title: Creative Music Therapy in an Acute Care Setting for Older Patients with Delirium and Dementia.
abstract: OBJECTIVE
  The acute hospital ward can be unfamiliar and stressful for older patients with impaired cognition, rendering them prone to agitation and resistive to care. Extant literature shows that music therapy can enhance engagement and mood, thereby ameliorating agitated behaviours. This pilot study evaluates the impact of a creative music therapy (CMT) programme on mood and engagement in older patients with delirium and/or dementia (PtDD) in an acute care setting. We hypothesize that CMT improves engagement and pleasure in these patients.
  
  
  METHODS
  Twenty-five PtDD (age 86.5 ± 5.7 years, MMSE 6/30 ± 5.4) were observed for 90 min (30 min before, 30 min during, and 30 min after music therapy) on 3 consecutive days: day 1 (control condition without music) and days 2 and 3 (with CMT). Music interventions included music improvisation such as spontaneous music making and playing familiar songs of patient's choice. The main outcome measures were mood and engagement assessed with the Menorah Park Engagement Scale (MPES) and Observed Emotion Rating Scale (OERS).
  
  
  RESULTS
  Wilcoxon signed-rank test showed a statistically significant positive change in constructive and passive engagement (Z = 3.383, p = 0.01) in MPES and pleasure and general alertness (Z = 3.188,p = 0.01) in OERS during CMT. The average pleasure ratings of days 2 and 3 were higher than those of day 1 (Z = 2.466, p = 0.014). Negative engagement (Z = 2.582, p = 0.01) and affect (Z = 2.004, p = 0.045) were both lower during CMT compared to no music.
  
  
  CONCLUSIONS
  These results suggest that CMT holds much promise to improve mood and engagement of PtDD in an acute hospital setting. CMT can also be scheduled into the patients' daily routines or incorporated into other areas of care to increase patient compliance and cooperation.
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Chin Yee
authors.initials: CY
authors.lastname: Cheong
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Jane An Qi
authors.initials: JA
authors.lastname: Tan
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Yi-Lin
authors.initials: YL
authors.lastname: Foong
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Hui Mien
authors.initials: HM
authors.lastname: Koh
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Denise Zhen Yue
authors.initials: DZ
authors.lastname: Chen
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Jessie Joon Chen
authors.initials: JJ
authors.lastname: Tan
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Ng
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Philip
authors.initials: P
authors.lastname: Yap
keywords: Acute hospital; Delirium; Dementia; Engagement; Music therapy