A new study from Anglia Ruskin University (ARU) in Cambridge, UK, published in the journal Nature Mental Health, has shown for the first time why music can reduce distress and agitation in people with advanced dementia.
There are an estimated one million people in the UK with dementia and more than half are diagnosed with advanced dementia, which can require specialist care and is often accompanied by behaviours such as agitation, aggression, wandering and resistance to care.
The research reveals the various benefits of music therapy, identifies mechanisms that explain why music can have these effects and offers a plan for implementing effective music therapy for people with advanced dementia.
Music therapy, delivered by trained therapists, can include singing, playing or listening to music. The therapist can also identify specific ways to use music in the daily routine of family members and carers.
The new study, led by Naomi Thompson from Anglia Ruskin University (ARU) in Cambridge, UK, is the first realist review of music therapy for dementia, combining academic research with stakeholder input to develop guidelines for tailored interventions.
The research shows that, if music therapy is tailored to individual needs, it can lead to immediate, short-term reductions in agitation and anxiety in people with advanced dementia, as well as improvements in attention, engagement, alertness and mood. Musical interactions can help people feel safer and more oriented in their environment, which can reduce distress levels and improve well-being.
MUSIC ACTIVATES MEMORIES
This effect occurs because music, whether played, sung or listened to, provides cognitive and sensory stimulation, activates networks on both sides of the brain that allow access to a person’s remaining abilities and memories, and helps people manage their emotions and stay calm. Music can also reduce physiological stress, especially on the autonomic nervous system.
Memories evoked by music, particularly those triggered by familiar music, are recalled more quickly and are more positive and specific than memories evoked without music, and often refer to earlier times in the person’s life. Songs from when the person was between 10 and 30 years old are the most effective.
As a form of non-verbal communication, music is accessible regardless of cognitive impairment or musical ability, and offers opportunities for social interaction with staff, carers and other patients or residents of care homes.
MUSIC THERAPY TRAINING
The study recommends that music therapists train other professionals, ensuring that all staff involved in caring for people with advanced dementia can use music, regardless of their experience. Resources, such as musical instruments and information on how to make personalised playlists, should be made available and families should be encouraged to use music to support their relatives.
Music can also benefit care staff and family members by reducing their stress levels and improving their wellbeing. It can provide meaningful moments that may be different from usual carer interactions, can encourage empathy and can help staff relate better to the person with dementia, especially at times of heightened distress.
The study included interviews with staff and music therapists on dementia wards at Cambridgeshire and Peterborough NHS Foundation Trust, a systematic review of published research and a national survey of healthcare professionals. The researchers also collaborated with the dementia nursing charity Dementia UK.
Lead author Naomi Thompson, from the Cambridge Music Therapy Research Institute at Anglia Ruskin University, said: “With an ageing population and increasing numbers of people diagnosed with dementia, music is a relatively simple and cost-effective way to improve the quality of life for those affected.”
“Our study not only demonstrates why music therapy is successful – meeting a person’s need for stimulation, supporting familiarity through reminiscing, encouraging relationships and emotional expression, and, importantly, helping to reduce distress and anxiety – but also paves the way for its wider use in dementia care,” Thompson added.
“Music, particularly recorded music, is an accessible way for staff and families to help manage distress, and music therapists can advise on how to tailor music to each person. In the same way that a doctor prescribes medication at a specific dose and frequency, a music therapist can outline an individualised programme, setting out how music should be used throughout a person’s day to reduce their distress and improve their wellbeing.”
