It began with the little things. Firstly, she forgot my name. Next, she sent my mum three birthday cards. She then was forced to give up playing the church organ since she played too many or too few verses, or even the completely wrong tune. My family and I could only do our best to adapt and support my Auntie Shelia as our worst fears were realised; she was diagnosed with dementia.
‘Someone in the world develops dementia every three seconds.’ (Dementia statistics | Alzheimer’s Disease International, 2020). It has been estimated there are 850,000 people with dementia in the UK, which is expected to rise to 1.6 million people by 2040 (Facts for the media, 2020). Approximately ‘52% of the UK public know someone who has been diagnosed with a form of dementia’ (Public attitudes towards dementia, 2020). Although these statistics are startling, it must be stressed that each number reflects a human life and that with every diagnosis, another family is affected.
Dementia describes a collection of diseases that trigger a loss of brain function and is classed as a ‘neuropsychiatric syndrome characterised by cognitive decline’ (Abraha et al., 2017). Most types of dementia are caused by a build-up of abnormal protein in the brain, leading to a reduction in the functioning of nerve cells and ultimately nerve cell death (Types of dementia, 2020). Alzheimer’s disease is the most common form of this type of dementia, affecting between 50-70% of cases (Facts for the media, 2020). Unlike Alzheimer’s disease, vascular dementia is caused by reduced blood flow to the brain as a result of narrowing or blockage in the blood vessels supplying the brain (Types of dementia, 2020). This affects up to 20% of those diagnosed with dementia (Facts for the media, 2020). Patients with dementia often exhibit an increased difficulty in performing daily tasks, maintaining social capabilities and remaining independent (Gómez-Romero et al., 2017). Dementia has a wide-reaching impact on the individual, their family and the wider society.
Due to the progressive nature of the disease, much research has been conducted to determine which methods of treatment are most appropriate and effective in delaying and possibly reversing the cognitive decline of patients and in managing the day to day impact of the disease. Amongst possible treatments, the effectiveness of music therapy has been highlighted. Research suggests it may help to reduce anxiety, depression and deterioration of speech quality of patients with dementia, whilst also enhancing their quality of life and the experience of their carers (Burns and Morris, 2018). Pharmacological treatments such as antipsychotic drugs are widely prescribed to control increased agitation, which is often more prevalent as the severity of the dementia decreases. However, researchers warn of the increased risk of medication misuse and the increased cost to NHS Services which pharmacological intervention may bring (Pedersen et al., 2017). The total cost of dementia care in the UK is currently £36.7 billion a year (How much does dementia care cost?, 2020).
Unlike medication which may have undesirable side effects and less than adequate results (Svansdottir and Snaedal, 2006), music therapy may provide a safer, effective and more enjoyable method of attempting to delay the sharp cognitive, behavioural and emotional decline of patients with dementia.
This report will describe the possible benefits of music therapy in the treatment of patients with dementia. The success of music therapy will be evaluated by considering its psychological benefits for patients with dementia, using evidence gained from clinical trials; its ability to enhance patients' quality of life through increased social interaction and improved experience of care, and the ability to roll out this intervention across the wider NHS and social care community.
It is important to define the terms music therapy and music intervention, both of which play an important role in the non-pharmacological treatment of patients with dementia. Music therapy is the clinical use of music by a credited professional to ‘improve [the] physical, social, communicative, emotional, intellectual and spiritual health and wellbeing’ of patients (About WFMT, 2011). This may involve either active elements, requiring physical participation in events such as singing, or receptive elements (passive actions) for example listening to music through headphones (van der Steen et al., 2018). These are tailored to the individual patient’s setting and preferences. Music intervention involves the ‘controlled use of music in a therapeutic setting’ (Pedersen et al., 2017) where the prescribing of personalised playlists using music preferences is a common practice. This report will mainly aim to focus on the benefits of using songs during interventions, including the use of playlists and singing in choirs.