Quality of Life Clinical Trial
Official title:
Evaluating an Individualized Music Program Intervention in Long-term Care
The goal of this study is to examine the impact of an individualized music program that includes music performance impacts quality of life, PRN drug use and scores on the RAI-MDS for residents of a long-term care facility. The impact of this program on staff at the long-term care facility and musicians performing at the facility will also be assessed.
There is abundant research identifying the value of music in improving quality of life for
older adults in residential faculties. This work suggests that there are at least two
critical factors that contribute to the success of music-based interventions for older
adults: familiarity, and active participation in the production of the music. With these
elements in mind, the investigators are proposing to develop a choral singing program
comprised of familiar music, introduced to residents at a Long-term care (LTC) facility
through individualized engagement with the songs, leading to weekly group participation run
by a professional musician at the Bonne Bay (Newfoundland and Labrador, Canada) Long-term
Care Facility.
Specific development of the choral program itself will be done through a co-design process
involving staff, residents, and care partners during the intervention. In general the
intervention will have residents work with professional musicians to select a few songs that
the residents will perform with the professional musician at the end of the week. The
specific development will determine three crucial issues for the intervention: 1) what music
is appropriate for the initiative? 2) what individualized engagements with the songs are
appropriate to each resident? 3) what modes of participation in the group events are
appropriate to each resident? The key factor with this co-design are that the music and the
level of engagement will be tailored to the individual resident.
The program will run over a full quarter in (July, August, September) allowing the
investigators to establish meaningful comparisons of secondary, quantitative data already
collected at all long-term care facilities on a quarterly basis. This data includes the
medication administration (medication administration records: MARS), behavioural episodes in
residents with dementia (dementia observational system: DOS), and the resident assessment
inventory minimum data set (RAI-MDS). Pre and post intervention data will be assessed for
participating residents at the Bonne Bay Long-term care facility. Pre-intervention data will
be collected for three years before the intervention to establish an appropriate baseline
for the intervention. The impact of the intervention on residents of the unit will also be
assessed through qualitative data. Interviews with residents or their care partners will
elicit the perceived benefits and challenges to participating in a music intervention
program from the participants' point of view. Care-partners will be identified by nursing
staff and/or the resident themselves as an individual who regularly helps with day-to-day
living needs of the resident. Care partners will only be interviewed when the cognitive
abilities of the resident prevent conducting an interview with them. All participants in the
study will be de-identified using a code system that allows us to intersect quantitative and
qualitative data in pursuit of a more rigorous view of potential impacts. This code system
will involve randomly assigning each participant a number. A master database connecting the
name and the number will be maintained in a password protected file on a password protected
computer in Dr. Zendel's lab. Research staff will use this master database under the
supervision of one of the data custodians during the de-identification process.
This intervention will also be studied from the staff perspective. While there are few
studies investigating the perceptions of staff in the implementation of music intervention
in healthcare settings, those that are published document the importance of considering the
staff perspective and the impact of this perspective on the overall success of this form of
intervention. A 'pre/post' interview process will engage how the music intervention was
perceived by staff, particularly regarding workload, role in the intervention, strengths and
challenges of the intervention, and the impact on overall work environment. Gaining an
understanding of the staff perspective on the implementation of this intervention will prove
invaluable to the overall feasibility of the initiative.
A final layer of inquiry will interview the musicians themselves, exploring a sense of
meaning and value gained through participation in the process, distinctions the musicians
make between music and music as intervention, how the musician defines and relates to their
practice as musicians, what and how that has shifted, what relationship the musician felt
emerged between themselves and the residents with whom they worked?
Basic demographic information including age, date of birth and sex will be recorded as part
of each interview (residents/care partners, music staff and LTC staff). Demographic
information will also be collected from the residents chart.
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