Musical Therapy for the Agitated Alzheimer's Patient By Stephanie Markarian

Abstract Alternative therapies during patient care have been implemented in many hospitals and health care facilities. A holistic approach is used as a foundation in order to satisfy patients’ physical, mental, spiritual and social needs. Holistic care has shown to improve the quality of care, providing better prognoses and outcomes. Certain illnesses may benefit from alternative therapies, while others may require use of specific pharmacological measures. Patients with Alzheimer’s have been shown to benefit from alternative therapies. Music therapy has been shown to reduce behavioral interruptions specifically agitated behaviors associated with Alzheimer’s disease. By providing music therapy within the environment, patients are able improve cognitive, behavioral and social skills. These skills help caregivers provide adequate care and help patients function at a maximum level.

Purpose of Study Problem Statement Alzheimer’s is a set of progressive symptoms resulting in cognitive, behavioral, emotional and physical impairment. The elderly population is rising in numbers, resulting in an increasing prevalence of dementia seen in health care settings. Medication administration can result in the risk for complications and side effects. Alternative therapies, including a variety of treatment approaches such as group therapy, meditation, relaxation and cognitive learning may serve as effective treatments in decreasing agitation in the Alzheimer’s patient. New interventions that can effectively reduce agitation, with minimal use of medication, must be identified and evaluated. Statement of purpose The purpose of this study is to evaluate the implementation and perceptions of nurses regarding music when caring for an agitated Alzheimer’s patient.

Research Hypothesis Patients participating in musical therapy will show a reduction in agitated behaviors. The need for further education and implementation of music therapy will be determined. Research Question Is music therapy effective in the reduction of agitation of Alzheimer's patients?

Review of the Literature Behavior Disruptions  Memory lapses, cognitive decline, motor decline, misjudgment and disorientation  Biting, shoving, pushing, restlessness, wandering, shadowing, sun downing, inappropriate undressing, inappropriate handling of objects, yelling, and repeating ones-self  Cohen-Mansfield Agitation Inventory (CMAI) Music Therapy  Passive and active participation  Preference of music  Group vs. individual Nurses Perceptions  The majority had positive attitudes  Lack of use, knowledge and training in the workplace  Research suggests that nurses and staff need more formal education, training and resources

Conducting the Study Research Design The research design for this quantitative study was a nonexperimental correlation design. Nurses’ perceptions and the need for implementation of music therapy with this patient population were the variables examined. The correlation was detected through statistical analysis of data collected with a thirteen question survey. Population The population in this study consisted of nurses working in an assisted living facility for Alzheimer’s patients that use music therapy Sample An estimated sample of ten nurses was selected as a representative sample of a larger population Setting The data collection took place in a private for profit assisted living facility for Alzheimer’s and dementia patients in an urban area in the northeast United States

Conducting the Study (continued) Plan for Data Collecting and Analysis  Quantitative questionnaire  Participants answered four demographic questions including type of licensure, education and years of practice and gender during the questionnaire  The remaining nine questions were formatted on a five-level Likert- type scale.  Questions evaluated participants’ perceptions and knowledge concerning the use of music therapy in multiple areas of nursing care  Data was analyzed with statistical analysis. Simple statistics including percentages were used

Conducting the Study (continued) Budget and Time Survey preparations, paper, driving, analyzing results, binding, poster Estimated Cost: $ Actual Cost: $ Estimated Time: 14 hours Actual Time: 13 hours

Proposed Funding Site  American Nurses Foundation  ANF Nursing Research Grants Program (2013)

Demographics Type of Licensure RN40% LPN60% Level of Education Bachelors40% Associates60% Masters0% Other0% Years of Experience Less than 1 year0% 1-5 Years40% 5-10 Years60% Years0% Gender Female100% Male0%

Results

Indications for Research & Nursing Care  The research revealed that 100% of nurses agree that music therapy can be effective in reducing agitation in an Alzheimer’s patient  There is not a need for more education in music therapy but there is a need for more implementation in the facility  Offers a safer, non-invasive way to reduce agitation in patients  Further education and staff encouragement is indicated in the use of music therapy  Implications for care conclude that the use of music therapy can reduce agitation, which can make care taking for Alzheimer’s patients easier, more effective, less invasive and safer; leading to a higher level of care and quality of life for patients