A Review of the Research Literature for the Use of Music and Music Therapy in the Setting of Dementia and How This Informs an Approach to Service Delivery by Music Moves Me Trust

By Jones, Vicki A. | The New Zealand Journal of Music Therapy, January 1, 2016 | Go to article overview

A Review of the Research Literature for the Use of Music and Music Therapy in the Setting of Dementia and How This Informs an Approach to Service Delivery by Music Moves Me Trust


Jones, Vicki A., The New Zealand Journal of Music Therapy


Background

The World Health Organization (201 2) and Alzheimer's Disease International (2012) declared dementia a public health priority. As the world's population continues to age, due to improvements in healthcare, the number of people with dementia is set to rise from an estimated 35.6 million in 201 0 (WHO and Alzheimer's Disease International, 2012) to 131.5 million in 2050 (Alzheimer's Disease International, 201 5). Worldwide, the number of people with dementia was estimated to be 35.6 million in 2010 (WHO and Alzheimer's Disease International, 2012), and is projected to increase to 131.5 million in 2050 (Alzheimer's Disease International, 201 5). From a New Zealand perspective, there were an estimated 48,182 New Zealanders living with dementia in 2011, with numbers set to triple to 147,359 in 2050. The estimated total financial cost of dementia in New Zealand in 201 1 was $954.8 million (Alzheimers New Zealand, 2012). A survey of 750 New Zealanders carried out in 201 5 reported that 63%, or almost two-thirds of those surveyed, knew or had known someone with Alzheimer's disease. Maori were more likely to report knowing someone affected by the disease, with a 72% positive response rate (Alzheimers New Zealand, 201 2). Therefore, on both a personal and societal level, dementia is likely to have an increasing impact on our future lives as New Zealanders.

Dementia

Dementia can be thought of as a "syndrome due to disease of the brain, usually chronic, characterised by a progressive, global deterioration in intellect including memory, learning, orientation, language, comprehension and judgment" (Alzheimer's Disease International, 2009). There are multiple disease processes leading to dementia, the most common of which are Alzheimer's disease, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. However, these pathologies can often be mixed (Jellinger, 2006). There are occasional treatable causes of dementia such as vitamin deficiencies or electrolyte or hormone disturbances, but otherwise there is currently no treatment that can reverse the progressive nature of the disease.

Each individual will experience dementia differently and will not necessarily exhibit a linear pattern through their illness, but there are thought to be three broad stages to the disease process. The early stage is typically the first one or two years, when signs and symptoms of the disease might be mistaken for normal ageing. There may be persistent short-term memory issues; mood disturbances, such as depression or anxiety; difficulty making decisions; and abnormally angry or aggressive responses to situations. In the middle stages, typically the second to the fourth or fifth years, the disease is having an obvious impact on day to day functioning, and there is increasing need for help from family and carers. There can be issues with wandering, agitation, and disturbed sleep. The late stages are thought to be from the fifth year onwards, with increased nursing needs as the person with dementia becomes more physically dependent (Alzheimer's Disease International, 2009).

The New Zealand framework for dementia care (Ministry of Health, 201 3) emphasises the need to move from a purely medical model of care, which may not maximise well-being and independence, to a more integrative approach that encompasses the psychosocial, spiritual, and cultural needs of the person living with dementia. Music therapy, "the professional use of music and its elements as an intervention in medical, educational and everyday environments", also seeks to "optimize [...] quality of life and improve physical, social, communicative, emotional, intellectual and spiritual health and well being" (World Federation of Music Therapy, 2011). Thus the principles of music therapy appear to fit perfectly into an integrative model of dementia care.

Behavioural and Psychological Symptoms of Dementia (BPSD)

One of the more challenging aspects of dementia, for both the person affected and their caregiver, is the behavioural and psychological symptoms that can accompany the diagnosis. …

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