Influence of caregiver singing and background music on posture, movement, and sensory awareness in dementia care.
OBJECTIVE
Previous research suggested caregiver singing could influence persons with severe dementia to communicate with increased competence, to cease aggression, and to cease disruptive screaming, while at the same time they seemed to understand what was going on when being cared for during morning care sessions. The aim of this study was to illuminate the posture, body movements, and sensory awareness of patients with dementia during three types of morning care sessions with professional caregivers: (a) the usual morning care situation, (b) a caring session in which familiar background music was played, and (c) a caring session in which the caregiver sang to and/or with the patient throughout. Nine patients with late-stage dementia and 5 professional caregivers participated in this study, and 27 sessions were videotaped (9 patients x 3 caring situations). DATA COLLECTION AND METHOD: Data collection was done by means of video recording and the data were analyzed using qualitative content analysis.


RESULTS
During the usual caring situation, patients demonstrated slumped posture, sluggish and asymmetric motion, listlessness, minimal awareness of both egocentric space and the physical environment, and a poor ability to perform to completion activities necessary for personal care. Both background music playing and caregiver singing had strong influences on the body and on sensory awareness. Patients had straightened posture, stronger and more symmetric movements, and a greatly increased awareness of themselves and their environment. Patients appeared to regain skills necessary for daily living, and demonstrated that they could perform tasks with intention, purpose, and competence. Caregiver singing, in particular, was very effective at drawing out capabilities that appeared to be lost in these patients. In addition, caregiver singing elicited a larger degree of mutuality in the interaction between patient and caregiver than was seen with background music.


CONCLUSIONS
These results provide further support for the use of caregiver singing in dementia care, and the findings on how caregiver singing can be used to help in dementia caring situations are discussed.
Neurotec Department, Center for Excellence in Elderly Care Research (CECAR), Karolinska Institutet, Huddinge, Sweden. Eva.Gotell@omv.ki.se
Eva
E
Götell
Steven
S
Brown
Sirkka-Liisa
SL
Ekman
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing* / Q000523:psychology; D001288:Attention; D001364:Awareness; D003142:Communication; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D008609:Mental Status Schedule; D009043:Motor Activity; D009147:Music Therapy / Q000379:methods*; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D009949:Orientation; D011187:Posture; D013548:Sweden; D014831:Voice