Dealing with a loved one who is agitated and aggressive is never easy—but it’s especially tough when that person has Alzheimer’s disease and can no longer understand what is “appropriate” behavior and what isn’t. Such behavioral issues are very common in Alzheimer’s patients…and medication helps little while potentially causing side effects.
This places a tremendous burden on family caregivers. In fact, behavioral problems are a primary reason why people with Alzheimer’s end up in nursing homes. And even if you’re just visiting your loved one in a nursing home rather than delivering around-the-clock care yourself, it’s still upsetting to witness and try to deal with that person’s distress.
So what can be done about these difficult behavioral issues? According to a recent study, activities involving music and cooking can help patients and as their caregivers. Here’s why…
Forty-eight nursing home residents with moderate-to-severe Alzheimer’s disease were randomly assigned to one of two group-activity programs—music or cooking. The goal was to see whether either or both programs would help reduce behavioral problems in patients and ease caregiver stress.
Before beginning the programs, each resident’s caregiver (the nursing home staff member assigned to that resident) completed a questionnaire. The point was to gauge the frequency and severity of the patient’s problem behaviors—including aggression, agitation, delusions, disinhibition (loss of inhibitions that would normally govern behavior) and sleep abnormalities (frequent awakenings, sleeping during the day instead of at night, etc.)…and to measure how much emotional or psychological distress the patient’s behavior caused for the caregiver. The higher the scores, the worse the problems. The questionnaire was repeated halfway through the programs and four weeks after the programs ended. The caregivers did not know which program the residents were enrolled in. (Though this study looked at professional caregivers, it’s reasonable to suppose that family caregivers—who typically would have less caregiving training and a deeper emotional attachment—would experience even greater stress when trying to manage a loved one’s behavioral problems.)
Two one-hour sessions were held each week for four weeks. In the music group, CDs were played featuring classical music and popular songs from the 1950s through 1980s. Participants were encouraged to listen, sing along and/or keep the beat on a small drum. In the cooking group, all participants cooperated in preparing various foods—for instance, by measuring, mixing, etc.—depending on their capabilities. Participants were invited to express their feelings and to recall memories that were evoked by the music or the food preparation.
The results were encouraging. Both programs helped reduce the severity of behavioral disorders and caregiver distress, with the music program being especially effective. Specifically, in terms of…
Severity of patients’ behavioral problems: In the music group, patients’ average score improved by 74% during the program…and four weeks after the program ended, there was still a 37% improvement. In the cooking group, the patients’ average behavioral score improved by 57%…and four weeks after the program ended, there was still a 32% improvement.
Caregiver distress levels: Among caregivers of patients in the music group, the average distress score improved by 78% during the program…and four weeks after the program ended, there was still a 44% improvement. In the cooking group, caregivers’ average distress score improved by 65% during the program…and four weeks after the program ended, there was still a 34% improvement.
According to the Alzheimer’s Foundation of America, music has the power to improve patients’ mood and cognitive function and to stimulate positive interaction because the part of the brain that responds to auditory cues requires little cognitive functioning. That’s why, even in advanced dementia, the ability to engage in music by singing along may remain intact.
Although this study showed greater benefits from music than from cooking, the benefits from the cooking were significant…and it’s possible that a patient who had a lifelong interest in cooking would respond more positively to a cooking activity than to a music activity.
Advice for caregivers: The supervisors who led the programs in this study were not professional music therapists or chefs—and in fact, one of the researchers’ goals was to look for nonmedical care strategies that could easily be adapted for use at home by family caregivers. So why not try re-creating the programs’ positive effects yourself when you’re with the Alzheimer’s patient you care for?
For instance, play some CDs when you’re together, choosing a style of music that is familiar and soothing, and encouraging your loved one to sing, clap or drum along to the tune. Or spend time together in the kitchen, preparing a simple recipe (such as pancakes) and inviting your loved one to handle safe and easy tasks, such as measuring, mixing and pouring. You might include other family members, too, to more closely duplicate the social aspect of the study’s group activities. You may end up doing everyone involved a world of good.
