Home-based Treatments

The newest issue of the Journal of Music Therapy (JMT) just came out! The study “Feasibility of Home-Based Neurologic Music Therapy for Behavioral and Psychological Symptoms of Dementia: a Pilot Study” was especially interesting for a number of reasons. Neurologic Music Therapy (NMT) is a more specialized form of music therapy requiring additional training. NMT utilizes a number of standardized interventions making it easier to measure outcomes for both research and treatment purposes. While music therapy is a remarkably effective treatment for Persons with Dementia, there are a limited number of practitioners and an even more limited number who have received the NMT training. In addition, more people are “aging in place” making it vital to provide home-based treatments that can also be utilized by family caregivers.

Participants were recruited from university-based clinics, had received neurological testing for dementia, and exhibited behavioral and psychological symptoms related to their disorder. What was interesting to me was that the outcomes for this particular study were not particularly positive. Sometimes journals skew towards publishing those studies that produce results. However, there is often much to be learned from failure. There were not significant improvements in any measures. Some participants dropped out due to stress to the patient and/or to the caregiver. A number transferred to long term placement and were no longer eligible for the study.

So, the question is whether or not NMT is appropriate and/or an effective treatment for this population. Why were the treatments more stressful for the patients and the family caregivers? Some possible theories proposed by the researchers include that by this point in the progression of the disorder, caregivers were likely to overwhelmed. One more therapy was simply too much. In addition, patients demonstrated the types of symptoms targeted by the study were likely to be at a point of not being able to live at home for much longer. One possible solution is to introduce the training at an earlier stage of dementia, giving caregivers the tools ahead of time to deal with troublesome symptoms.

I am looking forward to further research on the subject! For more information, see the Journal of Music Therapy Fall 2019, Vol. 56, Num. 3.