Introduction
Dementia is an overall term used to describe a group of symptoms linked to the deterioration of memory, thinking capacity, and social functioning to the extent of decreasing one’s ability to do daily chores effectively (Vink et al., 2013). Several intervention measures have been attempted in a bid to establish the most effective way to counter dementia. Music therapy and psychotropic medication are the main interventions that have been employed to limit the effects of dementia disorders. Although little research has focused on non-pharmacological treatments such as music therapy, the current evidence shows promising findings for the intervention of dementia. According to Wall and Duffy (2010), when used effectively, music has the potential to improve cognitive, social, and emotional skills coupled with alleviating behavioral challenges. However, this article will argue that music intervention is an effective alternative to pharmacological treatments when intervening in behavior challenges linked to dementia. In a bid to determine the benefits of music therapy in the intervention of behavioral, social, and cognitive difficulties among older people with dementia, this paper will review current evidence for music therapy as the better mitigating approach as compared to psychotropic medication.
The condition of dementia
The number of patients living with dementia internationally is rapidly growing with the majority of the aged patients in nursing homes reported to showing symptoms of the condition (Ridder, Stige, Qvale, & Gold, 2013). In many cases, the agitation has been treated with psychotropic medication by administering psychotropic drugs. Psychotropic medication entails the use of any clinically approved medication with the ability to improve cognitive, behavioral, and emotional skills. Psychotropic medications have beneficial effects, but they are short-lived and they have the ability to transfer agitation rather than clear it. Apparently, there are escalating concerns with regard to the detrimental side effects such as stroke or even death following continued usage of psychotropic drugs (Ridder et al., 2013). Furthermore, the use of these drugs is linked to a decline in quality of life, since they dampen the hormonal functioning of the patient’s body. Research has shown that interaction with music is a possible way of compensating for disorders that affect perception, social involvement, attention, and judgments, thus causing a decline in agitation.
Music as an alternative intervention
Music therapy is described as the use of music and its constituents to improve patients’ health. McDermott, Crellin, Ridder, and Orrel (2013) argue that various treatments of dementia rely on the patients’ ability to communicate verbally. Even though these authors show that the benefits of music therapy in dementia treatment are insufficient in the long term, they acknowledge that it is a better approach because it has no side effects on the patient. When a patient becomes incapacitated to the extent of being unable to talk, music therapy serves as a possible alternative for communication. Group music therapy improves social engagements amongst group members, thus promoting communication ideas and alleviating social isolation. Music therapists employ two major music intervention approaches, viz. receptive and active music therapy. The receptive approach entails listening to a particular music by the therapist after which s/he sings or plays recorded music for the clients. This method in most cases is suitable for patients who cannot express their preferences due to incapacitation. On the other hand, active music therapy entails active participation by the patients by encouraging them to take part in musical improvisation via instruments or voice. This move helps in the reduction of agitation. For instance, patients suffering from high blood pressure are said to benefit hugely from active music therapy (Wall & Duffy, 2010).
How music therapy works
Successful music therapists must possess the skills of both therapists and musicians in a bid to benefit dementia patients optimally. Therapists should be in a position to choose and employ musical parameters sufficiently grounded on the clients’ needs and objectives. Active music therapy involving singing can promote the development of articulation, rhythm, and breathe control. For patients with breathing difficulties and speech problems, singing has been viewed as therapeutic since it increases oxygen saturation rates (Sung, Lee, Li & Watson, 2012). Singing and dancing in a group can facilitate the development of social skills and create awareness of other people. Playing musical instruments can boost gross and fine motor coordination in people with motor disorders. Research by McDermott et al. (2013) indicate that cognitive functioning deteriorates in the course of disease progression, but with the introduction of music therapy, cognitive functions may stay stable until the closing stages of dementia. Listening to music may reduce stress, anxiety, and fear. Patients show reluctance to the use psychotropic medications, but when music is introduced, they show appreciation and prolonged musical abilities. In addition, during the late phases of dementia when other means of intervention like psychotropic medication have failed, many patients remain responsive to music therapy.
Effects of music on agitation
The nature and stage of dementia influence the effectiveness of music therapy. If the nature is a severe one or the progression of the disease is at the last stages, the patient is less likely to respond to psychotropic medication. The side effects may result in increased agitation and irritability. In contrast, music therapy is viewed to initiate improvement in attitude and mood within a short time. Caregivers should demonstrate the ability to select music that has maximum benefits to patients in different stages of the disease. According to Sung et al. (2012), music therapy is better as compared to psychotropic medication because it does not only reduce the patient’s agitation, but it also alleviates the caregiver’s burnout and irritability. Furthermore, music therapy improves the level of engagement between the patients and the caregivers, which facilitates social interactions and self-esteem. Aged people require care approaches that have no adverse side effects because their immune system is highly susceptible to psychotropic drugs. According to the Lawton’s person-environment fit theory, modifying the patient’s environment by introducing music can help in managing behavioral problems of old people with dementia (Sung et al., 2012).
Conclusion
The purpose of this paper was to explore the effectiveness of music therapy in the treatment of people with dementia as opposed to psychotropic medication. The reviewed research demonstrated that music therapy has greater influence on reducing agitation among aged people with dementia as compared to psychotropic medication. In a bid to minimize the use of psychotropic medication and avoid its side effects as well as caregivers’ burnout, this paper has explored music as an alternative intervention. Group music therapy is highly effective in reducing emotional and behavioral symptoms of dementia. However, as Wall and Duffy (2010) suggest, despite the consistent findings favoring music as an effective therapy mitigating approach for dementia in older people, more research is needed before endorsing or denying such claims. In addition, more research is needed to evaluate the effectiveness of using music therapy alongside pharmacological treatments like psychotropic drugs.
References
McDermott, O., Crellin, N., Ridder, M., & Orrel, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International Journal of Geriatric Psychiatry, 2(28), 781-794.
Ridder, H., Stige, B., Qvale, G., & Gold, C. (2013). Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & Mental Health, 17(6), 667-678.
Sung, H., Lee, W., Li, T., & Watson, R. (2012). A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. International Journal of Geriatric Psychiatry, 2(27), 621–627.
Vink, C., Zuidersma, M., Boersma, F., De Jonge, P., Zuidema, U., & Slaets, J. (2013). The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomized controlled trial. International Journal of Geriatric Psychiatry, 3(28), 1031-1038.
Wall, M., & Duffy, A. (2010). The effects of music therapy for older people with dementia. British Journal of Nursing, 19(2), 108-113.