Nursing via Music Therapy - Term Paper Example

Nursing via Music Therapy MAJOR CONCEPTS Music Therapy aids elderly dementia patients Music therapy helps in dementia patients when it is familiar. An obstacle faced by elderly residential care patients with mental illnesses is a diminished capacity to respond to stress and the unfamiliar. The ability to integrate into a new environment becomes impaired, therefore success has been achieved when elderly patients are immersed in environments with as much familiarity as possible. The styles of music and individual songs they enjoyed while younger can diminish stress levels, as well as modify adverse, external stimuli in their surroundings for the prevention of excessive anxiety. (Ip-Winfield and Groke, 2011.) Benefits include the reduction of anxiety and insomnia, when conducted with the correct sensitivity and familiarity. (Skingley and Vella-Burrows, 2010), (Short, 2007) This is similar to findings yielded by other researchers indicating that music therapy alone is insufficiently therapeutic for elderly dementia patients without a component of familiarity. In order to find the most beneficial musical scores, historical and cultural sensitivity is necessary. (Ip-Winfield and Grocke, 2011), (Cooke et al. 2010) Music may be associated with other culturally relevant activities, such as a folk dance. Non-Western audiences may derive limited benefit from music without the associated cultural trappings. (Ip-Winfield and Grocke, 2011) The underlying principle is the issue of familiarity, music is a vehicle for stress reduction in a new environment, and in some cases the vehicle requires some bonus features to yield the full benefit. 2.) Stroke recovery is enhanced by music therapy While prior studies indicate benefits for dementia patients resulting from music therapy, there are additional benefits that can be gleaned through an intensification of the process. Evidence suggests neurophysiological as well as psychological healing is possible, such as that described for stroke victims herein. The damage inflicted by a stroke has long-lasting and varied forms of debilitation. True recovery is a complex process that may never be fully realized. But research is ongoing to aid the sufferer in regaining as much functionality as possible. Truly effective therapies for regenerating lost or damaged brain function are rare. But a cost-effective strategy with some potential is embodied in music therapy. In this case, it is not so much a matter of listening to music, but more an matter of engaging the stroke survivor in creating music themselves, as a way to retrain the brain to achieve effective motor control once again. Some of these methods include electric pads that simulate simple keyboards to foster improvements in speed, precision, and gross motor control. The focus required to closely listen to, or create music with simple instruments triggers improvements in the sensory motor system according to the work of Fujioka et al. 2012. Music has the potential to strengthen connections between the auditory and sensorimotor systems for better coordination. Auditory listening and the creation of music offers direct access to the auditory-motor network, to the advantage of the stroke victim in recovery. In a similar vein, Altenmǘller et al. (2009) found compelling electrophysiological benefits improving use of the patients hands through a process of neural reorganization. 3. Music Therapy lessens pain from major surgery. Any form of major surgery is a time of considerable stress for patients and their families. Studies have found that the outcome of surgeries can be affected by feelings of anxiety on the part of the patient prior to the procedure. (Twiss et al. 2006) this is especially true for heart surgery. This is not simply an issue of stress during hospitalization while awaiting the procedure, major heart surgery is scheduled in advance, and feelings of anxiety often persist for up to three months afterwards, according to Twiss et al. (2006) even if the surgery appears to be technically successful from the point of view of the medical professionals performing the procedure, post operative pain can diminish the patients quality of life for many months. Studies show a link between anxiety and the presence of post operative pain. The link between pain and anxiety is due in part to the stress that increases cardiovascular workload before, during, and after the surgery. It follows therefore, that if the heart is under greater strain then surgery upon it will result in greater pain. With the need for heart surgery diagnosed in advance, this allows plenty of time for the patient to stress him or herself into or worsened postoperative position. Studies have shown that music reduces this anxiety, and therefore – if used properly can reduce post operative pain. Other data indicates that the listeners neurological and physiological properties can a line or harmonize based on the rhythm of the musical sequence for therapeutic improvement. (Chan et al. 2006), (Nut and Utley, 2011) It becomes reasonable to suppose that this alignment could grow into a self therapy technique to reduce preoperative anxiety, and thus the greater pain associated with it. Other studies indicate that music therapy is less effective for pre-existing chronic pain, (Nutt and Utley, 2011) but the reduction of anxiety can prevent the onset. Reid et al. (2008) even attributes music therapy to a reduction in the pain from rheumatoid arthritis. 4.) Insomnia is helped by music therapy There are a wide range of psychological, behavioral, and pain related disorders that can interfere with the normal sleep cycles of elderly patients. And many of these physiological, and behavioral issues can be affected by music therapy. Music therapy can relieve stress and education resulting from the relocation to a new environment where the person is more dependent on caregivers. Earlier studies have blamed unfamiliar surroundings as a strong source of anxiety in the elderly. And music becomes an effective means to evoke familiar impressions for the reduction of stress. (Ip-Winfield and Groke, 2011.) Music primarily conveys psychological relief that translate into the reduction of physiological symptoms. Stress worsens pain, and the elimination of stress can lessen pain, improving patient outcomes and quality of life. Specific organic illnesses are unlikely to be affected, but the underlying emotional triggers that interfere with patient recovery through insomnia and other disorders can be helped through this form of therapy. (Skingley and Vella-Burrows, 2010) Essay The Benefits of Music Therapy as a non-invasive therapeutic modality Introduction In the ongoing pursuit of care and comfort for elderly patients, there are a number of challenges that may not have traditional therapeutic solutions. For the elderly, traditional surgery is less effective due to the increased difficulty in wound healing, and general survival. Drugs are always an option, but they are only effective to a point. Some drugs have the potential for dangerous synergies to the detriment of the patient. These and other challenges create a strong motivation for noninvasive, alternative aids for aged patient recovery. It is essential to consider non-invasive options whenever evidence emerges supporting their efficacy. Standard modalities involving pharmaceuticals and invasive surgery are essential, but limited in effectiveness for certain elderly patients, or those suffering chronic conditions. Surgery and drugs have limits, beyond which continued usage is counterproductive. Music therapy is an alternative we will explore below for a variety of conditions affecting aged patients. Dementia Initially, many researchers focus upon conditions such as depression or dementia, connecting the potential of music therapy to strictly psychological ailments; but there are other ways the therapy can prove useful. Music therapy helps dementia patients through a connection with familiar impressions, especially in the case of senior citizens. An obstacle faced by elderly residential care patients with mental illnesses is a diminished capacity to respond to stress and the unfamiliar. The ability to integrate into a new environment becomes impaired, therefore success has been achieved when elderly patients are immersed in environments with as much familiarity as possible. The styles of music and individual songs they enjoyed while younger can diminish stress levels, improve insomnia (Short, 2007) as well as modify adverse, external stimuli in their surroundings for the prevention of excessive anxiety. (Sung et al. 2010), (Gerdner & Buckwalter, 1999) this is similar to findings yielded by other researchers indicating that music therapy alone is insufficiently therapeutic for elderly dementia patients without a component of familiarity. In order to find the most beneficial musical scores, historical and cultural sensitivity is necessary. (Ip-Winfield and Grocke, 2011) Music may be associated with other culturally relevant activities, such as a folk dance. Non-Western audiences may derive limited benefit from music without the associated cultural trappings. (Ip-Winfield and Grocke, 2011) The underlying principle is the issue of familiarity, music is a vehicle for stress reduction in a new environment, and in some cases the vehicle requires some bonus features to yield the full benefit. Some studies indicate benefits for dementia patients resulting from music therapy, but there are additional benefits that can be gleaned through an intensification of the process. Not only psychological, but the reinforcement of neurological pathways that music allows can translate into organic benefits. Evidence suggests neurophysiological as well as psychological benefits are possible, such as that described for stroke victims below. Stroke The damage inflicted by a stroke has long-lasting and varied forms of debilitation. True recovery is a complex process that may never be fully realized. But research is ongoing to aid the sufferer in regaining as much functionality as possible. Truly effective therapies for regenerating lost or damaged brain function are rare. But a cost-effective strategy with some potential is embodied in music therapy. In this case, it is not so much a matter of listening to music, but more a matter of engaging the stroke survivor in creating music themselves, as a way to retrain the brain to achieve effective motor control once again. Some of these methods include electric pads that simulate simple keyboards to foster improvements in speed, precision, and gross motor control. The focus required to closely listen to, or create music with simple instruments triggers improvements in the sensory motor system according to the work of Fujioka et al. 2012. Music has the potential to strengthen connections between the auditory and sensorimotor systems for better coordination. Auditory listening and the creation of music offers direct access to the auditory-motor network, to the advantage of the stroke victim in recovery. In a similar vein, Altenmǘller et al. (2009) found compelling electrophysiological benefits improving use of the patients hands through a process of neural reorganization. Neurological benefits through musical therapy are increasing in popularity, but there are also other ways that psychological benefits of music can translate into physiological advantages for other organ systems. As stated above, there are situations were surgery is of limited value; when weighed against the time and difficulty necessary for a complete recovery. The issue of recovery is a challenge for the medical establishment. Surgery Any form of major surgery is a time of considerable stress for patients and their families. Studies have found that the outcome of surgeries can be affected by feelings of anxiety on the part of the patient prior to the procedure. (Twiss et al. 2006) this is especially true for heart surgery. This is not simply an issue of stress during hospitalization while awaiting the procedure, major heart surgery is scheduled in advance, and feelings of anxiety often persist for up to three months afterwards, according to Twiss et al. (2006) even if the surgery appears to be technically successful from the point of view of the medical professionals performing the procedure, post operative pain can diminish the patients quality of life for many months. Studies show a link between anxiety and the presence of post operative pain. The link between pain and anxiety is due in part to the stress that increases cardiovascular workload before, during, and after the surgery. It follows therefore, that if the heart is under greater strain then surgery upon it will result in greater pain. With the need for heart surgery diagnosed in advance, this allows plenty of time for the patient to stress him or herself into or worsened postoperative position. Studies have shown that music reduces this anxiety, and therefore – if used properly can reduce post operative pain. Other data indicates that the listeners neurological and physiological properties can a line or harmonize based on the rhythm of the musical sequence for therapeutic improvement. (Chan et al. 2006), (Nut and Utley, 2011) It becomes reasonable to suppose that this alignment could grow into a self therapy technique to reduce preoperative anxiety, and thus the greater pain associated with it. Other studies indicate that music therapy is less effective for pre-existing chronic pain, (Nutt and Utley, 2011) but the reduction of anxiety can prevent the onset. Insomnia Large-scale comparative studies summarizing the findings of music therapy surveys provide more ammunition for psychological, and physiological benefits – in the form of sleep. We have seen in earlier sections evidence for neurological benefits arising from stress relief in the elderly, and the reduction in insomnia is among them. (Skingley and Vella-Burrows, 2010) elderly residents of a nursing home often suffer excessive anxiety due to the unfamiliarity of their surroundings, a chief source of stress within the nursing home/managed-care facility. (Ip-Winfield and Groke, 2011.) Insomnia is one of many symptoms that can manifest as a result of this sense of physical alienation from the novel setting of an extended care facility, combined with diminished independence. And these symptoms are amenable to music therapy. Earlier, dementia was discussed as a persistent issue pertaining to the elderly requiring alternatives beyond more and more drugs for those most likely to be on an extensive pharmaceutical regimen already. This catch-all terminology could easily include agitated behavior that would include the inability to achieve a decent night’s sleep. Skingley and Vella-Burrows to describe a range of behavioral issues among the elderly as a result of agitated stress improved through the use of music therapy. Additional research would be beneficial to address the question of whether – and to what extent the benefits are truly physiological. Studies of music therapy pointed mainly to psychological benefits. Yet when used in the right way, these can translate into physiological benefits that can assist with surgical recovery in a way that drugs may not. More research would be helpful to distinguish between various causes of insomnia. If insomnia is caused simply by a state of persistent emotional agitation, then it is suspected that music therapy would indeed prove beneficial. In addition, a lack of sleep could also result from persistent physical distraction, such as chronic pain. Additional delineation of the available research would be helpful to determine what level of organic discomfort interfering with the normal sleep process could be affected by music therapy? An underlying organic illness directly preventing sleep is unlikely to be affected without powerful drugs, but previously we had discussed the advantages of music therapy in pain management. If prolonged musical engagement can alleviate the stress levels that agitate the heart, causing greater pain after the surgery, then the stress relief from music should alleviate pain dependent insomnia. Conclusion The above studies demonstrate that music therapy is effective in connecting elderly patients with familiar impressions that tend to reduce stress in ways that bring documented therapeutic benefits. These benefits include relieving anxiety and compensating for the challenges elderly dementia sufferers have in adapting to changes in their environment. These psychological advantages can relieve lengthy periods of anxiety that often precede major internal surgery. This is a persistent problem in cardiology, as a more stressed heart is capable of more pain following surgery. Music can relieve this strain. And stroke victims in addition, can be aided in their recovery through the reinforcement of the connections between damaged brain regions. While promising, music therapy does not appear to affect chronic, pre-existing pain with definite organic cause. Nonetheless, this form of care could prove to be a valuable tool when properly utilized. On balance, there is compelling reason to explore this potential, as comprehensive surveys of multiple methods of music therapy have given consistent evidence of benefit. (Skingley and Vella-Burrows, 2010) References Altenmǘller, E., Marco-Pallares, J. Mǘnte, T.F., 2009. Neural Reorganization Underlies Improvement in Stroke-induced Motor Dysfunction by Music-supported Therapy.The Neurosciences and Music III—Disorders and Plasticity: Ann. N.Y. Acad. Sci. 1169: 395–405 (2009). doi: 10.1111/j.1749-6632.2009.04580.x c 2009 New York Academy of Sciences. Cooke, M.L., Moyle, W., Shum, D.H., Harrison, S.D., Murfield, J.E., 2010. A randomized controlled trial exploring the effect of music on agitated behaviours and anxiety in older people with dementia. Aging Ment Health. 2010 Nov;14(8):905-16. Chan, M.F., Wong, O.C., Chan, H.L., Fong, M.C., Lai, S.Y., Lo, C.W., Ho, S.M., Ng, S.Y., & Leung, S.K. (2006). Effects of music on patients undergoing a c-clamp procedure after percutaneous coronary interventions. Journal of Advanced Nursing, 53(6), 669–679. doi:10.1111/j.1365-2648.2006.03773. Fujioka, T., Ween, J.E., Jamali, S., Stuss, D.T., Ross, B. 2011. Changes in neuromagnetic beta-band oscillation after music-supported stroke rehabilitation. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES. Issue: The Neurosciences and Music IV: Learning and Memory. Ann. N.Y. Acad. Sci. ISSN 0077-8923. Ip-Winfield, V. Groke, D., 2011. Group Music Therapy Methods in Cross-Cultural Aged Care Practice in Australia. Australian Journal of Music Therapy Volume 22, 2011 59. Nutt, A. Utley, R. 2011. Music Therapy for Postoperative Pain Management: A Review of the Literature. LOGOS: A Journal of Undergraduate Research • Missouri State University • Fall 2011. Reid, C.M. Papaleontiou, M., Ong, A. Breckman, R. Wethington, E., Pillemer, K. 2008. Pain & Aging Section. Pain Medicine. Volume 9 • Number 4 • 2008. Short, A., 2007. Theme and Variations on Quietness: Relaxation-focused Music and Imagery in Aged Care. Australian Journal of Music Therapy Volume 18 (2007) Skingley, A., Vella-Burrows, T., 2010. Therapeutic effects of music and singing for older people. NURSING STANDARD january 13 :: vol 24 no 19 :: 2010 35. Twiss, E. Seaver, J. McCaffrey, R. 2006. The effect of music listening on older adults undergoing cardiovascular surgery. 224 ª 2006 The Authors. Journal Compilation ª 2006 British Association of Critical Care Nurses, Nursing in Critical Care 2006 • Vol 11 No 5. Read More