Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations

’Music therapeutic caregiving’, when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with’Music therapeutic caregiving’. Through a qualitative content analysis two themes emerged.’Being in a different reality’ was based on’usual’ morning care situations. The caregivers’ experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,’Being present’, was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that’Music therapeutic caregiving’ might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving

Singing, background music and music-events in the communication between persons with dementia and their caregivers

The overall aim of this thesis is to illuminate the impact of singing and music on persons with dementia and their caregivers, and to describe a concept based on caregiver singing. The aim of Study I was to illuminate the importance of music events and the reactions and social interactions of patients with dementia or suspected dementia and their caregivers before, during and after such events, including the reminder of the day. The ethnographic method was used. Patients displayed the ability to sing, play instruments, perform bodily movements and make jokes during the music events. While singing familiar songs, some patients recalled distant memories, which they seemed to find pleasurable. During and after the music events, the personnel experienced a bonding with the patients, who seemed easier to care for. In Study II, the aim was to examine the employment of active music‑making by caregivers during the course of their actual caregiving activities, focusing on verbal communication. The phenomenological-hermeneutic method was used. In the absence of music, patients communicated with cognitive and behavioral symptoms associated with dementia. During caregiving activities, the caregivers devoted their verbal communication to narrating and explaining the activities to the patients. However, the patients and the caregivers had difficulties understanding one another. When background music was playing, caregivers reduced their verbal instructions and narrating, while the patients communicated with an enhanced understanding of the situation, both verbally and behaviorally. When caregivers sang to the patients, a paradoxical influence was observed. Despite an evident reduction in the amount of verbal narration and description by the caregivers, the patients tacitly understood what was going on. In Study III, the aim was to illuminate the movement and sensory awareness characteristics of persons with dementia and their caregivers during usual morning care sessions, morning care sessions with background music playing, and morning care sessions in which caregivers sang to and/or with patients. Qualitative content analysis was used. It revealed that during the usual morning care session, patients exhibited slumped posture, sluggish and asymmetric motion, listlessness, minimal awareness of both their egocentric and physical environment, and a poor ability to perform activities necessary for personal care to completion. Both background music playing and caregiver singing had a strong influence on body and sensory awareness. Particularly during caregiver singing, patients displayed straight posture, strong and symmetric movements, and greatly increased sensory awareness of themselves and their environment. In Study IV, the aim was to illuminate vocally expressed emotions and moods between caregivers and persons with severe dementia when caring for patients during usual morning care sessions, morning care sessions with background music playing, and morning care sessions in which caregivers sang to or with the patients. Qualitative content analysis was conducted. Emotions/moods and vitality were interwoven. It sounded as if the patients regained vitality when listening to music and caregiver singing. In one group, positive emotions were dominant from the start and were enhanced when listening to background music and singing. Between one caregiver and patient, negative emotions and moods were dominant from the start and intensified during music listening and caregiver singing. Study V is a description of an active way of singing by caregivers, and patients are invited to sing along, but they can also respond in a receptive way and just listen to the singing. Conclusions: Listening to background music and particularly caregiver singing had a positive influence on the patients and caregivers

The Use of Music and Music Therapy in Ameliorating Depression Symptoms and Improving Well-Being in Nursing Home Residents With Dementia

Background: Studies have shown music therapy can improve depression symptoms in dementia and the use of music activities show promise to have positive impacts on wellbeing. However, few studies show the influence of a music intervention led by certified nursing assistants (CNAs) trained by music therapists to address depression symptoms and wellbeing in individuals with dementia.Methods: Credentialed music therapists (1) administered 2-weeks of music therapy, (2) a 3-days training to CNAs, (3) followed by 2-weeks of music activities, singing and music-with-movement, led by CNAs for 62 nursing home residents with moderate dementia, (4) then measured depression symptoms using the Cornell Scale for Depression. We obtained video consent for 26 of the 62 residents who were video recorded receiving CNA-led music-based caregiving activities. Using the Music in Dementia Scale, over 200 h of video data was observed and raters measured changes in well-being, e.g., levels of enjoyment, mood and engagement in the residents, during the CNA facilitated music activities.Results: A repeated measures ANOVA revealed that mean depression scores differed statistically significantly between time points, p ≤ 0.001. Residents' baseline depression symptoms significantly declined following 2 weeks of music therapy, p ≤ 0.001, increased during a 2-weeks wash-out period, p = 0.389, but appeared to stabilize following the 2-weeks music activity, p = 1.00. A video analysis and paired sampled t-test demonstrated a significant improvement in wellbeing in residents who engaged in music with movement, p = 0.003. Wellbeing improved slightly, but not significantly for residents who participated in the singing intervention, p = 0.165.Conclusion: Findings suggest that music therapy can significantly decrease depression symptoms in nursing home residents with dementia. Music activities designed by music therapists and facilitated by CNAs may help sustain the reduction of depression symptoms and improve wellbeing in nursing home residents with moderate to severe dementia

Vårdarsång - En kommunikationsmetod med fokus att främja komplexa omvårdnadssituationer i vård av personer med demenssjukdom

This article is a review of studies with Music Therapeutic Caregiving (also known as Caregiver singing) in the care of persons with dementia. The term Music Therapeutic Caregiving, in Swedish, Vårdarsång, was developed in 2001 with the definition ”when caregivers sing for or together with persons with dementia during care”. Persons with dementia have difficulties in communicating, which commonly results in resistive behaviors or verbal or physical aggressiveness in interaction with others. These behaviors mainly occur during care situations that threaten integrity for example in various bathroom situations. Research of Music Therapeutic Caregiving has in research shown to solve these situations, as it becomes a way to communicate and thus a way for the person and caregivers to encounter and cooperate.Denna artikel sammanställer genomförda studier om Vårdarsång inom demensvård. Begreppet Music Therapeutic Caregiving, på svenska Vårdarsång, myntades år 2001 med definitionen ”när vårdare sjunger för eller tillsammans med personer med demenssjukdom under omvårdnad”. Som en del av sjukdomen har personer med demenssjukdom svårigheter att kommunicera. Detta resulterar ofta i beteenden som motsträvighet och verbal och fysisk aggressivitet i interaktion med andra. Dessa reaktioner är vanliga under vardagliga integritetshotande omvårdnadssituationer, såsom hjälp med kroppshygien och toalettbesök. Forskningresultat med Vårdarsång har visat sig kunna underlätta dessa situationer, då vårdarens sång för eller tillsammans med den demenssjuka ger förbättrad möjlighet till kommunikation, samarbete och genomförande av omvårdnadshandlingar

Music-therapeutic Caregiving\u27: The Necessity of Active Music-making in Clinical Care

The authors introduce a new term here, music-therapeutic caregiving (MTC), to describe an active form of music-making by caregivers to and/or with patients during the course of actual caregiving activities. The goal for the patient in such a process is not the performance of music but the performance of a host of activities important for daily living and personal health. While MTC may involve singing on the part of the patient, its major focus is on \u27receptive singing,\u27 in other words, patient responsiveness to caregiver singing and the resultant effect this has on compliance, cognition, and emotion. A brief case study of the use of MTC in dementia care is presented, followed by a description of its general features. MTC is an extremely straightforward technique, one that can greatly increase the quality not only of patient care but the caregiver–patient relationship as well. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Finding the Key to Communion—Caregivers’ Experience of ‘Music Therapeutic Caregiving’ in Dementia Care: A Qualitative Analysis

‘Music therapeutic caregiving’ (MTC), when caregivers sing for or together with persons with dementia (PWDs) during caring situations, has been suggested as a way to reduce PWDs’ behavioral and psychological symptoms of dementia (BPSD). An intervention was designed to elucidate what influences MTC might have on PWDs and their caregivers. The aim was to describe professional caregiverś experiences of caring for PWDs during morning care situations without and with MTC. Group interviews were conducted, and a qualitative content analysis was performed. Two themes were revealed. The first (without MTC), Struggling for care in communion, encompassed four sub-themes: Hampered communication; Physical and mental struggle with aggression; Struggling with ethical demands; and The reward—consolation and love. The second theme (with MTC), Consolidating care in communion, encompassed two sub-themes: awakening cooperation, and feeling of well-being. The authors conclude that MTC could be used to help caregivers provide improved care. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Evaluation of communication behavior in persons with dementia during caregivers’ singing

The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWD

The Impact of Singing in Caring for a Person With Dementia: Single Case Analysis of Video Recorded Sessions

Music Therapeutic Caregiving (MTC), when a caregiver sings for or together with a resident with dementia, has been used to enhance communication between caregivers and residents. This single case study measured communication in a resident with dementia during \u27usual\u27 and MTC morning care. Video observations of 8 weekly sessions, consisting of 4 recordings of usual morning care and 4 recordings of morning care with MTC intervention provided the data. The Verbal and Nonverbal Interaction scale was used for analysis. Under the MTC condition, the resident’s positive verbal and nonverbal communication increased by 23%. Furthermore, negative verbal and nonverbal communication, decreased by 80%, compared to the \u27usual\u27 morning care sessions. Under the MTC condition, the resident was able to remember words to songs and singing with the caregiver occurred in 39 of the 40 observed minutes. The findings indicate that MTC could be an effective nursing intervention in dementia care. (PsycInfo Database Record (c) 2020 APA, all rights reserved