Alzheimer's Agitation Prevention Music Therapy - Research Paper Example

? Alzheimer's Agitation Prevention By Music Therapy Agitation is a broad terminology encompassing stress, anger, bad temper, impatience or related behavior displayed by elderly patients suffering with severe dementia. Studies involving stress threshold conclude that anxiety aggravates with stress and when the level of stress reaches threshold, agitation occurs. Research studies divulge that when background music is played during meal time, the patient enjoys the food and exhibits less agitation as compared to the period when no music is played during meal time. Observations reveal that music elevates mood and removes the gloom and therefore patient eats more as well as enjoys the food, while absence of music does not distract the patient from the atmosphere of obscurity and thoughts. Moreover, caretakers are also in a happy mood while serving the food making a psychological impact on the patient. The present article highlights the chief themes of agitation as well as aims to examine how intervention of music could control agitation in Alzheimer's patients. Introduction Alzheimer's disease (AD) is a debilitating condition that affects the elderly population. According to Peng (2003), dementia is a condition that “affects problem solving ability, decision making, judgement, our ability to orient ourselves in space, and our ability to put together simple sentences and understand and communicate with words…Dementia is a permanent, progressive disease that affects mostly the elderly.” AD is also a kind of dementia influencing memory of the individual, difficulties in languages, gross motor co-ordination is severely affected, the cognitive abilities are influenced, the decisive power of the individual is affected and thus an overall personality of the individual is altered (Alzheimer's Association, 2004). Agitation is considered as an improper verbal or motor activities. Patients may display four kinds of agitation behavior which are expressed under different themes- * Non-aggressive Verbal Behavior: Under this category illogical jabber takes place. The patient may ask repeated questions, bringing irritation to the caretaker. * Non-aggressive Physical Behavior is displayed when the patient gets bored, frightened or confused and seek security as well as expression for pain. The patient display rapidity, drifting, boring body motions, hoarding or stakeout. * Aggressive Verbal Behavior- The patient may utter abusive words, may curse the care takers which could be awful for the loved ones. * Aggressive Physical Behavior- Patient may display aggression in the form of physical action such as beating, scraping or kicking the care takers. These actions could be sometimes dangerous for the loved ones of the caretakers (Management of Agitation Behavior). Management of agitation is of paramount significance for Alzheimer's patients. Modification of environment could serve as an imperative step to reduce the agitation. Music is known to be an entertaining action therefore listening to music have positive health implications. Music is calming to ears, relaxes brain and removes gloom and stress. Numerous studies disclose that music has the power to help ailing, injured, physically challenged, mentally unsound individuals or elderly population. These studies indicate that the presence of music serves as a therapy for these cases. Playing patient's favorite music can diminish the agitation. Music enhances the uptake of meals, relaxes the body when played during bath or exercise, fill the individual with positivity and enthusiasm. According to Clark et al (1998), music provides mental strength to the Alzheimer's disease and those suffering with dementia. Their study indicate that music afford a positive advantage as it aids in diminishing agitation. This is displayed through the behavior of the patient as the patient becomes less aggressive especially during bath time and they also display reduced requirement for physical control. Literature Review Various studies have been carried out across the globe to study the intervention of music on the behavior and agitation of Alzheimer's patient. Agitation in behavior is mostly stress related, studies have been carried out to reduce the agitation persisting in the Alzheimer's patient for better quality of life and to prevent further aggravation of the condition. The symptoms of Alzheimer's disease encompass physical and emotional well-being it becomes imperative to reduce stress so as to reduce the fight back efforts. Under such conditions music plays a vital role. When this was applied with Alzheimer's patients, it was observed that the agitation of the patient was reduced (Lou, 2001; Killick & Allan, 1999). According to Lord & Garner, (1993) observed that AD cases displayed an increase in the levels of well-being, greater social interaction, improved autobiographical memory after regular music therapy. Such improvements were not observed in AD cases taking other activity therapies. According to Cohen-Mansfield & Warner (1997), found that music therapy reduced abnormal vocalizations and brought improvement in agitation behavior displayed by the AD patients. According to Gerdner (2000), agitation behavior was found to be reduced in AD cases having severe dementia who played an individualized program of music. Four week experiment was performed by Goddaer & Abraham. (1994), with alternate music and no music phase. Their observation reveals that the agitation was reduced soon after the music phase and there was little agitation. Aggression was also reduced in physical actions as well as verbal communication indicating that music does have a profound impact in improving the condition of Alzheimer's cases. According to Denny (1997), if music is being played during the mealtime, the agitation level was found to be reduced as compared to the meals taken in the absence of music. As most of the studies to see the impact of music on the condition of Alzheimer's patient were carried out in nursing homes, the impact was found to be positive. However, one of the studies was carried out in hospital environment and there results did not show any significant improvement in the Alzheimer's condition (Clair & Bernstein, 1994). In the study performed by Gerdner and Swanson (1993), when music familiar/ recognizable to the patient was played, a positive impact was observed in the patient's mood and behavior and the patient was less agitated. Further, if preferred music is played then there an auxiliary decrease in agitation was observed. According to Tame (1984), music is found to influence health and ethics in a positive manner in ancient China. This was further highlighted by Rangneskog (2000). Additionally, researchers were keen to find out why music affects the Alzheimer's cases profoundly while frequent conversation could not? According to Kirkland, language area is well defined in brain while music does not occupy a particular area of the brain and dementia therefore influences conversation and emotions, on the other hand, music elicits responses of all kinds. According to Kirkland, various changes are observed in the Alzheimer's patient encompassing, "... changes in facial expression and tension, increased eye contact, vocal activity and physical movement". Though in Alzheimer's disease, patient may not be active or tend to lose many abilities but the musical perception is retained. With the increase in the work-pressure and cut-throat competition, where every individual has to prove his/her worth, stress level is mounting which is becoming a contributory factor for the augmentation in Alzheimer's cases. Moreover, enhanced life-expectancy prolongs the duration of stress and pressure phase leading to dementia (Kachaturian, 1996). Methodology to study the impact of music on the reduction of agitation encompassed, determination of various parameters such as kind of music including mild music, classical music and pop music. Apart from these, the interval of music followed by no music phase was also studied in various studies to conclude that music therapy does have an essential role in reducing the agitation in Alzheimer's disease. Several reports reveal that music and music therapy have a profound impact on the improvement in conditions of dementia and especially Dementia of the Alzheimer's type (DAT) (Cooper, 1991; Lloyd, 1992; Smith, 1992). Conclusion Although music cannot provide any substitute to the medications but it does display a reduction in the agitation of Alzheimer's patients. Various studies carried out across the world indicate that a difference is observed when music is played and related agitation level. Music has the immense potential to alter the mood and makes an individual feel happy. Thus, music serves as an antidote to stress and comforts the individual, relaxes the mind and inculcates contentment in Alzheimer's case. References 1. Alzheimer’s Association (2004). Fact Sheet: About agitation and Alzheimer’s disease. 2. Clair, A.A. and B. Bernstein (1994). The effect of no music, stimulative background music and sedative background music on agitated behaviours in persons with severe dementia. Activities, Adaptation, and Aging. 19, 6170. 3. Clark, M.E., Lipe, A.W., Bilbrey, M. (1998). Use of music to decrease aggressive behaviours in people with dementia. Journal of Gerontological Nursing. 24, 107. 4. 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