Hong Kong-designed music and dance classes boost dementia sufferers’ mood
Study found marked improvements in behaviour and psychological symptoms after eight-week music and movement programme for elderly sufferers of the debilitating brain condition
Ms A was irritable and refused assistance for daily activities, Ms B had a poor memory and her mind often wandered, while Mr C was often agitated. After joining 37 other compatriots with dementia in specially designed music and movement classes, Madam A became more positive and willing to interact with others, Madam B was able to follow instructions, and Mr C’s moods became more stable.
These elderly subjects were part of a study conducted by the University of Hong Kong’s Centre for Behavioural Health and the Tung Wah Group of Hospitals’ residential old people’s homes. The findings revealed on June 14 show the effectiveness of the music and movement programme – twice-weekly classes for eight weeks – in improving behaviour and lessening the psychological symptoms of old people with dementia.
According to Dr Rainbow Ho, director of the Centre for Behavioural Health, the programme was the first of its kind, tailor-made for elderly Hongkongers who have dementia. A team of experienced therapists in the areas of music, dance movement, expressive arts and arts psychology designed the classes. A pilot trial involving five elderly subjects over two 30-minute sessions was conducted to find out the participants’ song preference and familiarity as well as their activity levels.
Each class, consisting of eight subjects, began with a breathing exercise with soft background music. Then, four Cantonese pop songs from the 1950s, ’60s or ’70s, and an extract of Chinese opera were played. While listening to the music, participants were encouraged to respond, sing and move freely to the words and rhythm. Objects such as small shakers and an artificial flower were used to enhance active engagement.
Alice Leung, assistant community services secretary at Tung Wah Group of Hospitals (TWGH), says there’s a demand for non-medical alternative treatments to help with the communication difficulties and emotional and behavioural problems that develop as dementia progresses.
This demand is spurred not only by the increasing number of patients because of the ageing population, but also by the undesirable side effects of medication, such as accelerated cognitive decline, cardiac effects, drowsiness and increased risk of falls. Relying on medication is likely to result in increased dependency, the researchers say.
The study, conducted from October 2014 to September 2015, tested a total of 73 people (average age 85) with dementia from 10 TWGH residential homes over the eight-week intervention. They were divided into two groups: the main study group attended twice-weekly 30-minute music and movement classes, led by an expressive arts therapy trainee from HKU and a social worker from TWGH. The control group received the usual care.
TWGH staff recorded the behavioural and psychological symptoms of the subjects before, during and at the end of the intervention. Two scientifically established and validated scales were used to measure symptoms: the Neuropsychiatric Inventory – Nursing Home (NPI-NH) and the Visual Analog Mood Scale (Vams).
Those in the experimental group showed statistically significant improvement in mood and reductions in unease and agitation. They showed better physical coordination and were less irritable. These differences were not found in the control group.
Previous studies have revealed similar findings. One reason for the improvements could be that playing the music individual patients like produces sounds that are familiar and predictable to them, say the researchers. Music could also provide a connection with positive memories from the past and induce relaxation.
Participants didn’t need to learn much in order to move to the music, an activity which gave them the chance for social interaction that did not rely on verbal skills.
This may provide an avenue for dementia patients to express their emotions, say the researchers.
However, how long the changes are sustained once the intervention ends is not known and requires further study. In the meantime, a set of A4-sized cards with vibrant images on one side and lyrics to songs on the reverse has been developed and will be distributed to caregivers at TWGH old people’s homes.
Ho hopes the government and social welfare agencies can provide resources for more research related to the expressive arts and hire more people to provide services to benefit more elderly people in need.
10 ways to help your elderly relatives
1. Listen to nostalgic songs
2. Clap along to the rhythm and play along with small instruments.
3. Sing along.
4. Do some simple craftwork together like colouring, collage, etc
5. Gently massage their shoulders and neck, hands and feet with body lotion.
6. Taste different fruit or food from their past.
7. Make small aromatherapy packs for placing by the bed or taking along in a handbag.
8. Plant flowers.
9. Watch dramas they love or view family photos together.
10. Go out to visit exhibitions and parks.