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What is Music Therapy?

Music therapy is the medical application of music to achieve personalized objectives such as stress reduction, mood enhancement, and self-expression. It is a well evidence-based treatment in the medical world. Attending to music, trying to sing, playing musical devices, or making music are all examples of music therapy activities. Participation does not necessitate any musical abilities or expertise (Cheong et al. 2016).

Substitute And Additional Therapy are used in treatment techniques to give patients with integrative treatment. With these tactics, music therapy is an essential strategy to explore. Music therapy involves performing music for clients or training them how to operate a piece of equipment so that they may engage in music-making (Cheong et al. 2016). Music therapists use melodic reactions to evaluate patients' psychological well-being, personal functionality, psychosocial adjustment, communicative skills, and intellectual capabilities. They then create music activities for people and communities depending on the requirements identified via music experimentation, responsive music listening, composition, lyrical conversation, music and visuals, musical performances, and music acquisition. Music therapists are essential members of the therapeutic group (Lam et al. 2020).

This study will focus on a practical activity (music therapy) within the dementia care setting where an elderly woman suffers from dementia which resulted in her forgetfulness and has a history of wandering which increases her vulnerability.

Alice, 81, was brought to the nursing facility because her nursing requirements could not be addressed at her residence owing to dementia. She has a background of roaming, which makes her more vulnerable. This mental deterioration affects her physiological and interpersonal abilities since she needs assistance with everyday chores such as basic grooming, nourishment, security, movement, and guidance.

Dementia impaired Alice's memory performance and capacity to carry out normal tasks; it is also frequently connected with problematic behaviors. As dementia develops, a person will necessitate help and support with operations of everyday livelihood (e.g., having to eat, personal care, movement) and experimental operations of everyday livelihood (e.g., dressing, cooking) (Dahms et al. 2021). 

Dementia patients frequently have communication challenges, such as difficulty choosing the proper term or understanding a discussion. Other variables that may hinder communication involve discomfort, other medical disorders, pharmaceutical adverse reactions, and hearing abnormalities. Dementia patients may progressively decrease their independence and grow increasingly dependent on the care and assistance of others. This may be a difficult transition and can be upsetting for both the client and the care provider. Efforts by the individual to maintain their independence may lead to friction with those giving care and assistance (Cheong et al. 2016).

Caring for dementia patients in their residences is a difficult care problem that creates ethical quandaries about how to reconcile autonomy with their security and well-being. For Alice, autonomy is essential for a high standard of life. Allowing Alice with dementia to participate in decision-making is critical to her self-determination and sense of value, as well as fostering respect and honesty.

Music therapy therapies, particularly music, can help people with communication difficulties build verbal and nonverbal interaction and linguistic abilities, as well as effective social competence. The supervisor's responsibility in this scenario was to engage with musical creativity. The mentor performs musically in a manner consistent with how he or she performs for the patient. The mentor then takes on the position of the client, and the supervisor proceeds to perform in a manner that matches the melody that the supervisee delivers for the customer. The supervisor progressively improves the musical knowledge by introducing expressive aspects that the supervisee was unable to use because of negative transmission (Cho 2018).

Music Therapy for Dementia Patients

Most music counselor has a preferred variety of equipment that they use in their music treatment practices. They understand the tenacity and dependability of these sounds in enhancing, empowering, and liberating their customer. Pianos, guitars and ukuleles, drums, tambourine, maracas, melodica, and hand-held percussion are some of the instruments utilized in music therapy. Music therapy sessions typically last for 45-60 minutes.

Music therapy principles of professional practice are norms for evaluating the efficacy of activities. The criteria for each of these operating procedures are given below, and all professional therapists must follow them when providing services. Based on the location, the beneficiary of music therapeutic interventions may be referred to by a range of names. The music therapy evaluation will concentrate on the client's requirements and capabilities in the main areas of emotional, intellectual, linguistic, societal, and physical functionality. The evaluation will also establish the client's auditory reactions, musical abilities, and musical interests (Gómez-Romero et al. 2017).

The music therapy evaluation will go into the patient's cultural background. Race, culture, dialect, religion/spirituality, financial background, familial history, sexual preference, sexual identities or representation, and service groups are examples of this.

The music therapy evaluation processes and findings were kept on file for the client. All music therapy evaluation procedures will be tailored to the client's biological age, diagnosis, degree of competence, and ethnicity. Monitoring music or other circumstances, interviews, verbal and nonverbal treatments, and assessment are some of the ways that may be used. Data can also be collected from several fields or sites, such as health and psychosocial events from the previous and current (Li et al. 2019).

The ultimate choice to admit a patient for music therapy activities, whether primary or advisory, will be taken by a professional therapist in collaboration with the multidisciplinary team, if relevant. The findings, judgments, and consequences of the music therapy evaluation will serve as the foundation for the patient's music therapy course and will be conveyed to those engaged in the patient's care. The outcomes will be shared with the customer as needed. Depending on the music therapy evaluation, the patient's diagnosis, and relevant evidence from other professions and authorities, the Music Therapist will create a unique care approach. When possible, the patient will be involved in the formulation of the service approach (Fusar-Poli et al. 2018).

Throughout the activity, the music counselor displayed regard for Alice's dignity, value, background, and understanding. Recognize patients' abilities to self-identity and autonomy, as well as the ability to contribute to choices affecting them. If specifically instructed by the patient, investigate and gather only facts related to the issue of therapy. Before beginning assistance or study, seek understanding permission from patients or their primary caregivers. When patients are incapable to provide knowledgeable permission, music counselors will strive to preserve the person's autonomy by informing and involving them (Ray and Mittelman 2017). In any textual or spoken communications, the therapist employed vocabulary that communicated regard for the integrity of Alice.

The purpose of music therapy is to attain outcomes that correspond to the patient's requirements. Therapy may assist improve functional ability, social competence, feelings, and synchronization, relying on the regions where the person is deficient. Its goal is to encourage the patient's self-expression and progress. Alice received feedback from music therapy that her talents were increased as a result of her creative engagement in the constructive environment. Subjugated sensations were freed as a result of music therapy. It also helped to alleviate the emotions of solitude (McDermott et al. 2018).

Challenges Faced by Dementia Patients

People can get several advantages from music and improve their overall standard of life. After a long day of tension, music can enable people to attain a high degree of tranquility and serenity. From a beneficial standpoint, music therapy, aided in improving motivation for Alice. Music boosts motivation while also increasing concentration duration, happiness, lifespan, and total skill learning (Aleixo, Santos and Dourado 2017). This motivator, coupled with the prospect of an appealing encounter, is particularly appealing to older adults. Music therapy can encourage an aged person to grow more interested in educating, speaking, exercising, and engaging with individuals. Exposure to music has been demonstrated to reduce hypertension and heartbeats. By hearing the words of a certain song, she was able to boost her psychological state. Alice saw improvements in her emotional, bodily, and interpersonal well-being following or throughout a music therapy practice. Music tended to get her to feel better and more at ease (Fakhoury et al. 2017).

From an unfavorable standpoint, certain songs evoked old recollections, and occasionally these recollections were not warm or pleasurable, leaving her feeling dreadful. It caused her to become despondent and, at times, worsened her stress symptoms.

While backing track has a strong impact on human conduct and memory, it may not be as beneficial in the elderly. People as early as their forties may begin to experience a progressive reduction in high-frequency audio, resulting in increasing difficulties listening to signals in the face of ambient music or sound. In dementia, music enhances cognition, emotions, conduct, and interaction (Gómez-Romero et al. 2017). The demands of the resident(s), the surrounding conditions, and the assets accessible, such as personnel and overall financial limits, must all be considered when choosing the best sort of hearing activation. A certain need is frequently handled in numerous approaches; in these cases, the different activation choices can be limited depending on their compatibility between contextual elements and resource availability, bearing in consideration that many treatments can also be employed in combination to maximize therapy (Moreno-Morales et al. 2020). 

The patient-centered strategy resulted in a dearth of patient confidentiality safeguards, and as a result, Alice was required to divulge all private details to engage in the treatment procedure. The next section of comments focused on issues connected to occupational competence. Nurses misused the nursing procedure to extend their careers, therefore the clients' advantages were overlooked. According to some analysts, the healthcare approach was established as a logical approach and is not founded on the real activity of caregivers.

References

Aleixo, M.A.R., Santos, R.L. and Dourado, M.C.D.N., 2017. Efficacy of music therapy in the neuropsychiatric symptoms of dementia: systematic review. Jornal Brasileiro de Psiquiatria, 66, pp.52-61.

Cheong, C.Y., Tan, J.A.Q., Foong, Y.L., Koh, H.M., Chen, D.Z.Y., Tan, J.J.C., Ng, C.J. and Yap, P., 2016. Creative music therapy in an acute care setting for older patients with delirium and dementia. Dementia and geriatric cognitive disorders extra, 6(2), pp.268-275.

Cho, H.K., 2018. The effects of music therapy-singing group on quality of life and affect of persons with dementia: a randomized controlled trial. Frontiers in medicine, 5, p.279.

Dahms, R., Eicher, C., Haesner, M. and Mueller-Werdan, U., 2021. Influence of music therapy and music-based interventions on dementia: A pilot study. Journal of Music Therapy, 58(3), pp.e12-e36.

Fakhoury, N., Wilhelm, N., Sobota, K.F. and Kroustos, K.R., 2017. Impact of music therapy on dementia behaviors: A literature review. The Consultant Pharmacist®, 32(10), pp.623-628.

Fusar-Poli, L., Bieleninik, ?., Brondino, N., Chen, X.J. and Gold, C., 2018. The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis. Aging & Mental Health, 22(9), pp.1103-1112.

Gómez-Romero, M., Jiménez-Palomares, M., Rodríguez-Mansilla, J., Flores-Nieto, A., Garrido-Ardila, E.M. and González-López-Arza, M.V., 2017. Benefits of music therapy on behaviour disorders in subjects diagnosed with dementia: A systematic review. Neurología (English Edition), 32(4), pp.253-263.`

Lam, H.L., Li, W.T.V., Laher, I. and Wong, R.Y., 2020. Effects of music therapy on patients with dementia—A systematic review. Geriatrics, 5(4), p.62.

Li, H.C., Wang, H.H., Lu, C.Y., Chen, T.B., Lin, Y.H. and Lee, I., 2019. The effect of music therapy on reducing depression in people with dementia: A systematic review and meta-analysis. Geriatric Nursing, 40(5), pp.510-516.

McDermott, O., Ridder, H.M., Baker, F.A., Wosch, T., Ray, K. and Stige, B., 2018. Indirect music therapy practice and skill-sharing in dementia care. Journal of music therapy, 55(3), pp.255-279.

Moreno-Morales, C., Calero, R., Moreno-Morales, P. and Pintado, C., 2020. Music therapy in the treatment of dementia: A systematic review and meta-analysis. Frontiers in medicine, 7, p.160.

Ray, K.D. and Mittelman, M.S., 2017. Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia. Dementia, 16(6), pp.689-710.

Zhang, Y., Cai, J., An, L., Hui, F., Ren, T., Ma, H. and Zhao, Q., 2017. Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing research reviews, 35, pp.1-11.

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