Better country dementia care

Rising levels of dementia is putting pressure on residential aged care facilities, including in rural and regional centers where nursing homes and staff are already under pressure.

Now a pilot program of personalized interventions, including residents' favorite songs, has been shown to make a big difference to dementia behaviors, drug use and carers' wellbeing.

Harmony in the Bush, a study led by Flinders University in five nursing homes in Queensland and South Australia, developed a multimodal person-centered non-pharmacological intervention program incorporating individual music selections to reduce, resulting in a significant reduction in resident agitation and staff stress levels.

The focus on resident-centered therapies, rather than drug interventions, led to less dysfunctional behaviors and psychological symptoms in the trial group of 74 people living with dementia and reduced stress reported by the 87 staff in aged care homes who took part in the study.

More than one-third of the residents reported mild-severe pain and mild-severe sadness before the intervention.

"The Harmony in the Bush model is effective in reducing agitation among dementia residents with the important spinoff of significant reduction in staff stress levels in nursing homes in rural Australia," says researcher Dr. Vivian Isaac, lead author on a new article in BMC Geriatrics.

The Flinders Rural and Remote Health team also found a reduction in the use of psychotropic medications and inappropriate medications when comparing residents' medication charts data covering three months pre- and post- the Harmony in the Bush intervention, as published recently in BMC Psychiatry.

In Australia, 60-70% of the people residing in nursing homes have dementia and about 70-90% of residents with dementia suffer from psychiatric or behavioral symptoms.

"The study found that the model gives staff with a structure to learn person-centered practice over about one month to reduce the impact of behavioral and psychiatric symptoms of dementia.

"The results show a statistically significant decline in aggressive behaviors, physically non-aggressive behaviors, and inappropriate verbal behavior, hiding or hoarding—with a similar reduction in staff stress and resident safety when resources for specialized dementia care may be limited."

The study provides promising evidence on the potential of this novel model in low-resourced settings, researchers says.

Further studies will look at the cost-effectiveness and reliability of the model, which researchers have based on the Progressively Lowered Stress Threshold principles and person-centered music in nursing homes (using personal devices during rest time) to reduce agitation and other stressful behaviors.

Music has proved helpful in dementia to raise mood, stimulate memories and provide a soothing effect.

These behaviors include agitation, mood dysregulation, and disturbed thoughts and perceptions, which pose a major challenge for the residents with dementia and nursing home staff.