The Evaluation of Musical Engagement in Dementia: Implications for Self-Reported Quality of Life

By Lem, Alan | Australian Journal of Music Therapy, Annual 2015 | Go to article overview

The Evaluation of Musical Engagement in Dementia: Implications for Self-Reported Quality of Life


Lem, Alan, Australian Journal of Music Therapy


According to the World Health Organisation (WHO), in 2012 approximately 35.6 million people worldwide lived with dementia (WHO, 2012). WHO further projects that this number will double every 20 years, reaching 65.7 million in 2030 and 115.4 million in 2050. This growing trend has been observed for a few decades, making policy makers and service providers recognise that, as our populations continue to age, the condition of dementia will eventually pose a considerable challenge for health and social services (Vaarama, Pieper & Sixsmith, 2008). Along with this recognition came an understanding that the evaluation of dementia-related services needs to incorporate new protocols that consider not only the traditional, clinically oriented assessment formats, but also data reflecting the views and assessments of the clients themselves. Whilst research has been signalling this problem for years, arguing that the views and responses of people with dementia should be taken into consideration (Torrington, 2006), the tools of assessment are still limited. A part of this challenge stems from the orthodox medical perspective on dementia, which looks at the condition chiefly in terms of a cognitive decline and associated functional difficulties. The other reason is that people who have dementia are often unable to participate in word-based surveys that require them to understand questions, give answers and articulate opinions. According to Balcombe, Ferry and Saweirs (2001) this has often resulted in people with dementia being excluded from research into their own quality of life.

The delivery of services for people who have dementia has many challenges. The condition is often associated with a loss of mobility, loss of independence, frailty, isolation, loneliness and depression. Each of these factors can severely affect the person's social engagement and be further responsible for many of the characteristic 'challenging behaviours' often associated with dementia (James, 2011; Zimmerman, Sloan & Reid, 2014). It is also important to understand that the majority of people who have dementia have lived through the milestones of normal human development and lead relatively normal lives in the community. They have often married, brought up families, had jobs and travelled. If one is to accept that, one should also recognise that elderly people with dementia may particularly benefit from services and therapeutic interventions that are delivered with the aim to assist them to reconnect with the fundamental qualities of life. This was pointed out clearly by Zeisel (2010), who argued that by connecting with dementia clients through faculties that do not deteriorate over the course of the disease, such as music, art and touch, it may be possible to help them achieve a better connection with others as well as the surrounding environment.

The applicability of music as a therapeutic medium with dementia clients has been known for decades (Bright, 1972, 1991). Clair (2000) suggested that making music together helps the clients to engage in life. Hays & Minichiello (2005) observed that music contributes towards increasing self-esteem, enhancing the feelings of competence and independence, and lessening the experience of social isolation. Lester & Petocz (2006) found that music interventions produced a marked improvement in mood and social behaviour as well as a significant decrease in non-social behaviour with dementia clients. Sixsmith and Gibson (2007) commented that music enables elderly people with dementia to engage in enjoyable activities that are socially enhancing and personally meaningful, leading to increased personal empowerment. Raglio et al. (2012) argued that, in later stages of dementia, engagement in music might lead to an improvement in communication abilities as well as a reduction of anxiety.

The main techniques of music therapy used traditionally with dementia clients have included the singing of familiar songs (Svansdottir & Snaedal, 2006; Ahn & Ashida, 2012), instrumental playing (Svansdottir & Snaedal, 2006) and music-facilitated movement (Svansdottir & Snaedal, 2006). …

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