Approximately 1.4 million older adults reside in skilled nursing settings in the United States (Harris-Kojetin et al., 2013). The incidence of situational and clinical depression in this setting is alarmingly high (Ulbricht, Rothschild, Hunnicutt, & Lapane, 2017) and is related to loss of independence, feelings of social isolation and loneliness, ever-present death and grief, stale programming, and lack of meaningful in-house activities (Choi, Ransom, & Wyllie, 2008). Situational depression is defined as depression associated with major life changes, such as transitioning into a long-term care setting, whereas clinical depression is believed to consist of a complex relationship between brain function, genetic factors, and social context (Hirshfeld, 1981; Joyce, 2008). Green, Magee, Steiner, and Teachman (2017) investigated changes in depressive symptoms over time of 64,095 older adults who were newly admitted to long-term care facilities. The findings indicated that the prevalence of depression increased over a 3-month period (54.3 cases per 100 residents at initial assessment, compared with 60.8 cases per 100 residents by follow-up). In addition, more than 50% of the residents exhibited a high risk for depression both at admission and follow-up. It is difficult to delineate situational from clinical depression in residents who reside in long-term care facilities. However, changes in the aging brain, loss of physical and cognitive function, and disruption of environmental and social contexts can lead to depression and a decreased quality of life residents who reside in long-term care (Choi, Ransom, & Wyllie, 2008; Kirchen, Hersch, & Pickens, 2014). Music as an Occupation (Means and End) The practice of occupational therapy was founded on the belief that engagement in client-centered, purposeful, and meaningful occupations promotes the health, wellbeing, and quality of life of all persons (McLaughlin Gray, 1998). In the 1995 Eleanor Clark Slagle Lecture, Catherine Trombly described occupation as a means and an end. She states that occupation is both a treatment end goal and a means to remediate occupational performance challenges. Trombly emphasized that the occupational therapist must ensure that the therapeutic approach is skilled by facilitating the just right challenge for the client. In turn, the client must possess the motivation to engage in the therapeutic process, which is heavily dependent on the treatment session reflecting a client-centered, purposeful, and meaningful approach. Music is a universal and meaningful occupation that can be used as a non-pharmacological intervention to