Effects of relaxing music on agitation during meals among nursing home residents with severe cognitive impairment

  • Jan Goddaer
    Affiliations
    School of Nursing “Ic Dien,” Roeselare, Belgium

    School of Public Health, Catholic University of Leuven, Leuven, Belgium

    School of Nursing, School of Medicine (Department of Psychiatric Medicine), and Center on Aging and Health, University of Virginia, Charlottesville, VA, USA
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  • Ivo L. Abraham
    Correspondence
    Address reprint requests to Ivo L. Abraham, PhD, FAAN, CS, Center on Aging and Health, University of Virginia, 170 Rugby Road, Chariottesville, VA 22903.
    Affiliations
    School of Nursing “Ic Dien,” Roeselare, Belgium

    School of Public Health, Catholic University of Leuven, Leuven, Belgium

    School of Nursing, School of Medicine (Department of Psychiatric Medicine), and Center on Aging and Health, University of Virginia, Charlottesville, VA, USA
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      Abstract

      Relaxing music was hypothesized to buffer the general nolse level typically found in dining rooms of nursing homes, exert a calming effect, and thus reduce agitated behaviors among residents with severe cognitive impairment. Twenty-nine nursing home residents with severe cognitive deficits participated in a 4-week protocol in which, following baseline observations (week 1), relaxing music was introduced (week 2), removed (week 3), and reintroduced (week 4). Subjects were observed in terms of total number of behaviors of the Cohen-Mansfield Agitation Inventory present during a given week, and the number of behaviors present on the subscales of aggressive, physically nonaggressive, verbally agitated, and hiding/hoarding behaviors. Significant reductions were observed on the cumulative incidence of total agitated behaviors (63.4%); as well as the cumulative incidence of physically nonaggressive behaviors (56.3%) and verbally agitated behaviors (74.5%). No significant reductions were noted in terms of aggressive behaviors and hiding/hoarding behaviors. Where significant reductions were achieved, a distinct pattern was observed. Agitation decreased during week 2, increased again during week 3, only to decrease again in week 4. In addition, variance effects were noted as well, as ranges and standard deviations of agitated behaviors narrowed over time. These findings are interpreted within Hall and Buckwalter's (1988) model of a progressively lowered stress threshold among dementia patients.
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      References

        • Abraham I.
        • Neundorfer M.
        The design and analysis of time series studies.
        in: Advancing nursing science through research. Vol. 2. Sage, Newbury Park, CA1990: 143-172
        • Abraham I.
        • Neundorfer M.
        • Currie L.
        Effects of group interventions on cognition and depression in nursing home residents.
        Nursing Research. 1992; 41: 196-202
        • Abraham I.
        • Reel S.
        Cognitive nursing interventions with long-term care residents: Effects on neurocognitive dimensions.
        Archives of Psychiatric Nursing. 1992; 6: 356-365
        • Athlin E.
        • Norberg B.
        • Asplund K.
        • Jansson L.
        Feeding problems in severely demented patients seen from task and relationship aspects.
        Scandinavian Journal of Caring Sciences. 1989; 3: 113-121
        • Beck C.
        • Rossby C.
        • Baldwin B.
        Correlates of disruptive behavior in cognitively impaired elderly nursing home residents.
        Archives of Psychiatric Nursing. 1991; 5: 281-291
        • Buckwalter K.
        • Hartsock J.
        • Gaffney J.
        Music therapy.
        in: Bulechek G. McCloskey J. Nursing interventions and treatments for nursing diagnosis. Saunders, Philadelphia, PA1985: 58-74
        • Cohen-Mansfield J.
        Agitated behaviors in the elderly: II. Preliminary results in the cognitively deteriorated.
        Journal of the American Geriatrics Society. 1986; 34: 722-727
        • Cohen-Mansfield J.
        • Billig N.
        Agitated behaviors in the elderly: I. A conceptual review.
        Journal of the American Geriatrics Society. 1986; 34: 711-721
        • Cohen-Mansfield J.
        • Marx M.
        • Rosenthal A.
        A description of agitation in a nursing home.
        Journals of Gerontology: Medical Sciences. 1989; 44: M77-M84
        • Courtright P.
        • Johnson S.
        • Baumgartner M.
        • Jordan M.
        • Webster J.
        Dinner music: Does it affect the behavior of psychiatric patients?.
        Journal of Psychosocial Nursing and Mental Health Services. 1990; 28: 37-40
        • Davies A.
        • Snaith P.
        Mealtime problems in a continuing-care hospital for the elderly.
        Age and Ageing. 1980; 9: 100-105
        • Dinther G.
        • Hendriks A.
        De invloed van muziek op het welbevinden van zwakzinnigen.
        Tijdschrift voor Ziekenverpleging. 1985; 38: 517-520
        • Donnerstein E.
        • Wilson D.W.
        Effects of noise and perceived control on ongoing and subsequent aggressive behavior.
        Journal of Personality and Social Psychology. 1976; 34: 774-781
        • Folstein M.
        • Folstein S.
        • McHugh P.
        “Mini mental state”: A practical method for grading the cognitive state of patients for the clinician.
        Journal of Psychiatric Research. 1975; 12: 189-198
        • Gerdner L.
        • Swanson L.
        Effects of individualized music on confused and agitated elderly patients.
        Archives of Psychiatric Nursing. 1993; 5: 284-291
        • Hall G.
        Care of the patient with Alzheimer's disease living at home.
        Nursing Clinics of North America. 1988; 23: 31-46
        • Hall G.
        • Buckwalter K.
        Progressively lowered stress threshold: A conceptual model for care of adults with Alzheimer's disease.
        Archives of Psychiatric Nursing. 1987; 1: 399-406
        • Hansell H.N.
        The behavioral effects of noise on man: The patient with “intensive care unit psychosis”.
        Heart and Lung. 1984; 13: 59-65
        • Hilton A.
        The hospital racket: How noisy is your unit.
        American Journal of Nursing. 1987; 87: 59-61
        • Jost J.
        Equilibre et santé par la musicothérapie.
        Editions Albin Michel, Paris, France1990
        • Levitt L.
        • Leventhal G.
        Effect of density and environmental noise on perception of time, the situation, oneself, and others.
        Perceptual and Motor Skills. 1978; 47: 999-1009
        • Nilsson K.
        • Palmstierna T.
        • Wistedt B.
        Aggressive behavior in hospitalized psychogeriatric patients.
        Acta Psychiatrica Scandinavica. 1988; 78: 172-175
        • Norberg A.
        • Athlin E.
        Eating problems in severely demented patients.
        Nursing Clinics of North America. 1989; 24: 781-789
        • Palmer H.
        Sea gulls … Music for rest and relaxation.
        Educational Activities, Inc, Freeport, NY1978 (Tape #AR504)
        • Petrie W.
        • Lawson E.
        • Hollender M.
        Violence in geriatric patients.
        Journal of the American Medical Association. 1982; 248: 443-444
        • Rogers J.
        • Snow T.
        An assessment of the feeding behaviors of the institutionalized elderly.
        American Journal of Occupational Therapy. 1982; 36: 375-380
        • Rossby C.
        • Beck C.
        • Heacock P.
        Disruptive behaviors of a cognitively impaired nursing home resident.
        Archives of Psychiatric Nursing. 1992; 6: 98-107
        • Ryden M.
        • Bossenmaier M.
        • McLachan C.
        Aggressive behavior in cognitively impaired nursing home residents.
        Research in Nursing and Health. 1991; 14: 87-95
        • Sandman P.
        • Norberg A.
        • Adolfsson A.
        • Eriksson S.
        • Nystrom P.
        Prevalence and characteristics of persons with dependency on feeding at institutions for the elderly.
        Scandinavian Journal of Caring Sciences. 1990; 4: 121-127
        • Teri L.
        • Larson E.
        • Reifler B.
        Behavioral disturbances in dementia of the Alzheimer's type.
        Journal of the American Geriatrics Society. 1988; 36: 1-6
        • Williams M.
        • Murphy J.P.
        Noise in critical care units: A quality assurance approach.
        Journal of Nursing Care Quality. 1991; 6: 53-59
        • Winger J.
        • Schirm V.
        • Stewart D.
        Aggressive behavior in long-term care.
        Journal of Psychosocial Nursing and Mental Health Services. 1987; 25: 28-33