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.

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