Feasibility of Conducting a Music Therapy Study With Hospice Patients with Dementia & Agitation

Authors

  • Barbara Reuer MusicWorx Inc.
  • Julie Guy The Music Therapy Center of California
  • Ann Sturley San Diego Hospice and the Institute for Palliative Medicine
  • Matt Soskins San Diego Hospice and the Institute for Palliative Medicine
  • Charles R. Lewis San Diego Hospice and the Institute for Palliative Medicine

DOI:

https://doi.org/10.15845/voices.v11i2.572

Keywords:

Music therapy, agitation, dementia, bathing, caregivers, non-pharmacological intervention, hospice

Abstract

This study's purpose was to explore non-pharmacological means for decreasing agitation in hospice patients with late stage dementia administered by caregivers.  Subjects in the study were patients on service with San Diego Hospice and the Institute for Palliative Medicine, diagnosed with late stage dementia, as determined by a FAST (Functional Assessment Staging) score of 7, and who were known to become agitated while performing certain tasks (e.g., bathing or eating). A music therapist assessed the subjects using an adaptation of the Music Therapy Assessment (Krout, 2000). The Short Portable Mental Status Questionnaire (SPMSQ) and Blessed Dementia Scale were administered pre- and post- intervention to assess cognitive functioning severity of dementia, respectively. Caregivers were trained to administer the Agitated Behavior Scale (ABS) after performing the stressful task without music (baseline). The music therapist created a CD for each subject based on the following: a) music background/preferences of subject (preferred styles of music, favorite selections or artists), obtained from family/caregiver, and b) subject responses observed during the assessment. Caregivers were instructed to complete the agitated task during the music intervention and immediately following the task completed an ABS evaluation. Out of the 51 patients referred for the study, 11 met inclusion criteria and were consented. Eight subjects completed the study. According to demographic information the majority of subjects were female, had previous music experience, and lived in a skilled nursing facility. The most frequent agitated task was bathing, which caused agitation in 75% of subjects. SPMSQ results indicated all patients had severe cognitive impairment and pre-/post-scores were the same. Pre-music intervention ABS scores were a mean of 23.46 (SD=5.8), and a mean of 20.69 (SD=7.1) for post-music intervention. This indicated that subjects became slightly less agitated overall though the effects were not statistically significant (t (7) = 1.41, p=0.2). Further analysis was unwarranted due to the lack of statistical significance and the small sample size. Two subjects demonstrated decreased agitation levels. Study limitations, implications for further research, and feasibility of research with late stage dementia patients receiving hospice care are discussed by the researchers.

Author Biographies

Barbara Reuer, MusicWorx Inc.

Barbara Reuer, PhD, NMT-F, MT-BC, is known internationally for her expertise in music-centered wellness and music therapy.  A graduate from the University of Iowa, she is Founder and Director of MusicWorx, a consulting agency based in San Diego, CA, and has more than 30 years of clinical experience in schools, convalescent facilities, retirement homes, hospices, medical and psychiatric hospitals, corrections facilities, substance abuse and eating disorders programs, health spas, as well as teaching at community colleges and universities. Major areas of Dr. Reuer’s current professional involvement are in the area of music therapy program and job development in San Diego County including an international music therapy internship program. In addition to her clinical work, she provides workshops and seminars (wellness, community building, stress management and pain management) nationally and internationally for health care professionals, educators and corporate clients. Dr. Reuer is a 2008 Southern California Cancer Pain Initiative Awardee for excellence in pain management.  She has served as President of the National Association for Music Therapy and is recipient of the American Music Therapy Association’s national Professional Practice Award in 2000 and the 2008 Lifetime Achievement Award.

Julie Guy, The Music Therapy Center of California

Julie Guy, M.M., NMT-F, MT-BC, is co-founder and vice-president of The Music Therapy Center of California (MTCCA). She has a Bachelor's of Music Degree in flute performance from Central Washington University and a Master's in Music Therapy from Western Michigan University and advanced training from the Center for Biomedical Training as a neurologic music therapy fellow from Colorado State University. Ms. Guy has been providing music therapy services to children with special needs and retirees in the San Diego area for ten years. She directs music-making and wellness programs for retirees at numerous retirement communities in San Diego and Orange Counties. Ms. Guy has been a guest on the KPBS Radio program “These Days”, KUSI “Good Morning San Diego” and Fox 5 News. In her work with children with special needs, she has co-authored learning materials for children including a DVD and CD/book, and is the host of a podcast series for parents and teachers.

Ann Sturley, San Diego Hospice and the Institute for Palliative Medicine

Ann Sturley, DrPH, RN, has worked at San Diego Hospice for 8 years, with 5 of these years in the research department.  She also has a history of monitoring and evaluating aid projects in developing countries.  Her interest in integrative medicine was born during her years in Asia.  Ann holds a doctorate in public health and a bachelor’s degree in nursing.   

Matt Soskins, San Diego Hospice and the Institute for Palliative Medicine

Matthew Soskins, PhD, Esq. is Associate Counsel and Director of Claims at Tri-City Healthcare District. Prior to joining Tri-City, he held positions as quality analyst, technical writer, and biostatistician at healthcare organizations including San Diego Hospice and the Institute for Palliative Medicine and Kaiser Permanente. He also taught as an adjunct professor at Northwestern University, Mesa College, and the University of California at San Diego. While working full-time, Dr. Soskins attended law school at the University of San Diego, earning his JD in 2008, graduating cum laude and as a member of the Order of The Coif. While in law school, he served as Lead Articles Editor and Senior Associated Editor of the San Diego International Law Journal, as a teaching assistant for contracts, and as a research assistant for professional responsibility. Dr. Soskins earned a B.A. in psychology from the University of California at San  Diego in 1997, graduating in three years. In 1999, he earned an M.S. from Northwestern University, where he went on to complete his Ph.D. in psychology in 2002. For his dissertation, Dr. Soskins invented the first successful countermeasure to brainwave-based lie-detectors, which was shown in two television appearances.

Charles R. Lewis, San Diego Hospice and the Institute for Palliative Medicine

Charles R. Lewis, MD is the Assistant Vice President for Medical Affairs at San Diego Hospice and The Institute for Palliative Medicine. He is also the Medical Director, Inpatient Care Center, the Director of the Integrative Palliative Medicine Program, and the Chairman of the Sacred Art of Living and Dying Committee. He also holds an academic appointment as Voluntary Clinical Instructor at the University of California, San Diego School of Medicine. Dr. Lewis has a background in family medicine and allergy/immunology. He is particularly interested in integrating complementary and alternative medicine approaches with conventional palliative medicine and enhancing spiritual care for hospice patients.

Downloads

Published

2011-06-28

How to Cite

Reuer, B., Guy, J., Sturley, A., Soskins, M., & Lewis, C. R. (2011). Feasibility of Conducting a Music Therapy Study With Hospice Patients with Dementia & Agitation. Voices: A World Forum for Music Therapy, 11(2). https://doi.org/10.15845/voices.v11i2.572

Issue

Section

Evaluating Quality in Research