Therapeutic Music Interventions to Support People With Dementia Living at Home With Their Family Caregivers

2019 ◽  
pp. 269-287
Author(s):  
Jeanette Tamplin ◽  
Imogen N. Clark
Keyword(s):  
Social Engagement ◽  
Self Awareness ◽  
Music Participation ◽  
Music Therapists ◽  
People With Dementia ◽  
Severe Stage ◽  
Musical Interactions ◽  
Diagnosis Of Dementia ◽  
Person With Dementia ◽  
At Home

Music can be used therapeutically in home and community settings throughout the trajectory of dementia. Communal singing experiences offer opportunities for music participation and social engagement that are accessible and enjoyable for people with dementia at any stage of severity. They also provide a means of communication and facilitate relationships between people with dementia and their carers through shared and meaningful musical interactions. In the early stages after a diagnosis of dementia, supported opportunities to sing together, along with the associated prospects for peer support and social interaction, may enable family carers to care for loved ones at home for as long as possible. In the later stages of dementia, singing may be the only way for the person with dementia to communicate and connect with others. Music processing capacities can be retained until the severe stage and music can stimulate memories and self-awareness for the person with dementia. Supported songwriting can be therapeutic for both people with dementia and their caregivers in facilitating emotional expression and acknowledging and validating feelings. This chapter explores the range of music participation opportunities available to people living with dementia at home with their caregivers at various stages of the disease. We also outline the differences in groups facilitated by music therapists and community musicians and highlight ways that caregivers can use music therapeutically in the home environment.

scholarly journals Differences in assistive technology installed for people with dementia living at home who have wandering and safety risks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eleanor Curnow ◽  
Robert Rush ◽  
Sylwia Gorska ◽  
Kirsty Forsyth
Keyword(s):  
Assistive Technology ◽  
Selection Process ◽  
Living Situation ◽  
Caregiver Support ◽  
People With Dementia ◽  
Multiple Characteristics ◽  
Person Characteristics ◽  
Person With Dementia ◽  
The Impact ◽  
At Home

Abstract Background Assistive Technology for people with dementia living at home is not meeting their care needs. Reasons for this may be due to limited understanding of variation in multiple characteristics of people with dementia including their safety and wandering risks, and how these affect their assistive technology requirements. This study therefore aimed to explore the possibility of grouping people with dementia according to data describing multiple person characteristics. Then to investigate the relationships between these groupings and installed Assistive Technology interventions. Methods Partitioning Around Medoids cluster analysis was used to determine participant groupings based upon secondary data which described the person characteristics of 451 people with dementia with Assistive Technology needs. Relationships between installed Assistive Technology and participant groupings were then examined. Results Two robust clustering solutions were identified within the person characteristics data. Relationships between the clustering solutions and installed Assistive Technology data indicate the utility of this method for exploring the impact of multiple characteristics on Assistive technology installations. Living situation and caregiver support influence installation of assistive technology more strongly than level of risk or cognitive impairment. People with dementia living alone received different AT from those living with others. Conclusions Results suggest that caregiver support and the living situation of the person with dementia influence the type and frequency of installed Assistive Technology. Reasons for this include the needs of the caregiver themselves, the caregiver view of the participants’ needs, caregiver response to alerts, and the caregiver contribution to the assistive technology assessment and selection process. Selection processes should be refined to account for the needs and views of both caregivers and people with dementia. This will require additional assessor training, and the development of validated assessments for people with dementia who have additional impairments. Policies should support the development of services which provide a wider range of AT to facilitate interventions which are focused on the needs of the person with dementia.

Person- and relationship-centred dementia care

2020 ◽  
pp. 233-248
Author(s):  
John Keady ◽  
Mike Nolan
Keyword(s):  
Life Story ◽  
Care Home ◽  
Theoretical Development ◽  
People With Dementia ◽  
Global Issue ◽  
Diagnosis Of Dementia ◽  
Working Together ◽  
The Senses ◽  
Story Work ◽  
Person With Dementia

Dementia is a global issue experienced on an individual and relational level. This chapter traces the emergence of both person-centred care and relationship-centred care, with the latter approach expressed through the Senses Framework. The Framework outlines the theoretical development and practical application of the Senses [security, belonging, continuity, purpose, achievement, significance] and highlights the importance of staff, carer, and [in this chapter] person with dementia all working together. This chapter describes the application of the Senses Framework to a recent practice development study set in a care home for people with dementia and shows how the study used a combination of the Senses and life story work to create an ‘enriched’ environment. The chapter concludes with a discussion about how the Senses can be used to facilitate an early diagnosis of dementia and to help people with dementia and their families to engage with a life ‘outside the front door’, termed ‘The Neighbourhood Space’.

scholarly journals Recruiting hard to reach populations to studies: breaking the silence: an example from a study that recruited people with dementia

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030829
Author(s):  
Becky Field ◽  
Gail Mountain ◽  
Jane Burgess ◽  
Laura Di Bona ◽  
Daniel Kelleher ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Future Research ◽  
Specific Population ◽  
Research Experiences ◽  
Multiple Strategies ◽  
Successful Recruitment ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
Hard To Reach Populations ◽  
Person With Dementia

ObjectiveTo share the challenges of recruiting people with dementia to studies, using experiences from one recently completed trial as an exemplar.BackgroundResearch publications always cite participant numbers but the effort expended to achieve the sample size is rarely reported, even when the study involved recruiting a hard to reach population. A multisite study of a psychosocial intervention for people with dementia illustrates the challenges. This study recruited 468 ‘dyads’ (a person with dementia and a family carer together) from 15 sites but the time taken to achieve this was longer than originally estimated. This led to a study extension and the need for additional sites. Recruitment data revealed that certain sites were more successful than others, but why? Can the knowledge gained be used to inform other studies?MethodsSecondary analysis of routinely collected recruitment data from three purposefully selected sites was examined to understand the strategies used and identify successful approaches.FindingsAt all three sites, the pool of potential recruits funnelled to a few participants. It took two sites 18 months longer than the third to achieve recruitment numbers despite additional efforts. Explanations given by potential participants for declining to take part included ill health, reporting they were ‘managing’, time constraints, adjusting to a diagnosis of dementia and burden of study procedures.ConclusionsSuccessful recruitment of people with dementia to studies, as one example of a hard to reach group, requires multiple strategies and close working between researchers and clinical services. It requires a detailed understanding of the needs and perspectives of the specific population and knowledge about how individuals can be supported to participate in research. Experiences of recruitment should be disseminated so that knowledge generated can be used to inform the planning and implementation of future research studies.

Hanging on to Some Autonomy in Decisionmaking: How do Spouse Carers Support this?

Dementia ◽  
2016 ◽  
Vol 18 (4) ◽  
pp. 1219-1236 ◽  
Author(s):  
Deirdre Fetherstonhaugh ◽  
Jo-Anne Rayner ◽  
Laura Tarzia
Keyword(s):  
Decision Making ◽  
Informal Care ◽  
Face To Face ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
Person With Dementia

In Australia, the majority of people with dementia live in the community with informal care provided by family, commonly a spouse. A diagnosis of dementia is a threat to one’s personhood and is often accompanied by perceptions of future dependency, which will involve the inability to carry out conventional roles and complete everyday tasks including making decisions. Being able to make decisions, however, is part of being a ‘person’ and it is through relationships that personhood is defined and constructed. In face-to-face interviews with seven couples (a carer and person with dementia dyad) and two spouse carers, this study explored why, and how, spouse carers support continued involvement in decision-making for people with dementia. The findings highlight the importance of loving and respectful relationships in the development of strategies to support continued decision-making for people with dementia.

scholarly journals 305 - What happens before, during and after crisis for someone with dementia living at home

2020 ◽  
Vol 32 (S1) ◽  
pp. 62-63
Author(s):  
Sabarigirivasan Muthukrishnan ◽  
Jane Hopkinson ◽  
Kate Hydon ◽  
Lucy Young ◽  
Cristie Howells
Keyword(s):  
Hospital Admission ◽  
Social Care ◽  
Dementia Care ◽  
Home Treatment ◽  
List Type ◽  
Crisis Resolution ◽  
People With Dementia ◽  
Health And Social Care ◽  
Person With Dementia ◽  
At Home

Background:Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that can have better outcomes and is the preference of people living with dementia.Purpose:To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.Objective:To identify critical factors for successful resolution of crisis and avoidance of hospital admissionMethods:The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.Findings:The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.Factors key for crisis resolution were a systems approach with embedded respect for personhood,attention to carer needs independently of the person with dementia,review and monitoring of the effect of medications,awareness and promotion of potential benefits with treatment at home,education of the health and social care workforce in dementia care, local availability of respite and other social care services.The Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.Conclusion:This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.

scholarly journals Non-Verbal Interactions Between Music Therapists and Persons with Dementia. A Qualitative Phenomenological and Arts-Based Inquiry

2021 ◽  
Author(s):  
Julie K Krøier ◽  
Brynjulf Stige ◽  
Hanne Mette Ridder
Keyword(s):  
Music Therapy ◽  
Lived Experience ◽  
Phenomenological Approach ◽  
Music Therapists ◽  
Verbal Interactions ◽  
Care Experience ◽  
Therapeutic Presence ◽  
Musical Interactions ◽  
Qualitative Phenomenological ◽  
Person With Dementia

Abstract When music therapists are supervising caregivers in how to apply music in their interactions with persons with dementia, we may term this as indirect music therapy practice. Musical interactions are mostly happening through nonverbal, implicit, and embodied knowledge, and, therefore, there is a need for exploring and verbalizing such interactions for music therapists to be able to disseminate to caregivers and other professionals. In this qualitative study, we examine how 6 music therapists with clinical experience in dementia care experience nonverbal interaction with persons with severe dementia living in nursing homes. Explorative focus groups were conducted to study the music therapists’ lived-experience descriptions about their nonverbal interactions with persons with dementia. Focus group transcripts were analyzed by a phenomenological approach, and the findings elaborated and peer validated by the use of musical improvisation as an arts-based analytic approach. The findings included five themes: vitality, disciplined subjectivity, attunement, therapeutic presence, and validation. The music therapists were guided by the vitality of the person with dementia, were aware of their own reactions, and sensed the needs of the person through disciplined subjectivity. They attuned to the person’s nonverbal musical parameters (e.g., tempo pitch and volume) and cocreated an open and mutual field through therapeutic presence and validation. The findings are relevant for future development of direct and indirect music therapy practice but contain limitations due to a homogenous and small group of participants. This study highlights the challenges of exploring nonverbal and musical interactions with the use of language-based methods of inquiry.

scholarly journals Carers’ experience of using assistive technology for dementia care at home: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034460 ◽  
Author(s):  
Vimal Sriram ◽  
Crispin Jenkinson ◽  
Michele Peters
Keyword(s):  
Assistive Technology ◽  
Phenomenological Study ◽  
Structured Interviews ◽  
Use Of Resources ◽  
People With Dementia ◽  
Social Environmental ◽  
The Uk ◽  
Qualitative Phenomenological ◽  
Person With Dementia ◽  
At Home

ObjectiveAssistive technology (AT) can help carers (family, friends and neighbours) and people with dementia to stay well and safely at home. There are important gaps in what we know about experience of using AT from the perspective of carers of persons with dementia. This study investigates carers’ experience of using AT in supporting and caring for persons with dementia who live at home.DesignQualitative phenomenological study with semi-structured interviews to achieve data saturation and thematic analysis to identify key themes.SettingCommunity-based within the UK.ParticipantsTwenty-three (14 women, 9 men) adult carers of persons with dementia who have used at least one AT device.ResultsAll participants reported benefiting to varying degrees from using AT. There were 5 themes and 18 subthemes that highlighted reasons for using AT and use of AT over time. Providing care for a person with dementia, motivation for using AT, changes to roles and routines, carer knowledge and skills for using AT and social, environmental and ethical considerations were the main themes. This study showed that AT can provide reassurance and support for carers of persons with dementia but there are difficulties with acquiring and continued use of AT as dementia progresses.ConclusionsCarers consider AT as an adjunct to care they provided in caring for a person with dementia. Use of AT should be considered in the personal, social and environmental context of persons with dementia and their carers. Further research and policy interventions are needed to address best use of resources and guidance on data sharing and data protection while using AT.

Do people with early stage dementia experience Prescribed Disengagement®? A systematic review of qualitative studies

2017 ◽  
Vol 30 (6) ◽  
pp. 807-831 ◽  
Author(s):  
Lee-Fay Low ◽  
Kate Swaffer ◽  
Margaret McGrath ◽  
Henry Brodaty
Keyword(s):  
Early Stage ◽  
Qualitative Studies ◽  
Subjective Experiences ◽  
Self Identity ◽  
Slowing Down ◽  
People With Dementia ◽  
Early Dementia ◽  
Diagnosis Of Dementia ◽  
Person With Dementia ◽  
Diagnostic Support

ABSTRACTBackground:Prescribed Disengagement® is the description of the post-diagnostic advice given to people after a diagnosis of dementia, which explicitly or implicitly suggests that the person should be slowing down or pulling back from activities. This results in isolation, loss of hope, self-esteem and self-identity, and threatens social health. This study aims to review whether Prescribed Disengagement® can be identified in the literature on subjective experiences of people living with early dementia.Methods:A systematic search was performed. Inclusion criteria were original empirical qualitative studies published in English that addressed the subjective experiences of living with a diagnosis of objectively defined early dementia. Thematic synthesis was undertaken.Results:Thirty-five papers involving 373 participants were included. Following a diagnosis, people with dementia struggled with self-identity, independence, control and status, activities, stigma, and how to view the future. Reactions in these areas ranged from active and positive to negative and passive. Many studies reported participants’ dissatisfaction with the way the diagnosis was communicated. There was insufficient information provided about dementia and limited treatments and support offered. The diagnosis process and post-diagnostic support may have contributed to disempowerment of the person with dementia, made it more difficult to accept the diagnosis, and exacerbated negative views and self-stigma around dementia.Conclusions:These results do not support the idea of Prescribed Disengagement®. However disengagement may have been implied during the diagnosis process and post-diagnostic support. Research is needed on how to improve the communication of dementia diagnosis and support people to live well post-diagnosis.

A review of couple-centred interventions in dementia: Exploring the what and why – Part A

Dementia ◽  
2017 ◽  
Vol 18 (7-8) ◽  
pp. 2436-2449 ◽  
Author(s):  
Therése Bielsten ◽  
Ingrid Hellström
Keyword(s):  
Cognitive Function ◽  
Relationship Quality ◽  
Negative Impact ◽  
Well Being ◽  
Dyadic Relationship ◽  
People With Dementia ◽  
Care Partners ◽  
Diagnosis Of Dementia ◽  
Person With Dementia ◽  
The Relationship

Introduction Symptoms of dementia bring about challenges to couples’ relationships. Relationship-focused support has been highlighted to be of significant importance for sustained relationship quality and to reduce the negative impact of dementia on the dyadic relationship. This review aimed to explore the ‘what’ and ‘why’ of interventions aimed at couples where one partner has a diagnosis of dementia and in which the couple jointly participate. Method Searches were performed in Academic Search Premier, CINAHL, PsycINFO, PubMed, Scopus and Web of Science from January 2000 to August 2017. Results Six studies were included. Objectives for the person with dementia was related to cognitive function and for the care partner the objectives were related to well-being. The majority of the outcomes were mirrored by the objectives and focused on cognitive function for people with dementia and depression and relationship quality for care partners. Our findings indicate that people with dementia should be included in the assessment of the relationship in order to gain an overall picture of relationship dynamics and to increase tailored support in couple-centred interventions. Conclusions The findings of this review indicate that joint interventions for people with dementia and care partners are lacking a genuine dyadic approach where both partners’ views of their relationship are valued. In order to identify targets for support and to use the appropriate outcome measures, the quality of the relationship should be recognised and taken into account. Moreover, there is a lack of a salutogenic approach in couple-centred interventions in which couples’ strengths and resources can be identified and supported.

scholarly journals 345 - 7 Critical factors for safely supporting dementia patients in mental health crisis in community

2020 ◽  
Vol 32 (S1) ◽  
pp. 105-106
Author(s):  
Sabarigirivasan Muthukrishnan ◽  
Kate Hydon ◽  
Lucy Young ◽  
Cristie Howells
Keyword(s):  
Hospital Admission ◽  
Social Care ◽  
Dementia Care ◽  
Home Treatment ◽  
List Type ◽  
Critical Factors ◽  
Crisis Resolution ◽  
People With Dementia ◽  
Person With Dementia ◽  
At Home

Background:Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that can have better outcomes and is the preference of people living with dementia.Purpose:To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.Objective:To identify critical factors for successful resolution of crisis and avoidance of hospital admissionMethods:The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.Findings:The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.The seven key factors key for crisis resolution were a systems approach with embedded respect for personhood,attention to carer needs independently of the person with dementia,review and monitoring of the effect of medications,awareness and promotion of potential benefits with treatment at home,education of the health and social care workforce in dementia care,local availability of respite and other social care services.a dynamic and flexible working ethos and meaningful MDT working with flattened hierarchyThe Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.Conclusion:This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.

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