomi Feil, creator of Validation Therapy, is seen on this popular video of utilizing music to communicate with someone in repetitive motion and non-verbal.
  • Here is a popular example of a gentleman coming alive with the help of his favorite music.
Action items for you to create Peace with Dementia:
Matt Estrade, MBA, CAPS is the Founder and Chief Mentor at Care Partner Mentoring, LLC in Covington/New Orleans, LA, USA. A more extensive biography can be found here.

Sunday, November 15, 2015

Holiday Tips for Peace with Dementia

The holidays should be peaceful and happy times. While they are positive for many people, these last months of the year certainly are busier times with holiday parties, shopping, and cooking. When you are a care partner for someone with dementia or have dementia yourself, the extra holiday tasks can make the holidays extra stressful.  Here are 2 links that may provide some appreciated information for you, along with some of my comments on the articles.

The first article is from the Mayo Clinic and discusses how to simplify the holidays this year.  These are good tips, but do remember that ultimately your loved one decides what are good ideas. For example, the article mentions to keep things low-key.  That is sage advice, unless your loved one with dementia love a loud party this year.  As a care partner, take care of yourself and do the best you can.  It is very hard to make everyone happy.

The second article/PDF is from the Alzheimer's Association regarding gift giving. Remember that this is just a good list of ideas and that no list is perfect.  It is divided up into different stages of dementia. You may not know the stage! When in doubt ask the family or professional care partner about what you are considering getting. While it may be well intentioned to get someone a memory aid, post it notes, a pad for writing down tasks, think about how the person with dementia will feel getting it.  It very well could be unintentionally insulting or make them feel like a child.  Instead, think about what hobbies they have always enjoyed, but keep it simple.  When in doubt, music or a music player can be a priceless gift that stimulates the mind and brings joy. Consider things that bring comfort on the list. Something not on the list are essential oils for aromatherapy.  Also, do not forget their care partner!  Offer a coupon book of hours to relieve them while they go to a movie, hair salon, or dinner.  Gift certificates for any of these place are nice as well, just remember they may need help to leave the house.

I hope you find this helpful and I welcome comments and additional holiday and gift ideas.
  • As always, write your favorite ideas, make a plan to follow through and see how it goes! 
  • Be flexible and go with the flow. Write down your successes and lessons learned.
  • Add a comment or question. 
  • Like us on FB and visit our website for a list of support groups and services.
Here's wishing you and your family and happy and peaceful holiday season!

Matt Estrade, MBA, CAPS is the Founder and Chief Mentor at Care Partner Mentoring, LLC in Covington/New Orleans, LA, USA. A more extensive biography can be found here.
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