Participation in the music program did not significantly affect agitation and anxiety in older people with dementia. Both the music and reading group activities, however, gave some participants a 'voice' and increased their verbalization behavior. Agitation was found to be predicted by a number of background factors (namely level of cognitive impairment, length of time in the facility and gender) (Cooke, Moyle, Shum, Harrison, & Murfield, 2010, p. 905-916).
In the final study, a music mediation was achieved to observe the effects of customized music programming on agitation and depression for people suffering with moderate to high levels of dementia. The study involved a two weeks with no-music and then two weeks with music: "music programs were streamed to the rooms of individuals assigned to a music group (N = 19) several hours per day each day for 12 weeks" (Janata, 2012, p. 8-15). The study revealed results that consisted of decreases in "composite scores on the Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, and Cornell Scale for Depression in Dementia" (Janata, 2012, p. 8-15). Not only that, but the reductions were speedy and continuous in both groups. The study demonstrated a unique way to use music and showed positive results that promoted reduction in agitation. "Creating an almost omnipresent musical atmosphere directed at the musical preferences and listening histories of residents in an assisted living facility may reduce average levels of agitation and depression among the residents" (Janata, 2012, p. 8-15).
Ultimately it would not be effective to suggest music therapy as the only treatment option to help reduce sundown agitation in elderly patients with dementia. Standard of care involves a multi-faceted approach along with sleep disorder protocols such as "sleep hygiene" that need to be taken into consideration. Although music therapy has been proven to have some positive results in some studies, others have noted no positive results, mixed results, or no long-term positive results leading to the conclusion that music therapy should be implemented in a treatment protocol for sundown agitation reduction, but not as a stand-alone treatment.
Music therapy has it benefits and should become a part of standard care. Since depression and anxiety are often extremely common in elderly patients with dementia, it is important to note and take into consideration the effectiveness music has on these two concerns. A combination of music therapy and the use of non-pharmacologic and pharmacologic methods like light therapy and pain medication can help relieve many of the symptoms associated with elderly patients with dementia that do not just stem from sundown symptoms. Elderly patients normally have a host of chronic ailments that need to be assessed and treated.
In conclusion, many avenues should be investigated and researched to help treat and sundown agitation in elderly patients with dementia. It will not only result in increased effectiveness in treatment overall, but it will help the many suffering with dementia to live better lives and not become such a burden both emotionally and financially, to their families and the carers in the in-patient facilities. Other avenues should also be researched like social interaction and nutrition (organic food and reduced sugar diets).
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