Home-based music therapy for persons with dementia and their spouses as primary caregivers.

Music therapy has been found to be an effective intervention for persons with dementia (PWD) and their primary caregivers (PC), yet the implementation of musical strategies to improve daily care in the home environment requires further exploration. This study developed and examined a home-based music therapy (HBMT) work model that offers weekly joint music therapy sessions, and additional bi-weekly phone-counseling sessions with the PC. This was followed by an additional 12-week support period that included 3 therapy sessions and 3 phone counseling sessions once every other fortnight, so that the same type of session occurred at a frequency of once a month. Participants were five couples (PWD + spouse as PC) who live in their home. Findings based on the qualitative multiple case study research method showed the importance of the music therapist's (MT) continuous support. The MT's presence made it possible to address the needs of both spouses, separately and together, while maintaining the required balance. Moreover, the MT's presence enabled better implementation of the musical strategies independently and this was maintained during the intervention and the support period.

Outcomes and experiences of an online Balance-Space music therapy intervention for cancer patients: A mixed methods study.

Coping with cancer requires both physical and emotional fortitude, and various intervention programs attempt to address these needs. Since the outbreak of the COVID-19 pandemic, many interventions have transitioned from live to online settings. Balance-Space is a music therapy intervention, which includes listening to original composed music, followed by an open discussion. Participants with a cancer diagnosis were randomized to either an online group music listening intervention or an online group meditation intervention. Both activities were followed by a group discussion led by two music therapists. A mixed methods study was employed and included both quantitative measurements of distress, anxiety, and pain and a qualitative analysis of the group discussion in the music intervention group. We found a significant reduction in participants' perceived pain levels following the music intervention when compared to the meditation intervention. This result was supported by qualitative content analysis, which revealed how music evoked physical reactions and affected the participants' experience of pain. There were no significant differences in participants' perceived distress levels and perceived anxiety levels between the two groups. These preliminary results are encouraging and support the need for further exploration of online music therapy interventions as a non-pharmacological treatment for cancer patients.

Why Music Therapists Choose to Work with a Clinical Population: An International Pilot Survey.

(1) Background: Throughout their career, music therapists make decisions regarding the clinical population they choose to work with. Though such decisions can have broad implications on the professional development of the music therapist, not much is known about the reasons for making these decisions and whether they are affected by demographic or professional factors. (2) Methods: In this pilot study, we surveyed 439 music therapists from six countries (i.e., Austria, the Czech Republic, Germany, Israel, Spain, and Switzerland) using an online questionnaire. We asked the respondents to explain why they chose to work with their main clienteles, and we examined whether their reasons were connected to demographic factors such as country of origin, gender, and seniority, and professional factors such as experience as a music therapist and population one works with. (3) Results: The category analysis of these responses pointed at nine distinct reasons that could be grouped into "practical reasons", "reasons of connection", and "innovation". There were differences in reasoning between music therapists from different countries, and with different degrees of seniority, but not between male and female music therapists. (4) Discussion: The implications on training programs and on policy makers are discussed as well as the importance of this subject to the development of music therapists' professional identity.

Behavioral activation for live-in migrant home care workers and care recipients in Israel: a pilot study.

In a growing global trend, individuals are migrating to other countries to live with and care for older adults with dementia. Although this trend addresses the geriatric workforce shortage, workers and older adults often experience distress. In a pilot study in Israel, six migrant care workers participated in a six-week group intervention in which they learned to increase valued, enjoyable activities for themselves and the older adult with whom they lived (behavioral activation). After the intervention, workers reported that they increased activities for themselves and the older adult and were satisfied, and quality of life and sense of achievement showed medium and large effect sizes, respectively. Participants suggested adapting the intervention to an online format for greater access. Although findings are tentative, the study points to promising strategies for migrant home care workers: focusing on the worker and older adult and offering online interventions.

Nursing aides' mentalization, expressed emotion, and observed interaction with residents with dementia: A quasi-experimental study.

This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.

Emotional availability in dyads of nursing aide - resident with dementia: Old tool, new perspective.

OBJECTIVES: This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide's sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident's responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction. METHOD: The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The interactions were coded using the emotional availability scales. RESULTS: Linear mixed-effect model analyses indicated that higher emotional availability of nursing aides was related to higher emotional availability of the residents. Nursing aides' emotional availability did not vary between "difficult" and "easy" residents or across the three interaction contexts. "Difficult" residents involved their nursing aides less than "easy" residents. DISCUSSION: The study documented the reciprocal nature of the interaction between nursing aides and residents with dementia. It suggests that nursing aides have an important role in promoting residents' responsiveness and involvement.

Towards sustainable implementation of music in daily care of people with dementia and their spouses.

Primary caregivers (PCs) of people with dementia deal with stressful daily living, especially spouses whose care recipient is at home. Several programs have been developed to aid caregiving by providing musical strategies, yet successful sustainable implementation of music in the daily lives of the couples awaits further research and development. To promote this, in this pilot study we proposed a music therapy program that included 12 weekly sessions with the couple in their home environment. In addition, there were bi-weekly phone counseling sessions with the PC, to reflect on the joint sessions and to help implement music in daily life. Findings based on the description, analysis, and interpretation of two cases showed that the proposed program provided a strong foundation upon which the treatment could succeed; it relied on natural forces such as the use of songs, which can empower each of the spouses individually, as well as together as a couple; and it included elements of ongoing support that enabled preservation of the accomplishments that were achieved during the sessions. Future research is required to examine whether this program is appropriate for couples in other housing contexts, and in different stages of dementia.

"Opening Our Time Capsule"-Creating an Individualized Music and Other Memory Cues Database to Promote Communication Between Spouses and People With Dementia During Visits to a Nursing Home.

Background: Family members play a critical role in caring for people with dementia, and their involvement in care continues even after their loved ones are placed in long-term care facilities. The dynamics of family involvement following institutionalization are complex and challenging. The strain on caregivers does not cease and communication difficulties are a major barrier due to deteriorating language abilities as a result of dementia. Also, caregivers' involvement has implications on the quality of life of both the older adult and his family members. Objective: To help alleviate caregivers' burden during visiting hours, by promoting communication opportunities. The program included the creation of an individualized database using personal music and photos that present life episodes. Methods: A qualitative research was used to explore spouses' experience during visits and the process of creating and using the individualized database. Participants included three women who regularly visited their partners who had dementia and resided in a nursing home. The first phase included creating an individualized database for each couple. In the second phase, four meetings were conducted, each woman with her partner, utilizing the database on a tablet. A case study research design was used and various types of data were collected and analyzed. The data included interview reports (pre-post intervention), preparation meetings reports, spouses' recorded reactions at the end of each of the four visits, and the music therapist's written log during the program. Results: All documented data revealed the difficulties, mostly the communication barrier, encountered by the three women during their visits to the nursing home. All reported that using the individualized database helped them to find ways to communicate with their partners, relive shared past experiences, and alleviate the stress and feelings of disconnection during visits. Conclusions: Forming a bridge between past and present via individualized music and photos databases can be helpful in bridging the gap between people with dementia in nursing homes and their family members.

The role of singing familiar songs in encouraging conversation among people with middle to late stage Alzheimer's disease.

BACKGROUND: Language deficits in people with Alzheimer's disease (AD) manifest, among other things, in a gradual deterioration of spontaneous speech. People with AD tend to speak less as the disease progresses and their speech becomes confused. However, the ability to sing old tunes sometimes remains intact throughout the disease. OBJECTIVE: The purpose of this study was to explore the role of singing familiar songs in encouraging conversation among people with middle to late stage AD. METHODS: Six participants attended group music therapy sessions over a one-month period. Using content analysis, we qualitatively examined transcriptions of verbal and sung content during 8 group sessions for the purpose of understanding the relationship between specific songs and conversations that occurred during and following group singing. RESULTS: Content analysis revealed that songs from the participants' past-elicited memories, especially songs related to their social and national identity. Analyses also indicated that conversation related to the singing was extensive and the act of group singing encouraged spontaneous responses. After singing, group members expressed positive feelings, a sense of accomplishment, and belonging. CONCLUSIONS: Carefully selecting music from the participants' past can encourage conversation. Considering the failure in spontaneous speech in people with middle to late stage AD, it is important to emphasize that group members' responses to each other occurred spontaneously without the researcher's encouragement.

The effect of background stimulative music on behavior in Alzheimer's patients.

Previous studies have demonstrated the benefits of music therapy in Alzheimer's patients, focusing either on improvement of healthy cognitive and social skills, or reduction of agitation symptoms. The present study examined the effect of background music on both positive and negative behaviors, during a time in which patients were not occupied with any structured activity. Twenty eight participants were observed both with and without stimulative, familiar background music. Results showed both a significant increase in positive social behaviors and a significant decrease in negative behaviors related to agitation when music is played. Results demonstrate the contribution of music to enhancing general positive functioning in elderly patients with dementia, and reducing negative behaviors typical of their condition.