SOURCE: Long EM. The effect of a personalized music playlist on a patient with dementia and evening agitation. Ann Longterm Care 2016;24:31-33.
A substantial minority of the Medicare population suffering from dementia (31%) live in long-term facilities, and staff often have to contend with such issues as agitation, aggression, wandering, and other mood changes.
Patients who present behavior problems often are treated with antipsychotic medications, since few other tools are known to be beneficial, despite the observation that antipsychotic medications feature a well-established adverse effect profile, including increased risk of death. Might music therapy be beneficial?
The author presented a case report of a dementia patient who had been treated with antipsychotics. A nursing student visited with the patient and shared headphones with her that played popular music from the time of the patient’s youth and young adulthood. Ultimately, the patient began to demonstrate progressively more involvement with the music, including singing along and tapping her fingers. The previously reticent patient became progressively more communicative. Problem behaviors diminished to the point that caregivers discontinued antipsychotics (previous weaning efforts had failed).
I have had a similar experience with one 95-year-old dementia patient. She has been very religious through much of her life, and her personality blossoms forth if I bring in an old hymnal and sing songs with her (somehow, despite her inability to remember her own children or any specifics about her prior life, she remembers dozens of lengthy hymns).
Learning music that is meaningful to our patients is a time-intensive endeavor. On the other hand, problematic behavior issues also can be quite taxing. Clinicians might consider informing involved family members or caretakers of the potential positive effects of music therapy.