Home-based family caregiver-delivered music Interventions for people living with dementia.

Music Intervention (MI) will be provided to participant dyads allocated to the first intervention. Family caregivers (CGs) will receive a 2-hour home-based MI training session (delivered in-person or using video communication software) where a music therapist will instruct the CGs on methods and strategies for using music to assist the person living with dementia (PwD) to become calmer (if agitated) or more energised (if apathetic). CGs will be instructed on how to choose music and engage the PwD in effective and respectful discussions with the aim of evoking autobiographical memories and sharing meaningful experiences. Strategies to engage the PwD and create opportunities for meaningful dialogue with the PwD will be provided, as well as training CGs to notice the PwD’s positive and negative responses to music. The activities to be taught comprise: a) singing familiar/preferred music followed by CG-facilitated discussions about the meaning of the songs for the dyad, the PwD, and significant others, and any associated memories; b) movement to music (e.g. upper body and arms imitating familiar dance movements to music) to assist in regulating arousal; and c) listening to familiar/preferred relaxing or enlivening music dependent upon behavioural and psychological symptoms of dementia (BPSD) present at the time to assist in regulating arousal. Following training, the CG will try out some of the methods learned with the PwD while the music therapist is still present, and the music therapist will offer feedback and further guidance to enable the CG to experience the activities in action with immediate support from the music therapist. The session will take at least 60 minutes and up to 90 minutes and will continue until the CG feels confident to deliver the intervention unsupported. CGs are then instructed to deliver the MI at least 5x per week for approximately 30 mins over a 12-week period. At 3-weeks and 6-weeks post allocation, the MI trainer will return to the dyad’s home, or utilise video communication software as necessary, for a second and third training session to further extend CG knowledge and skills, and improve and monitor adherence to the protocol. These sessions will involve the MI trainer providing additional techniques for use within the MI program. These techniques will include how to combine gentle touch with singing, transitioning from dancing to relaxation, and further skill training in how to facilitate dialogue. Further, the trainer will observe the CG delivering the intervention with the PwD and the trainer will then provide additional feedback to help the CG hone his/her skills and increase the effectiveness of the intervention. Fortnightly phone conversations with CGs by those providing the MI training will be used to support the CG, check-in as to how they are progressing with the use of the MI and answer any questions they may have.