None listed
Conditions
Brief summary
Relationship quality between community-dwelling people with dementia (PwD) and their family caregivers (FCG) is recognised as a major factor that influences health and wellbeing of both, and consequently impacts their ability to live together in the family home. The family home with familiar people and surroundings is recognised as the optimal care environment for PwD. Supporting PwD to remain in the family home also reduces care costs to individuals and society, and is recognised as a strategic priority by the Australian Government. The primary aim of this proposed randomised controlled trial is to determine whether therapeutic choir participation and supported home-based music engagement improve relationship quality between community-dwelling PwD and FCG. Secondary aims will examine whether the choir intervention is cost effective and can improve wellbeing and quality of life indicators for PwD and FCG. Key questions to be addressed by this randomised controlled trial ask whether therapeutic choir participation and home-based music engagement for community-dwelling people living with dementia and their family caregivers improve ratings for: • the primary outcome measuring relationship quality between PwD and FCG • and secondary outcomes measuring: 1) quality of life for PwD and FCG 2) depression for PwD and FCG 3) social connectedness for PwD and FCG 3) caregiver experience for FCG 4) observations of anxiety in PwD Using a single-blind, randomised controlled trial, 180 PwD + FCG dyads will be randomised to either 20 weekly choir sessions with home-based music program facilitated by a registered music therapist or a waitlisted control group. Eligible participants, recruited from 6 sites (4 metropolitan and 2 rural), will be community-dwelling people with a diagnosis of dementia and family caregivers who provide the majority of care in the home. Outcome measure questionnaires, collected by a blinded assessor, will be taken prior to the intervention (baseline), midpoint (week 11), and following completion of 20 choir sessions (week 21).
Interventions
Participants randomised to the music therapy intervention group will attend 20 weekly 2-hour choir sessions consisting of singing and social interaction. 90 minutes of singing activities (vocal warm-ups, participant requested songs, round singing, and simple part singing) will be followed by 30 minutes for social interaction over refreshments. The intervention will be facilitated by a Registered Music Therapist in a community venue (ie. community hall, day centre). Music therapist will receive t
Participants randomised to the music therapy intervention group will attend 20 weekly 2-hour choir sessions consisting of singing and social interaction. 90 minutes of singing activities (vocal warm-ups, participant requested songs, round singing, and simple part singing) will be followed by 30 minutes for social interaction over refreshments. The intervention will be facilitated by a Registered Music Therapist in a community venue (ie. community hall, day centre). Music therapist will receive training in how to deliver the intervention protocol (the therapeutic choir sessions) to ensure standardisation of the intervention. An intervention protocol has been developed for this training. This training includes strategies for how to provide cues and modify songs and musical activities to maximise engagement for people with dementia and also their family caregivers. It will also focus on strategies for managing safety issues and negative responses to the intervention. The intervention also includes provision of education to participants in the intervention group on how to use their own music therapeutically at home (to promote relaxation and reminiscence) and recordings of songs from choir sessions to use as desired. This education will be provided in the form of written handouts to caregivers with tips and examples for how music can be used to manage behaviour and modify mood. The therapist will check in with caregivers regularly throughout the intervention and provide feedback and suggestions for how to use music therapeutically at home. There is no minimum requirement for participants to use the home music program, rather we will monitor the amount of home music use via a diary completed at each weekly choir session. Attendance logs will also be completed at each weekly choir session to monitor adherence to the intervention.
Sponsors
The University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Community-dwelling people living with dementia (PwD) and their co-residing family caregivers (FCG) will be eligible for the project. Both PwD and FCG participants must have functional hearing and speak English. For PwD, inclusion criteria are: aged at least 60 years and a confirmed diagnosis of dementia, OR probable dementia (i.e. a cognitive impairment level of 12–24 on the Mini Mental State Exam OR features consistent with Alzheimer’s type dementia as per DSM-V. For FCG, inclusion criteria include age equal or greater than 18 years and either a spouse/partner, family member (eg. daughter or son), or close friend.
Exclusion criteria
Living in residential care at time of recruitment Unable to hear at all (deafness) Unable to speak English
Outcome results
None listed