Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia.
Author: Thomas KS1, Baier R2, Kosar C3, Ogarek J3, Trepman A4, Mor V5
Affiliation:
1Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI. Electronic address: Kali_Thomas@Brown.edu.
2Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI.
3Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI.
4Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI.
5Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI.
Conference/Journal: Am J Geriatr Psychiatry.
Date published: 2017 Apr 14
Other:
Pages: S1064-7481(17)30285-3 , Special Notes: doi: 10.1016/j.jagp.2017.04.008. [Epub ahead of print] , Word Count: 255
OBJECTIVES: The objective of this study was to compare resident outcomes before and after implementation of an individualized music program, MUSIC & MEMORY (M&M), designed to address the behavioral and psychological symptoms associated with dementia (BPSD).
SETTING: 98 nursing homes trained in the M&M program during 2013 and 98 matched-pair comparisons.
PARTICIPANTS: Long-stay residents with Alzheimer's disease and related dementias (ADRD) residing in M&M participating facilities (N = 12,905) and comparison facilities (N = 12,811) during 2012-2013.
INTERVENTION: M&M is a facility-level quality improvement program that provides residents with music specific to their personal histories and preferences.
MEASUREMENTS: Discontinuation of anxiolytic and antipsychotic medications, and reductions in behavioral problems and depressed mood in 2012 (pre-intervention) and 2013 (intervention), calculated using Minimum Data Set (MDS) assessments.
RESULTS: The proportion of residents who discontinued antipsychotic medication use over a 6-month period increased from 17.6% to 20.1% among M&M facilities, while remaining stable among comparison facilities (15.9% to 15.2%). The same trend was observed for anxiolytic medications: Discontinuation of anxiolytics increased in M&M facilities (23.5% to 24.4%), while decreasing among comparison facilities (24.8% to 20.0%). M&M facilities also demonstrated increased rates of reduction in behavioral problems (50.9% to 56.5%) versus comparison facilities (55.8% to 55.9%). No differences were observed for depressed mood.
CONCLUSIONS: These results offer the first evidence that the M&M individualized music program is associated with reductions in antipsychotic medication use, anxiolytic medication use, and BPSD symptoms among long-stay nursing home residents with ADRD.
Published by Elsevier Inc.
KEYWORDS: Alzheimer's disease; Music therapy; nonpharmacological intervention; nursing homes
PMID: 28483436 DOI: 10.1016/j.jagp.2017.04.008
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