MUSIC AND QUALITY OF LIFE AMONG NURSING HOME RESIDENTS WITH DEMENTIA )PART 2)

Activities directors, caregivers, and healthcare professionals,here is some great information
Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia brain boosting activities

MARTIN GIZZI, MD, PHDCHAIRMAN, NJ NEUROSCIENCE INSTITUTE AT JFK MEDICAL CENTERPROFESSOR AND CHAIRMAN, DEPARTMENT OF NEUROSCIENCE, SETON HALL UNIVERSITYPRESIDENT, MUSIC FOR ALL SEASONS MEDICAL ADVISORY BOARD

Mr. Dallow is a composer and pianistand is the co-founder of two orchestras, the New York Virtuosi Chamber Orchestra and thePhilharmonic Orchestra of New Jersey.The New Jersey Neuroscience Institute at JFK Medical Center is a comprehensive facilitydesigned exclusively for the diagnosis, treatment, and research of complex neurological andneurosurgical disorders in adults and children. Services offered at the Institute include programs in minimally-invasive and reconstructive spine surgery, peripheral nerve surgery, brain tumors,dizziness and balance disorders, epilepsy, sleep, memory problems/dementia, cerebral palsy,stroke, and spasticity and movement disorders.

As a department of Seton Hall University'sSchool of Graduate Medical Education, NJNI serves as the clinical setting for SHU's residencytraining in neurology. Martin Gizzi, MD, PhD is Professor and Chairman of Neuroscience at Seton Hall UniversitySchool of Graduate Medical Education, Chairman of the NJ Neuroscience Institute, andPresident of the Medical Advisory Board of MFAS. He holds a PhD in experimental psychology,an MD and is a board certified neurologist. He has been a prolific researcher, securing grantsfrom the National Institutes of Health and the National Aeronautics and Space Administration. His research with NASA led to several experiments performed on board the space shuttle.Project design and resultsFor this project, MFAS provided live, interactive music performances at a long-term carefacility.

23 patients with diagnoses of dementia were enrolled with appropriate consent. Stafftracked the number of falls, number of times sedating medication was given and quality of lifeusing the Quality of Life in Dementia (QOLID) scale. QOLID was developed in 1988(Alexopoulos et al, 1988a,b) and has been extensively validated in populations with dementia(Brod et al, 1999; Logsdon et al, 1999 and Ready et al, 2002).

The current study used a repeated measures design, testing subjects before and after two live music performances given six weeksapart. Each set of measures was taken at two-week intervals.The principal result was a measured increase in quality of life as measured by the QOLID.Scores increased significantly following each performance, and maintained this increase for aslong as six weeks. The effect was highly significant (F (5, 105) = 4.12, p = .002).

There was atrend for the use of sedating medications to fall in the two-week period following each

performance; however, because the overall use was so low there was not a signficiant effect (F(5,105) <1, p=.84).

Similarly there was a trend of decline in the number of falls in the two-weekperiod following each performance, but the effect was not significant (F (5, 105) <1, p = .5).The results strongly support the value of live musical performances in facilities that care forpatients with dementia and speak directly to the mission of Music For All Seasons.

The non-significant trends suggest that larger studies would be helpful in documenting decreased risk anddecreased medical expenses for patients attending regular musical performances.

It is our intentto repeat the study with a larger sample and using a control population rather than a repeatedmeasures design.

REFERENCESAbsher J and Cummings J. Noncognitive behavioral alterations in dementia syndromes.In Handbook of Neuropsychology. F Boller and J Grafman (Eds), 1993, pp. 315-338,Elsevier,

Amsterdam.Alexopoulos G, Abrams R, Young R et al. Use of the Cornell Scale in nondementedpatients. J Amer Geriatr Soc 1988a; 36:230-236.Alexopoulos G, Abrams R, Young R et al. Cornell Scale for depression in dementia. BiolPsychiat 1988b; 23:271-284.Aragon D,

Farris C and Byers J. The effects of harp music in vascular and thoracicsurgical patients. Altern Ther Health Med 2002; 8:52-54.Boller F and Duyckaerts C. Alzheimer disease: clinical and anatomic aspects. InBehavioral Neurology and Neuropsychology. T Feinberg and M Farah (Eds), 1997, pp.521-544, McGraw-Hill, New York.Brod M, Stewar A, Sands L et al.

Conceptualization and measurement of quality of lifein dementia: The dementia quality of life instrument (DQoL). Gerontologist 1999; 39:25-35.Clark M, Lipe A and Bilbrey M.

Use of music to decrease aggressive behaviors inpeople with dementia. J Gerontol Nursing 1998; 24:10-17.Cummings J.

Depression and Parkinson’s disease: A review. Am J Psychiatry 1992;149:443-445.Gotell E, Brown S and Ekman S. Caregiver singing and background music in dementiacare. West J Nurs Res 2002; 24:195-216.Gregory D.

Music listening for maintaining attention of older adults with cognitiveimpairments. J Music Ther 2002; 39:244-264.

4Hebert M, Parlato V, Lese G et al. Survival in institutionalized patients: Influence ofdementia and loss of function capacities. Arch Neurol 1995; 52:469-475.Konlaan B, Bjorby N, Bygren et al.

Attendance at cultural events and physical exerciseand health: a randomized controlled study. Public Health 2000; 114:316-319.Logsdon R, Gibbons L, McCurry S et al.

Quality of life in Alzheimer’s disease: Patientand caregiver reports. J Mental Health Aging 1999; 5:21-32.Moretti R, Torre P, Antonello R, Cazzato G and Bava A.

Depression and Alzheimer’sdisease: symptom or comorbidity? Am J Alzheimers Dis Other Demen 2002; 17:338-344.Myskja A and Lindbaek M.

Examples of the use of music in clinical medicine. TidsskrNor Laegeforen 2000; 120:1186-1190.Ragneskog H, Asplund K, Kihlgren M and Norberg A.

Individualized music played foragitated patients with dementia: analysis of video-recorded sessions. Int J Nurs Pract2001; 7:146-155.Ready R, Ott B, Grace J et al.

The Cornell-Brown scale for quality of life in dementia.Alzheimer Dis Assoc Disord 2002; 16:109-115.

Remington R. Calming music and hand massage with agitated elderly. Nurs Res 2002;51:317-323.Zimmerman S, Gruber-Baldini A, Hebel J, Sloane P and Magaziner J.

Nursing home facility risk factors for infection and hospitalization: importance of registered nurseturnover, administration and social factors. J AM Geriatr Soc 2002; 50:1987-1995.

read all about MUSIC AND QUALITY OF LIFE AMONG NURSING HOME RESIDENTS WITH DEMENTIA and come back here for more great information

MUSIC AND QUALITY OF LIFE AMONG NURSING HOME RESIDENTS WITH DEMENTIA )PART 1)

Activities directors, caregivers, and healthcare professionals,here is some great information
Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia brain boosting activities

MARTIN GIZZI, MD, PHDCHAIRMAN, NJ NEUROSCIENCE INSTITUTE AT JFK MEDICAL CENTERPROFESSOR AND CHAIRMAN, DEPARTMENT OF NEUROSCIENCE, SETON HALL UNIVERSITYPRESIDENT, MUSIC FOR ALL SEASONS MEDICAL ADVISORY BOARD

Dementia is an enormous public health issue, affecting 13-15 million Americans and at least halfof residents in long-term care facilities have dementia. Quality of life issues for this populationare varied but uniformly include the non-cognitive issues of apathy, depression, agitation, sleepdifficulties, loss of autonomy and social isolation. It has been said that “patients withAlzheimer’s disease do not die of the disease, they die with it from some other cause” (Boller andDuyckaerts, 1997).

Across the spectrum of dementing illnesses from vascular dementia to Parkinson’s and Alzheimer’s diseases, depression is both a manifestation of the dementingprocess (Cummings, 1992) and the consequence of social isolation. In the view of someinvestigators, depression itself may be responsible for the precipitous declines in clinical course(Absher and Cummings, 1993). The consequences of agitation and sleep difficulties may also be dramatic. The need for sedatingmedications during the daytime leads to poorer social interaction and exacerbates a reversal ofthe sleep-wake cycle. Demented patients, already inclined to increasing disorientation after nightfall, will be more alert and agitated following a day during which sedatives have been used.This, in turn, leads to a greater use of hypnotics at bedtime, contributing to the steady declineinto the vegetative stage of many dementias.The medical benefits of musicThe use of music in dementia has extended into multiple areas involving both the cognitive andnon-cognitive aspects of the condition.

Go tell et al (2002) have identified increased verbalcomprehension among demented patients exposed to singing. Gregory (2002) induced highermeasures of attentional ability in adults with cognitive impairments following weekly musicsessions. Clark et al (1998) saw reductions in 12 or 15 identified aggressive behaviors in a long-term care population with dementia during and following exposure to music. Music has alsobeen documented to reduce agitation among elderly (Remington, 2002) and demented(Ragneskog et al, 2001) residents of long-term care facilities.

Music For All Seasons (MFAS) is a not-for-profit organization that brings, live, interactivemusic performances to audiences in long-term care facilities, medical centers and other facilities.The organization operates on the principle that music serves a healing purpose as well asimproving cultural awareness and social connectedness.Brian Dallow is the co-founder and Executive Director of Music For All Seasons, which he andhis wife, Artistic Director Rena Fruchter, created in 1991.

Mr. Dallow studied at the Royal College of Music, the Royal Academy of Music, the London School of Economics, BrandeisUniversity, and Rutgers University. He holds degrees in performance, composition and theory,and musicology. In addition to Music For All Seasons,

Mr. Dallow is a composer and pianistand is the co-founder of two orchestras, the New York Virtuosi Chamber Orchestra and thePhilharmonic Orchestra of New Jersey.The New Jersey Neuroscience Institute at JFK Medical Center is a comprehensive facilitydesigned exclusively for the diagnosis, treatment, and research of complex neurological andneurosurgical disorders in adults and children. Services offered at the Institute include programs in.......read all about MUSIC AND QUALITY OF LIFE AMONG NURSING HOME RESIDENTS WITH DEMENTIA and come back here for more great information

Music Therapy for Parkinson's and Dementia

Activities directors, caregivers, and healthcare professionals,here is some great information
Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia brain boosting activities

Caregiver.on.ca

Music therapy holds so many promises for so many types of diseases, not only for memory loss but also for working with people who have movement disorders, especially Parkinson's.


Research at Beth Abraham Hospital shows that "Parkinson's Disease patients regain some ability to organize and perform movements that were lost due to the disease. Not just any melody will do. The music must evoke a response in each patient, which is used by Tomaino to help the patient enact a specific physiological movement, such as walking. For the patient to move physically, the rhythm must be stimulating and the music familiar enough to allow for carry-over outside the music therapy session."


Michael Thaut, AoA Grant Project Director of Colorado State University, in the bulletin on the White House Mini-Conference on Aging and Music Therapy, 1994, states: "The results of this study impact neurological rehabilitation because they demonstrate that particular elements of music have a specific effect on motor systems. After three weeks, the patients with Parkinson's disease demonstrated longer stride length and improved gait velocity by an average of 25 per cent. These data validate the effectiveness of auditory rhythm to improve gait through the rhythmic coupling of auditory and motor systems."


In working with persons who have dementia, certain cautions need to be taken, as certain types of music may cause agitation. Two example come to mind:

one psychologist told me that in his Alzheimer special care unit, their least successful "musical session" involved live bagpipe music: this session was not meant to be retreive memories (the audience had no special association with the music and therefore could not access long-term memories) but meant as more of a quality of life occasion, but the results were increased agitation and outbursts. Their most successful sessions (audience was relaxed and peaceful) were with classical music and hymns.
Be prepared that people may retrieve both positive and negative memories. Connie Tomaino of Beth Abraham told the story of the time she played a waltz to a women who broke out in sobs, only to find out later that the woman had been in a concentration camp (unknown to Connie at the time) and hearing waltz music was a traumatic event for her.

For those interested in learning more about the effects of music therapy on memory and gait, I would suggest contacting the National Association for Music Therapy at 301.598.3300. You can contact them for additional information on specific music research. Their brochure also lists specific federally funded studies and one of the responsibilities of the recipients is the dissemination of their study's results: many will have write-ups in brochures, booklets, books, magazines, etc.


Here is a partial list of recipients from the National Association for Music Therapy:

TITLE: Music Therapy for Alzheimer's and Dementia Individuals:
Recipient: University of Iowa, Kate Gfeller, School of Music 319.335.2611

TITLE: Music Therapy in Alzheimer's Disease
Recipient: University of Miami, Ted Tims 305.284.3943

TITLE: A Rhythmic Sensorimotor Music Therapy Program to Improve Gait Ability in Parkinsonian Patients and Healthy Elderly
Recipient: Colorado State University, Michael Thaut 303.491.7384

You may also want to contact the Institute for Music and Neurologic Function at 718.519.4164 and ask for their booklet "Music has Power" -- it is good write-up of the overall picture on the therapeutic benefits of music. They are also conducting research in five catorgories: music and hearing, music and language, music and memory, music and learning, and music and recovery from nerve injury.


Other comments about the use of music:
Rosemary Bakker Gerontologist/Interior Designer smartage@msn.com

The best type music? I have seen the best results with using the music
that was popular in the patient's "prime" time of life. That is if you have the luxury of knowing what the individual enjoyed. Our recreational therapist was familiar with our above mentioned gentleman and realized what he needed. Some good old fashioned swing music was wonderful. For a 50-year-old patient, R&B might do the trick. Soft, or "elevator music" is never inappropriate. Most older patients, especially here in the Bible Belt, respond well to instrumental hymns and spirituals.


Poor choices would obviously be rock, jazz, polkas, lively spirited songs and oddly enough patriotic music (especially with veterans). You want to avoid "getting the juices flowing,"' so to speak.

Music is a pwerful tool for those with dementia

Because music is so good for persons with Alzheimer's disease or any dementia for that matter. Music groups or 1:1 activities with music should happen often.
Here is a link to article about music and dementia
Click here
Click here to see the importance of music for nursing home residents with dementia
I have posted a link to a music activity many residents enjoy
Click here to see it again
Click here for a link to songs dementia folks are sure to enjoy.
You can even print out these songs
So Activity and other Healthcare professionals and caregivers, friends and loved ones have a time for music and singing everyday

Another great dementia activity

Before you begin to design or use a dementia activity, it is of the utmost importance that you known persons you are interacting with. It is helpful to recognize the dementia folks likes and dislikes as well as their strenghts and weaknesses. Also helpful is knowledge of the dementia persons past life and experiences since they may not be able to tell you them. Clinical observation is of the utmost importance here.

Persons with dementia, as well as other nursing home residents, love music.Music is such a powerful tool. Often dementia folks remember words to familiar songs even when they are otherwise non verbal. Singing improves dementia persons' mood. Singing is also good for the lungs.

Click here to learn more about an easy to do dementia music activity