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Music Therapy in the Elderly Population

Page history last edited by rosamorton@... 7 years, 3 months ago

 

 

Music Therapy in the Elderly Population

 

 

Introduction

 

Music therapy will discuss how the elderly population can improve the quality of their lives, I will use videos and some articles to describe how music can be very important in the lives of the elderly. Music therapy is often effectively used to create a peaceful and safe environment conducive to the overall development of the person.

 

Music greatly influences our mood. In our daily lives we are constantly surrounded by music and noise (car horns, people whisper, wind ...). It is difficult for listeners to imagine a world void of sound. When we see a film that excites us greatly, it usually is the accompanying music that sets the mood. The same scene with different music would conjure up different emotions, we would set ourselves in points or objects other than the scenario or we produce other feelings. Music has nonverbal, creative, structural and emotional qualities that facilitate contact, interaction, self-consciousness, learning, expression, personal development and communication in a therapeutic relationship .

 

 

Objectives: The reader will explore how music therapy can help elderly people with Alzheimer’s, Stroke, Parkinson’s diseases and Social and emotional issues.

 

Background 

 

According to Musictherapy.org Music Therapy "is the clinical and evidence-based use of music to accomplish individualized goals within a therapeutic relationship by a certified professional". Music therapy first appeared on the therapy stage in 1789 in an unsigned article in a Colombian Magazine titled "Music Physically Considered."

 

Musictherapy.org also explains the history of this amazing approach. It says that in the early 1800s, writings on the therapeutic value of music appeared in two medical dissertations, the first published by Edwin Atlee (1804) and the second by Samuel Mathews (1806). Atlee and Mathews were both students of Dr. Benjamin Rush, a physician and psychiatrist who was a strong proponent of using music to treat medical diseases.

 

The 1800s also saw the first recorded music therapy intervention in an institutional setting (Blackwell’s Island in New York) as well as the first recorded systematic experiment in music therapy (Corning’s use of music to alter dream states during psychotherapy). (musictherapy.org,1999).

 

Recent research shows the use of music can be used as a healing art or science and one of the ways in which it can be used is to help the frail, home bound elderly. In a study of home bound elders ages 61-86 who were diagnosed with a major or minor depressive disorder, symptoms of depression, anxiety, and distress were decreased for the 8-week study period as well as for the 9-month follow-up period when music therapy was used, when exposed to stressful situations.

 

It is concluded that the effects of music on healing can be effective on all levels: physical, mental, emotional, and spiritual. (Steckler, 1998).

 

Current Research

 

 Music and the elderly:

 

Music therapy has been shown to be one of the most effective treatments for seniors. Music therapy can be an effective tool for older adults to help maintain current levels and slow the regression of speech and language skills in the areas of expressive and receptive communication, choice-making, oral motor, and sequencing, motor planning, answering questions, phonemic awareness, speech intelligibility and patterns of language.

 

As dementia or Alzheimer’s disease progresses, an individual loses his or her ability to speak, though many people are still able to sing favorite songs or hum. Rhythm-based exercises paired with words can enhance speech intelligibility for the stroke patient or person with Parkinson’s disease. And also improves social and emotional skills of a senior. (Larson, 2012)

 

 Effectiveness of music therapy in reducing agitated behavior among patients with Alzheimer's:

 

Alzheimer’s disease is a brain disorder that is progressive. It destroys brain cells, causing memory loss and difficulties with thinking and behavior that affect work, hobbies and every aspect of an individual’s life. There is no cure for Alzheimer’s disease, but some medications have been found to slow the progression temporarily. (musictherapy.imnf.org, 2012)

 

In ancient civilizations, music was utilized to mend disturbed minds with its healing power. In the late 1980s and 1990s, as "the graying of America" began, many researchers were interested in the use of music in Alzheimer's disease (AD) patients. Studies found that music therapy was effective in managing behavioral disturbances among AD patients in geriatric settings. This study was designed to determine the efficacy of music therapy in reducing agitated behavior among Japanese American elderly who were afflicted with Alzheimer's disease.

 

Eight subjects were selected among residents in a Japanese Skilled Nursing Home in Los Angeles, California. A single-case design experiment was conducted for 10 days with 5-day baseline and 5-day experiment phases. Results obtained by Paired-sample t-test suggested that music intervention was significant in reducing nonphysically aggressive behaviors among AD patients at the nursing home.(Kusano, 2004)

 

Regular musical leisure activities can have long-term cognitive, emotional, and social benefits in mild/moderate dementia and could therefore be utilized in dementia care and rehabilitation.( Särkämö, 2014)

 

  • A great approach for Alzheimer patients is “The Music and Memory program” we can see more details about this approach under Music and Memory by Rosemary Quatrale.

 

 How Music Therapy can help stroke survivors.

 

According to the American Stroke Association, music therapy has been scientifically and medically proven to be a valuable tool in rehabilitation after a stroke in areas of movement and muscle control, speech and communication, cognition, mood and motivation (Thaut, 1999).

 

•Movement and muscle control improvement can be achieved by a steady beat, musical timing, and rhythmic patterns. Suggested activities include playing a drum to boost range of motion in the upper extremities, exercising to an upbeat music, and timing music to complement the usual walking pattern.

 

•To improve speech and communication in a stroke survivor, a music therapist uses rhythm, melody, and singing. Suggested activities include exercising mouth muscle, rhyming, chanting and rapping and singing the words and transferring them to speech (Thaut, 1999).

 

According to Teppo Särkämö, a Finnish researcher at the University of Helsinki and the Helsinki Brain Institute, listening to music for a few hours daily can significantly improve a stroke patient’s early recovery. A study on 54 patients with right or left hemisphere middle cerebral stroke showed valuable improvement in verbal memory and focused attention after 2 months of music therapy. Patients who listened to music daily also had a more positive attitude compared to those who listened to audio books.

 

Based on these results, Särkämö  suggests that music should be a daily part of rehabilitation, since it is a “targeted, easy-to-conduct and inexpensive means to facilitate cognitive and emotional recovery”. The team also found that 3 months after the stroke, verbal memory improved from the first week post-stroke by 60% in music listeners compared to 18% in audio book listeners and 29% in non-listeners. Similarly, focused attention — the ability to control and perform mental operations and resolve conflicts among responses — improved by 17% in music listeners, but no improvement was observed in audio book listeners and non-listeners. These differences remained six months after the stroke. (foundation, 1998)

 

 

 

 Music therapy in patients with Parkinson's disease. 

 

Parkinson’s Disease is a brain disorder that affects movement. It is a chronic, progressive disease that begins with a tremor in the affected limb, when the limb is at rest. In Parkinson’s Disease, nerve cells die or become impaired. Four features that characterize Parkinson’s Disease are: trembling of a limb when it’s at rest; slowness of movement, stiffness of the limbs and the body, and poor balance. (therapy.imnf, n.d.).

 

There is no treatment to slow or stop the progression of the disease but there is treatment to ease the most bothersome symptoms. Medications may relieve some symptoms and lifestyle modification, physical therapy and speech therapy can improve an individual’s quality of life. Music therapy has been found to be exceptionally effective for people with Parkinson’s Disease.

 

The efficacy of active music therapy (MT) compared with physical therapy (PT) on motor and emotional functions in patients with Parkinson's disease (PD). Sixteen patients (mean age 63.1) participated in a 3-month PT intervention that included weekly passive stretching exercises, specific motor tasks, and strategies to improve balance and gait.

 

Sixteen patients (mean age 62.4) participated in a 3-month MT intervention that consisted of weekly sessions, including choral singing, voice exercise, rhythmic and free body movements, and active music involving collective invention.

 

Measures included the Unified Parkinson's Disease Rating Scale (UPDRS), Happiness Measure, and Parkinson's Disease Quality of Life Questionnaire. MT had a significant overall effect on bradykinesia as measured by the UPDRS. Post-MT session findings were consistent with motor improvement, especially in bradykinesia items.

 

Over time, changes on the Happiness Measure confirmed a beneficial effect of MT on emotional functions. Improvements in activities of daily living and in quality of life were also documented in the MT group(Pacchetti, 2000).

 

 

 

 

 Music therapy and social and emotional issues.

 

In the elderly population depression and anxiety are emotional difficulties that can interfere with recovery of an illness or condition. Depression may appear as agitation, restlessness and irritability. It can include difficulty concentrating and changes in appetite. The most easily recognized signs are feelings of hopelessness and helplessness, self–hate and thoughts of death or suicide. Depression may also appear as anger or discouragement. (imnf.org, n.d.)

 

Alternative therapies like Music Therapy can be implemented to reduce the onset, duration, and severity of depressive symptoms in older adults. The interventions are designed primarily for individuals experiencing mild and severe depression. Music Therapy can help to overcome depression for loss of spouse, loss of independent living or other related social issues. (Mosher-Ashley, 1997)

 

Here is an example how music therapy can overcome social issues:

Virgil: Decreasing isolation

Setting: Individual music therapy in nursing home

Primary goals: Encourage positive socialization, provide emotional support

By his choice, Virgil stays in his bed for most of every day, and the activity director at his facility says Virgil chooses not to attend any group activities. Virgil does enjoy listening to country music, however, and usually has his radio on in his room. During her visits, the music therapist plays guitar and sings country songs requested by Virgil. In an early session, the music therapist also introduced Virgil to the paddle drum, and now Virgil laughs while telling about how his wife cannot believe he is a drummer. The music therapist continues to build a relationship with Virgil, and in the future, perhaps Virgil will agree to attend group music therapy sessions (aplaceformom.org) .

 

 

 

  • Examples

 

1. Cedar Lake Home West Bend, Wisconsin, has a music therapy approach that was designed to meet the physical, mental, and social needs of residents ranging from those completely independent to needing extensive personal care. The intent of the approach was to develop successful experiences aimed at restoring individual dignity and to provide opportunities to share. Music was introduced in a variety of ways to make participation in physical activities and exercises an enjoyable experience even in cases where physical movement was painful (Palmer, 2015).

 

Music was used as a basic tool in reality orientation, to stimulate mental functioning by the call and response technique in sing-along sessions, and to use memory skills by lining-out new songs. More able residents were encouraged to perform solos at chapel, learn to play new instruments, and participate in band and choir programs. A song-writing technique was used with a group of mentally alert but physically disabled residents to help them accept their situation and overcome damaged ego problems (Palmer, 2015).

 

2. Clara: Dementia care

Setting: Individual and group music therapy

Primary goals: Access and exercise long-term memory, decrease agitation and increase positive socialization

 

Clara is in the middle stages of dementia, with significant short-term memory limitations as well as aggressive behaviors towards staff and peers. Because of Clara’s agitation, the nursing staff sometimes hesitates to involve her in groups with other residents, but Clara immediately expresses interest when she sees the music therapist with her instruments. Clara does not remember the music therapist from week to week and usually takes some convincing to participate in music-making since she remembers being told she was a monotone in grade school (Palmer,2015).

 

Once Clara begins singing, however, she can sing all the words to many of the familiar songs of her hey day, and once engaged in music, Clara also participates in interventions that encourage story-sharing and playing instruments with the other group members, facilitating socialization. Clara is inevitably smiling at the end of music sessions and often continues singing and humming for some time afterwards.

 

3. Teresa: Decreasing agitation

Setting: Individual music therapy

Primary goals: Decrease verbal and motor agitation, provide emotional support, facilitate life review

 

In the late part of her life, Teresa has lost most of her eyesight and much of the time is disoriented and anxious about where she is and whether she is alone. At times, this leads to verbal agitation, yelling, and throwing objects on the floor in her room.

 

Teresa does not attend groups because of her agitation’s effect on other residents, but she does sometimes calm down when given one-on-one attention. The music therapist uses music to draw Teresa’s attention to the present, mirroring her agitation with up-tempo songs then gradually changing to slow, gentle songs as Teresa relaxes. Teresa says she enjoys singing spiritual songs and sometimes will talk with the music therapist about her children and her younger years (Palmer,2015).

 


 

  • Discussion 

THE ELDERLY tend to isolate or to be isolated; thus enters into a vicious circle, in which the absence of stimuli or social relations becomes a lack of curiosity about the reality of their environment. In such circumstances, music can be very helpful, I was very interested in this program, because I can see people happier if they listen music, dance and participate in recreational activities, most of these older adults worked a lot of their lives and they didn't have the chance to participate in activities like this.

 

I love music, I miss that in every party or birthday there would be music, I used to dance in every party in Peru, but when I moved to the USA it was very different because in a birthday party here, people just talk. Music is very important in the lives of every human being, because it brings you happiness, health, and older adults need this joy in their lives.

 

  • Future trends 

In just a few years music therapy has become part of all therapeutic means of which the doctor may have to treat various diseases and psychological conditions, especially in the elderly and in children. Indeed, although in ancient times music was considered to have a special therapeutic value, but has only recently begun to be used in clinical practice.

 

The first and one of the most important results have prompted extend the field of application, especially in geriatrics, to explore new possibilities in rehabilitation and studying different techniques in order to bring the activities based on sound patients with reduced intellectual capacity or problems that affect brain function (memory loss, decreased attention span).

In this sense, music therapy uses many single and group techniques to improve  music and sound in the rehabilitation of certain aspects of mental life elder. 

 

 

  • Conclusion

Music therapy has applied to elderly patients, however, specific objectives based on the possibility offered sound to stimulate and communicate with patients, for psychic organic reasons (cerebral arteriosclerosis, etc.) or (senile dementia, etc.) tend to withdraw into themselves. Since the musical sound activates specific sensations, have been successful especially in the rehabilitation of certain intellectual faculties more or less affected.

 

The possibility of associating music, especially rhythm, some movements or true dance forms has led to use sound as a tool for rehabilitation of motor deficits of different type and origin; therefore, it is possible to establish useful relationships between music therapy and physiotherapy.

 

Moreover, the fact that music is a language not based on the word has favored its application in the rehabilitation of patients with difficulty speaking (aphasia) following thrombosis or a arterioles cerebral sclerosis; likewise, it has to be proved effective in the rehabilitation of elderly affected by a decrease in hearing ability.

 

Finally, since the music in the background is also thought activity, proved optimal also be a means for stimulating and intellectual processes for recovery of brain functions affected (senile dementia, etc.). It has also been shown to involve patients from dementia in music therapy sessions allows a partial recovery of the ability to care, coordination of physical movements and performing simple intellectual operations.I think Music therapy will be increasing in home care not just in the United States, but also in the world. The Elderly population needs to have joy and peace during the last stage of their lives and I think music is the best way to ensure they find that.

 

Other Links:

http://www.soundscapingsource.com/how-does-music-therapy-help-in-hospice/

http://www.infinitymusictherapy.com/#!services-for-older-adults/cf4j 

 

References

 

Foundation, S. (1998). thestrokefoundation.com. Retrieved from http://www.thestrokefoundation.com/index.php/music-and-stroke/22-how-can-music-therapy-help-stroke-survivors

http://www.musictherapy.org/about/history/. (1999). Retrieved from musictherapy.org.

imnf.org, m. t. (n.d.). musictherapy,imnf.org. Retrieved from Emotional issues: http://musictherapy.imnf.org/services/category/inpatient-depression-and-anxiety

Kusano, Kanako. Effectiveness Of Music Therapy In Reducing Agitated Behavior Among Alzheimer's Disease Patients. n.p.: UMI Dissertation Services, ProQuest Information and Learning, Ann Arbor, MI, 2004.

Larson, D. (2012, April 16). http://www.aplaceformom.com/blog/music-therapy-for-the-elderly/. Retrieved from aplaceformom.com.

Mosher-Ashley, P. M. (1997).

musictherapy.imnf.org. (2012). musictherapy.imnf.org. Retrieved from http://m

Pacchetti, Claudio, et al. "Active Music Therapy In Parkinson's Disease: An Integrative Method For

Reducing Depression In Older Adults. n.p.: Health Professions Press, Baltimore, MD, 1997.

Palmer M. Music therapy in a comprehensive program of treatment and rehabilitation for the geriatric resident. Activities, Adaptation And Aging [serial on the Internet]. (1983, Mar 1)

Motor And Emotional Rehabilitation." Psychosomatic Medicine 62.3 (2000): 386-393.

usictherapy.imnf.org/services/category/inpatient-alzheimers-and-other-dementias

Steckler, M. A. (1998). "Effects Of Music On Healing.". Journal Of Long Term Home Health Care: The PRIDE Institute Journal , 17.1.

therapy.imnf, m. (n.d.). musictherapy.imnf.org. Retrieved from http://musictherapy.imnf.org/services/category/inpatient-parkinsons-disease

Särkämö, Teppo, et al. "Cognitive, Emotional, And Social Benefits Of Regular Musical Activities In Early Dementia: Randomized Controlled Study." Gerontologist 54.4 (2014)

Thaut, Michael H., and Gerald C. McIntosh. "Music Therapy In Mobility Training With The Elderly: A Review Of Current Research." Care Management Journals 1.1 (1999): 71-74.

 

Comments (3)

sobee4@... said

at 12:02 am on Apr 14, 2015

Rosa,

Your Page looks great!! I especially like how you created a different color scheme to make it more easy to read and pop out. It also makes your page that much more unique! I am impressed at all the different link and videos you could find on this topic. REading this has helped me to realize how important music therapy is and how prominent it actually is! I liked hearing about your own experiences with music and Peru. My only possible suggestion would be to add more paragraphs breaks to your wording so it is more easily read. Though it may not be a problem.
It looks very great. congrats Rosa,

Tobee

Jennifer McCarthy said

at 9:06 pm on Apr 17, 2015

Rosa, please let me provide comments and suggestions on your wiki to help with the revision process. I love to edit and critique, so please take my suggestions lightly.

- Please look at Wikipedia to get a feel for the tone of a wiki. http://en.wikipedia.org/wiki/Main_Page
What you will realize is that the word "I" is not used. I'm not sure about our wiki for this class, because it wasn't explained very clearly in the grading criteria, but in English classes I've taken, the wiki is to provide information and not any personal thoughts.

- Have someone help with edits for grammar after your revisions are complete. You want it to be clear, concise, and without any errors.

- Your title says "Music Therapy in the Elderly Population." Why is it pink and underlined? At first glance, I thought it was a hyper-link and I tried clicking on it.

- Solid introduction to the subject of music therapy.

- Why is the word "Social" capitalized in your objective statement? Also, make the objective visually stand out. It's hiding among the other information.

- Great background and history on music therapy.

- "Current Research: Music and the Elderly" solid writing here. No use of "I." This is the tone I'd stick with.

- I like the organization and how you meet all of your objectives, and incorporate a lot of research. Bravo!

- Under "Music Therapy and Social and Emotional Issues" I got lost when you wrote, " Here is an examples." It's singular, and then it turns green and the font or something changes. It could flow better to the "Virgil" example.

- Great examples, future trends, tons of resources used. You are very strong in meeting the assignment grading criteria and the hard part is over. I would work on the editing of the writing, and use of color choices. Overall, you have gone above and beyond all of the other Wiki pages I have looked at. Very strong work Rosa and thanks so much for allowing me the space to provide a peer review.

rosamorton@... said

at 10:11 pm on Apr 17, 2015

Jen, sweetie. I appreciate suggestions but this is my first class that has required a Wiki and was going by what others in the class were doing. English is not my native language and I am doing the best I can. I understand you may not like my color design and I will take that into consideration in the final version of my Wiki. With respect to my grammar, I will take care of that on my final draft, with help from a tutor. I do not see what is wrong with my title being pink and underlined, as most people know, a hyperlink is blue, not pink, sorry you were confused by that detail. Thank you for all your ideas.

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