Dementia and Music: Changing How We Care
There are currently around 850,000 people living with dementia in the UK, with this number expected to rise to one million by 2025. Dementia has higher health and social care costs (£11.9bn) than cancer (£5.0bn), stroke (£2.9bn) and chronic heart disease (£2.5bn) combined. The Dementia 2020 challenge calls on the UK to become a world leader in dementia care and research.
A recent report by International Longevity Centre UK and The Utley Foundation has revealed what music means for people with dementia, and explored the current and potential role of music-based interventions.
As a charity promoting the power of music to change the way we care, Music as Therapy International believe the findings of the report can provide a springboard for bringing music into the lives of the thousands of people living with dementia throughout the UK.
A recent survey of the music therapy profession undertaken by BAMT found that there are currently 900 music therapists in the UK and about 250 of these practitioners work with people with dementia. In other words, only a tiny minority of people with dementia have regular access to music therapy.
When delivered effectively, music gives carers and loved ones an avenue through which to sustain relationships and share experiences and can help to minimise the often-upsetting symptoms of dementia such as agitation, anxiety and depression.
Moreover, it can help to improve a person’s wellbeing and quality of life. It appears that people with dementia retain clearest memories for music they enjoyed and heard between roughly the ages of 10 and 30. A growing research base, spanning some twenty to thirty years, is beginning to demonstrate the range of benefits of music for people with dementia.
Importantly, of the large number of non-pharmacological therapies identified and examined, the review concluded that music therapy was one of just two forms of intervention for which there is convincing evidence of effectiveness in reducing the behavioural and psychological symptoms of dementia.
Additionally, when used appropriately and in a meaningful way, the use of music has no known negative impacts. This should particularly be noted when comparing to interventions which can have tangible negative impacts, such as the use of anti-psychotic medications.
Funding is key
The costs of music-based interventions are absorbed in a variety of ways. For example, some care homes will fund music-based interventions; funding may be provided through NHS continuing care budgets; local authorities may support some provision, by charities and by philanthropic trusts; other expenses will be self-funded. A survey undertaken by Live Music Now identified that music budgets in the surveyed homes were twice as big as for other activities, but still very small at around £100/month per home.
Music-based interventions can form part of what is funded from Personal Health Budgets (PHB) and Integrated Personal Commissioning (IPC). However, PHB and IPC funding will remain reserved for those with the highest levels of health and social care need. It is not, therefore, feasible to consider that all or even most people with dementia will be able to use personalised statutory funding to access music-based interventions.
Making music accessible
It has been speculated that just 5% of the 20,000 UK care homes offer good quality music and arts activities for residents. With a relatively small number of music therapists working in dementia care, and until funding is increased, there is a genuine need for alternative, cost-effective approaches to be explored.
One solution highlighted by written evidence submissions for the Commission examined the potential for music therapists to adopt a role as trainers and in cascading best practice and the principles of music therapy.
Making the most of a music therapist’s role in training others, and continuing to include musicians and other colleagues in their work, could help to reach many more people with dementia than could be by specialist music therapy intervention alone, whilst also ensuring the continued value and support of the music therapy profession.
Spreading the word
Despite the promising findings, the report also highlighted the range of benefits that music can offer people with dementia appears to have not yet reached the general public. It concluded there was a clear need for the value of music for people with dementia to be more clearly expressed in public-facing literature and PR campaigns, with raising public awareness vital in order to maximise the potential of this field of work.
The points set out here are by no means exhaustive, and the full Commission report has more recommendations for development in the field of music and dementia. What is clear, however, is that music has a key part to play in dementia care in the UK. The potential is undoubtedly there, now it is up to us as a society to realise this potential together.