An Application of Music Therapy for Nursing Home Residents with Dementia

Purpose: To examine the use of music therapy in nursing home (NH) residents living with dementia with agitation and aggressive behaviors and receiving as needed psychotropic medications.Background: Agitation and aggressive behaviors associated with dementia occur in 15 to 20% of NH residents. In California, 14% of NH residents with dementia and related behavioral symptoms receive psychotropic medications despite an increased risk of side effects which can lead to falls and injury. Providers often prescribe psychotropic medications as first-line treatment for symptoms associated with dementia. Non-pharmacological approaches such as music therapy may improve dementia-related behaviors and decrease the use of psychotropic medications among residents with dementia.Methods: This was a pretest-posttest quality improvement project with two-weeks pre-intervention and eight weeks of intervention in a single NH. Ten NH residents experiencing dementia with associated agitation and aggressive behaviors and on as needed psychotropic medications were recruited. They participated in twice-weekly, 30-minute, individualized passive music therapy delivered with MP3 device players and headphones. Residents and family were contacted to determine music choices. Prior to intervention, one 60-minute training session was provided to nursing and activity staff. Participants’ demographic and medical information were collected from electronic medical records and the most recent Minimum Data Set 3.0. Pre-intervention and intervention data on frequency and severity of agitated and aggressive behaviors and frequency of as needed psychotropic medication administration was collected from medication administration records (MAR) and an investigator-developed behavior monitoring tool (IDBM). Mean frequencies of as needed psychotropic medications, agitation and aggressive behaviors and mean severity level for agitation and aggressive behaviors pre-intervention and post-intervention were compared from