Design of Participants Involved
The examination was a randomized controlled preliminary, looking at the impacts of musical treatment on agitation in the elderly. Seven residents were randomly selected from Fraser Healthcare Center. Fraser healthcare is a skilled nursing facility and rehabilitation center that is governed by the Department of Health and Environmental Control (DHEC). Skilled nurses and assistants are available to deliver care to residents. The choice of nursing home meets the research criteria, considering residents with dementia. The inclusion and exclusion criteria were applied during the selection process. As a result, two residents were excluded from the experiment because of their poor educational background. Consequently, three residents were asked to withdraw because they could not provide a consent agreement. Thus, two residents fulfilled the research criteria. The participant’s ages were 77 and 84 years respectively. It is important to note that both residents were female. A calming music was administered to residents on a weekly basis. The researcher coded the results collected during each session. Residents were incorporated in the event because they were diagnosed with dementia using the DSM-IV criteria, which was affirmed by a nursing doctor and had an abnormal state of social issues demonstrated by a Cohen-Mansfield Disturbance Inventory (CMAI) score of >44.
The CMIA score is the standard score prescribed for residents with dementia. The ethics committee board endorsed the research. Members were randomized to either the music treatment condition or the recreational movement condition. To guarantee randomized designation, fixed envelopes were utilized to guarantee suitable randomization.
Description of Project Implementation
The CMAI is a nursing-rated questionnaire that evaluates the recurrence of agitation in residents with dementia (Goldstein-Levitas, 2016). The research instrument was developed to evaluate 29 behaviors associated with dementia. Based on this assumption, caregivers rate their findings on a 7-point scale. Since the research focuses on agitation, the CMAI was utilized to evaluate the occurrence of agitation at baseline (Janzen, Zecevic, Klosec, & Orange, 2013). The research instrument was also used to evaluate the level of disturbance for incorporation purposes.
The CMAI tool categorizes behaviors into four lead, which includes physically aggressive, physically non-aggressive, verbally aggressive and verbally non-aggressive (Vink, Zuidersma, Boersma, Zuidema, & Slaets, 2013). The symptoms of agitation are clarified under the four headings. Based on this classification, the researcher scored each participant based on the frequency of his or her behavior. A modified adaptation of the CMAI tool was used to evaluate the resident’s behavioral pattern during the intervention period. Rather than rating the recurrence of every manifestation on a 7-point scale, the appearance or nonappearance of each side effect was assessed to decrease time utilization for the attendants. Appraisals of agitated behavior of each participant occurred for each session on a weekly basis. Participants were treated to music therapy once a week. The music session lasted for forty minutes. Each session was observed for signs and frequency of agitation using the CMAI tool.
During each assessment, residents were evaluated for the presence and absence of the commonly established behaviors as categorized under the CMAI instrument. Based on the project design, the agitation frequency was recorded one hour before and four hours after the therapy session. Agitation is a restless conduct or ill-advised physical and verbal activities that may cause inconvenience for relatives, nursing staff, and caregivers (Ray & Mittelman, 2017). The symptoms of agitation include irritability, anxiety, restlessness, pacing, and anger. Agitation is a manifestation of dementia, which stimulates verbal or aggressive conduct. Agitation in a resident with dementia frequently ascends in circumstances where one cannot process mental activities.
Data Analysis
The CMAI tool was utilized to investigate whether benchmark attributes varied between the music treatment and the time of administration (Ray & Mittelman, 2017). The frequency of each element was recorded after repeated trials to analyze the variance of music treatment on residents with dementia. Based on the analysis, the result measure was the aggregate mean score at four hours after the session, which was transformed to accomplish a normal distribution. For this examination, the researcher included sessions where residents displayed one agitated conduct, one hour before the therapy session.
The results showed that music treatment administered during the research duration has a positive impact on diminishing agitation conduct in people with dementia. However, residents who do not enjoy music found it difficult to come with the music session. As a result, one participant showed no significant improvement during the therapy session. The mean score for the four lead showed that music therapy has a significant impact on the resident’s behavioral conduct. Based on the four lead, residents showed no sign of physical and verbal symptoms of agitation. However, residents who showed one or more signs of verbally non-aggressive symptoms became clam during the music therapy treatment (Goldstein-Levitas, 2016). The participant’s desire for music influenced the outcome of the experiment.
The research had its challenges and limitations. In previous literature, a standard CMAI was utilized, assessing the seriousness of every conduct on a 7-point scale, while the researcher in this experiment utilized an adjusted form to assess conduct and tallied the frequency of occurrence (Ray & Mittelman, 2017). Utilizing a modified variant of the CMAI with dichotomous score may not have been sensitive to recognize any reduction in agitation. A second constraint of the investigation was that absolute blinding could not be ensured because the researcher and other nurses who evaluated the CMAI scores took the participants to either the movement or the music treatment room. Nevertheless, residents were ignorant of the investigation purpose, which may have kept them from being one-sided towards the outcome.
Evaluation of Project Outcomes
Music treatment in view of non-pharmacological interventions is effective in managing symptoms of dementia. It will be of enthusiasm for medical policy makers and nursing doctors based on financial viewpoints and utilization of HR as it is theorized that the number of residents with dementia be treated in a comparable time structure. Administering one’s familiar music can diminish cortical, which rises with pressure and this may additionally diminish agitation. In addition, music stimulates positive reactions during depressing moments. Besides, it is found that memory for recognizable music was spared in agitated individuals. Thus, music therapy stimulates the resident’s motor activity and cognitive reasoning.
The findings revealed that holistic approaches to memory care are critical, particularly given the increasing number of dementia and the negative outcomes of these conduct on others, which result in expanded weight and cost. Subsequently, lessening and preventing agitating practices of those with dementia is a standout amongst the most critical objectives of restorative interventions in dementia care. Music treatment is viable in reducing agitated practices of deranged people and easing the weight of nursing staff in healing homes. In addition, music treatment is straightforward for nursing staff to learn and execute to those with dementia. Future research ought to explore the significance of lessening negative behavioral recurrence and expanding apparent capacity to manage agitated behaviors among nursed and family caregivers.
Cohen-Mansfield Agitation Inventory (CMAI). (Author).
References
Goldstein-Levitas, N. (2016). Dance/movement therapy and sensory stimulation: A holistic approach to dementia care. American Journal of Dance Therapy, 38(2), 429-436.
Janzen, S., Zecevic, A. A., Klosec, M., & Orange, J. B. (2013). Managing agitation using non-pharmacological interventions for seniors with dementia. American Journal of Alzheimer’s and Other Dementias, 28(5), 524-532.
Ray, K. D., & Mittelman, M. S. (2017). Music therapy: A non-pharmacological approach to the care of agitation and depressive symptoms for nursing home resident with dementia. Dementia, 16(6), 689-710.
Vink, A. C., Zuidersma, M., Boersma, F., Zuidema, S. U., & Slaets, J. P. (2013). The effects of music therapy compared with general recreational activities in reducing agitation in people with dementia. International Journal of Geriatric Psychiatry, 28(10), 1031-1038.