Rural residents benefit from tailored dementia program
A tailored dementia program using music has reduced challenging behaviours and drug use among residents and stress levels of staff in rural aged care homes, a pilot study has found.
A tailored dementia program using music has reduced challenging behaviours and drug use among residents and stress levels of staff in rural aged care homes, a pilot study has found.
Flinders University piloted and evaluated the person-centred, non-pharmacological dementia care model Harmony in the Bush, which involves creating playlists of residents’ favourite music.
The study included 74 residents with dementia and 87 staff including personal care workers and nurses at five residential aged care homes in rural South Australia and Queensland.
Residents listened to their tailored playlists for 20-30 minutes twice a day during rest times throughout the intervention.
In addition to personalised music, the study involved staff education and providing a low stress environment in aged care homes, said lead researcher Dr Vivian Isaac.
“We found significant changes in the agitation, aggression and dysfunctional behaviours among residents. We also saw that with the changes in residents, the stress level [of staff] before and after the intervention also declined,” Dr Isaac told Australian Ageing Agenda.
Those behaviours include pacing and aimlessly wandering, which fell in prevalence from 87 per cent at the beginning of the study to 66 per cent after four weeks, according to the paper published in BMC Geriatrics.
Other common symptoms that reduced over the four weeks include general restlessness (from 74 per cent to 54 per cent), trying to get to a different place (from 64 per cent to 28 per cent), using repetitive sentences (from 61 per cent to 27 per cent) and cursing and verbal aggression (from 55 per cent to 38 per cent).
Music is meaningful
Dr Isaac said residents’ challenging behaviours reduced because they were doing a meaningful activity.
“Music is very effective for people with dementia… music has the capacity for residents with dementia to process that information and enjoy it,” said Dr Isaac, a senior lecturer at Flinders University Rural Health South Australia.
The study used the 43-item Caregiver Stress Inventory tool to determine staff stress to behaviours that occur in residents with dementia, such as aggression, inappropriate behaviour, resident safety and resource deficiency.
It found that the CSI score was 3.6 on average at the beginning of the study and 3.1 after the intervention.
The study also identified a decline in the use of psychotropic medication among residents.
“The residents’ [behavioural and psychological] symptoms reduced, so the need for psychotropic medicines was less,” Dr Isaac said.
Model benefits many
The model has benefits for the residents, staff and the aged care facility, he said.
“It provides a framework of staff education and training because dementia training is important in dementia care. It shows this framework of how environment influences the behaviours of dementia residents,” he said.
He said this model could be widely adopted in all aged care facilities following a larger scale trial.
Dr Isaac is doing further research to explore the cost-effectiveness and reliability of this model, which the researchers have also based on the Progressively Lowered Stress Threshold, a model that provides a framework for person-centred dementia care.
The facilities involved in the study were Ozcare Port Douglas Aged Care, Mutkin Residential and Community Aged Care and Resthaven on Quarry in Queensland and Barmera Aged Care and Tanunda Lutheran Home in South Australia.
Main image: Dr Vivian Isaac
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No one should be surprised by the findings, as it’s simply an example of Person Centres Care, which so often is missing for people with dementia who are systematically institutionalised, segregated, isolated and chemically restrained. We should however, be shocked that this is seen as novel.
Music is just one of 100s of activities that can and do help dementia sufferers live a better quality and enjoyable life. What is missing are educated and caring staff members, able to take the time and effort to help our most vulnerable. Where there is the will, there is a way.