Neuropsychiatric symptoms that result from dementia can take a great toll on not only the patient, but the patient’s caregivers. In 2015, Hsu et al. conducted a feasibility study investigating the preliminary effects of a five-month music therapy treatment program on neuropsychiatric symptoms in individuals with a diagnosis of dementia. The study was carried out in two United Kingdom nursing homes, with one-on-one sessions with a qualified music therapist who was registered with the Health and Care Professions Council.
The researchers justified their study by highlighting the relative scarcity of randomized control trials in one-on one sessions with qualified music therapists within this population. They then formulated inclusion criteria and used randomization to assign experimental and control groups within each home, ultimately running 6 participants through their feasibility study. The researchers identified four key constructs found in each session conducted: use of well-known/overlearned songs, improvisation as ‘free music-making between client and therapist’, psychotherapeutic verbal skills, and facial/body expressions. The sessions were recorded and presented to staff members in 15 minute presentations. Working in tandem, the music therapists and staff members used these presentations to identify symptoms and potential triggers, and incorporate music therapy treatment ideas throughout the week. The researchers stated that these sessions were imperative for engaging and incorporating staff into this new treatment paradigm.
Outcomes were measured with The Neuropsychiatric Inventory for Nursing Homes, which measures twelve behavioral and functional domains, and Dementia Care Mapping, an observational measure that measures overall well-being. Researchers also collected data through a heart and movement monitor, and through semi-structured interviews.
Results showed that the individuals receiving music therapy showed an overall decrease in neuropsychiatric symptoms and an increase in well-being. Staff members rated disruptive behaviors to be less frequent in patients receiving music therapy.
There were several limitations in the study, some of which the researchers also outlined. Blinding was not possible, meaning bias could have swayed results at many points throughout the research. As a feasibility study, initial results must be cautiously interpreted due to the small participant size, lack of sample size calculations, and relative lack of power. Hsu et al. also identified potential contamination in randomization and limited data collection windows for well-being assessment.
In spite of these limitations, this feasibility study shows promising foundational work for future replication as a larger randomized control trial with more rigorous data collection, randomization, and statistical analysis. The researchers knowledgeably incorporated staff to a high degree, responsibly explained and demonstrated session design by identifying key constructs and including a case study, and acknowledged the limitations involved in a feasibility study.
Hsu, M. H., Flowered, R., Parker, M., Fachner, J., & and Odell-Miller, H. (2015). Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: A cluster randomised controlled feasibility study. BMC Geriatr BMC Geriatrics, 15(1), PMID: 26183582