The rationale for the use of singing, listening, playing instruments and movement with music for people living with dementia

This thesis will explore the types of musical activities initiated by music therapists and informal caregivers as well as the musical activities that show possible improvement in specific areas of cognition and behavioural and psychological symptoms of dementia.

It has been established that there is a lack of knowledge in how music interventions are used for people with dementia (van der Steen, et al., 2018) and that music therapy using a specific treatment protocol resulted in higher efficacy (Livingston et al., 2014).

The rationale for the use of various musical activities within music therapy and music interventions for people living with dementia is explored, specifically, singing, listening, playing instruments and movement with music. The study uses a mixed methods research design. Data was collected from 3 sources, a systematic literature review, HOMESIDE, an international music and reading intervention randomised controlled trial (Baker et al., 2019) and a survey of UK music therapists’ practice. The data analysis used non-parametric statistical tests (Field, 2018), inductive content analysis (Elo and Kyngäs, 2008), and reflexive thematic analysis (Braun and Clarke, 2019) to connect the perspectives of researchers, music therapists, informal caregivers and people living with dementia. This research study was conducted as a sub-project of the HOMESIDE study where a large portion of the data is collected from.

Findings show that there is a proclivity towards using singing or listening over movement or musical instruments based on, personal preferences of the informal caregivers and music therapists, practical considerations such as access to instruments or an appropriate location, and a belief that the musical activity will best support the person with dementia. Findings also show that certain musical activities may be best used for certain symptoms. In particular, singing is often used to maintain the use of language. Quantitative evidence shows that there is a significant reduction in the severity of nighttime behaviours between baseline and post-intervention timepoints Z=2.5, p<0.046. In addition, data shows a larger positive change in reduction of irritability symptoms for care recipients who are in earlier stages of dementia U=10.0, p=.040.

It is recommended that future studies focus on exploring the effect on specific musical activities on specific symptoms of dementia, with the aim to maintain or improve the use of language, reduce unwanted night-time behaviours and reduce irritability. Further research should connect the effects of specific musical activities and the scientific knowledge which may explain why these changes occur. This can identify areas where music therapy could be more targeted to the needs of the person living with dementia considering the need, most appropriate activity to use and the necessary training for informal caregivers and music therapists required for regular intervention.