Music therapy (MT) is a therapeutic modality that attends to physical, cognitive, and social deficits.1 This may involve singing, listening, and other musical activities. MT initiates the stimulation of the parasympathetic nervous system and imposed autobiographical recall, both of which can activate and improve cognition and neuropsychiatric symptoms.2 This article discusses how MT can be incorporated into nursing practice for people living with dementia (PLWD).
Currently, there are 5.9 million patients with Alzheimer disease, the most reported type of dementia, in the US. This number is expected to increase to 14 million by 2050, with healthcare costs surpassing $1 trillion.3 The trends and emotional implications of dementia indicate an impetus for more use of therapeutic interventions. An estimated 50% of primary care physicians suspect that the medical profession is not equipped to provide care to this growing population.3 Studies suggest that MT improves neuropsychiatric symptoms and cognition, reduces anxiety, and may enhance memory recall.4,5 Additionally, emotions evoked through music could be a potential mechanism of emotional self-regulation.4,5
Efficacy and relevance
MT can be incorporated into almost any setting. Although music can be incorporated into nursing practice, it does not replace the extensive training and expertise provided by board-certified music therapists. Nurses can educate the care partners and family members on the possible use of music to help alleviate symptoms related to dementia.
Nurses may not feel confident due to a lack of musical training and exposure, but learning MT techniques appropriate for care planning can increase its use while also expanding the range of resources for patients.
Studies have shown that PLWD exhibited improved orientation, attention, and executive function when they participated in a musical activity.6 Another study found similar results, specifically increased Mini-Mental State Examination scores following music interventions and significantly enhanced orientation, language, and memory.7 Exploring the correlations between music, emotions, and memory may offer more specific guidance on future interventions and implementation.8 The majority of the studies demonstrated music to be an inexpensive, effective, and nonintrusive method for improving depression, anxiety, and neuropsychiatric symptoms resulting from dementia.
Music in nursing practice
Nurses can consider these recommendations to advocate for and incorporate music into a clinical setting.
* Assess for musical preferences and any environmental or sensory barriers to optimize engagement in the musical activity.
* Ask the patient and family members whether the patient has participated in MT in the past and how they responded.
* Collaborate and co-coordinate MT sessions with any music therapists on staff.
* Before initiating the MT treatment, identify the patient's or care partner's specific desired outcomes within the agreed-upon time frame.
* Because many PLWDs live at home, the nurse can provide resources about music interventions during discharge education.
The nurse should observe the patient for any emotional or physical responses, including whether the individual recognizes or recalls the melody or lyrics. Noting these types of behavioral changes throughout multiple sessions will help the nurse to evaluate the effectiveness of music as an intervention.
Conclusion
Research supports MT as a valuable nonpharmacologic intervention and suggests its therapeutic effects can lead to a higher quality of life. MT has been shown to have positive effects on cognition and neuropsychiatric symptoms, making it a potentially effective treatment for PLWD. Nurses are in the unique position to apply innovative, evidence-based approaches like music as a therapy to promote personalized and holistic care.
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