A recent study has revealed groundbreaking insights into how and why music alleviates distress and agitation in individuals with advanced dementia. In the UK alone, approximately one million people are living with dementia, with over half of these cases being advanced, necessitating specialist care. This level of dementia is often accompanied by behaviours such as agitation, aggression, and wandering, making effective care approaches essential.
Published in the prestigious journal Nature Mental Health, the study offers a comprehensive look at the myriad benefits of music therapy. It delves into the mechanisms behind music’s calming effects and outlines a strategic approach for integrating music therapy effectively into the care of individuals with advanced dementia. When administered by professional therapists, music therapy can vary from singing and playing to simply listening to music. Therapists also tailor musical activities to enhance the daily care routines managed by families and caregivers.
This pioneering research was spearheaded by Naomi Thompson from Anglia Ruskin University (ARU) in Cambridge. It marks the first review of its kind that integrates academic study with input from stakeholders to craft personalised therapeutic interventions. The findings suggest that when music therapy is customised to meet individual needs, it can significantly reduce agitation and anxiety on a short-term basis, improving attention, engagement, alertness, and mood. Engaging in musical activities fosters a sense of safety and orientation, diminishing distress and bolstering overall well-being.
The therapeutic effect of music is attributed to its ability to provide cognitive and sensory stimulation. It activates neural networks across both brain hemispheres, tapping into the person’s residual capabilities and memories. Music is an emotional and cognitive anchor, helping individuals manage their feelings and maintain calmness. Additionally, it can be specifically adapted to mitigate physiological stress within the autonomic nervous system.
One of the most poignant aspects of music therapy is its ability to evoke memories, mainly through familiar tunes. Music-evoked memories are typically more vivid, positive, and specific than those recalled without musical cues. Songs from the person’s youth—specifically those ages 10 to 30—are most effective in triggering meaningful recollections.
Music transcends verbal communication barriers and is accessible to everyone, regardless of their cognitive impairments or musical skills. It facilitates social interactions with caregivers, staff, and other residents, enhancing communal bonds. The study advocates for music therapists to train other care professionals so that everyone involved in dementia care can effectively use music, regardless of their prior experience.
Further recommendations include equipping care facilities with musical instruments and resources to create personalised playlists. Families are encouraged to integrate music into their caregiving routines, benefiting not only the people living with dementia but also the caregivers by reducing their stress and enhancing their well-being. Music creates unique moments that differ from regular interactions, fostering empathy and improving engagements with dementia patients, particularly in times of heightened distress.
The research was comprehensive, involving interviews with staff and music therapists at mental health wards specialising in dementia at the Cambridgeshire and Peterborough NHS Foundation Trust, a systematic review of existing studies, and a national survey of healthcare professionals. It also included collaboration with Dementia UK, a leading nursing charity specialising in dementia.
Naomi Thompson, the lead researcher from the Cambridge Institute for Music Therapy Research at ARU, emphasised the simplicity and cost-effectiveness of music as a therapeutic tool. She highlighted its efficacy in meeting individuals’ stimulation needs, fostering familiarity through cherished memories, encouraging emotional expression, and, crucially, reducing distress and anxiety. This study not only underscores the effectiveness of music therapy in enhancing the quality of life for those affected by dementia but also sets the stage for its broader application in dementia care settings.
Dr Ben Underwood, co-author and Research and Development Director at the Cambridgeshire and Peterborough NHS Foundation Trust and Associate Professor at the University of Cambridge expressed optimism about the potential of music to soothe highly distressed dementia patients, heralding the study as a significant advancement in bringing music therapy into mainstream NHS dementia care.
More information: Naomi Thompson et al, How and why music therapy reduces distress and improves well-being in advanced dementia care: a realist review, Nature Mental Health. DOI: 10.1038/s44220-024-00342-x
Journal information: Nature Mental Health Provided by Anglia Ruskin University
