Conceptualizing attunement in dementia care: a meta-ethnographic review

Krøier, Julie Kolbe; McDermott, Orii; Ridder, Hanne Mette Ochsner

doi:10.1080/17533015.2020.1827276

Cited by 13 publications

(10 citation statements)

References 36 publications

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“…Their relationships seemed to move from task‐orientated, which diminishes personhood, 61 to more aligned with the VIPS principles defined by Brooker 10 : PCCS helped caregivers adopt an individualised approach; better understand their perspective; and create a positive social environment. This contributes to current research on PCCS, live music training outcomes, music therapy skills‐sharing 34,52 and attunement in dementia care 62 . Additionally, caregivers advocated for other care homes and caregivers to adopt PCCS, acknowledging it as useful and effective in various daily caring contexts.…”

Section: Discussionmentioning

confidence: 80%

“…This contributes to current research on PCCS, live music training outcomes, music therapy skills‐sharing 34 , 52 and attunement in dementia care. 62 Additionally, caregivers advocated for other care homes and caregivers to adopt PCCS, acknowledging it as useful and effective in various daily caring contexts. This is also noted in previous findings.…”

Section: Discussionmentioning

confidence: 99%

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Person‐centred caregiver singing for people living with dementia in South Africa: A mixed methods evaluation of acceptability, feasibility, and professional caregivers' experiences

Stuart‐Röhm,

Clark,

Baker

2023

Health Expectations

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BackgroundDementia care in South Africa faces challenges including a paucity of published research, a prevalent medical model in healthcare, and inadequate caregiver training. Music is a meaningful psychosocial intervention in dementia care, yet its application is not always safe and effective. A training protocol was codesigned to enhance caregivers' delivery of person‐centred care through attuned, live singing.ObjectivesThis study explored the acceptability and caregivers' experiences of a person‐centred caregiver singing (PCCS) protocol in South Africa.MethodsA PCCS workshop was applied at seven aged care homes in Cape Town, South Africa. Forty‐one formal caregivers adhered to inclusion criteria and consented to attend one workshop on PCCS. Mixed methods data collection was obtained from questionnaires containing a Likert scale and written reflections. Quantitative data were analysed through nonparametric tests and narrative descriptions, and qualitative data through thematic content analysis. Findings were integrated deductively using seven components of acceptability.ResultsFindings converged to show caregivers' positive experiences, highlighting observed improvements in residents' wellbeing, caregivers' capabilities, empathic connection, and person‐centred care beyond the one‐on‐one. Caregivers' limited song repertoire and residents' unpredictability hindered implementation, however, the skills acquired appeared useful and applicable.ConclusionsIntegration of findings suggests the acceptability of PCCS as caregivers experienced PCCS as a helpful, easy‐to‐implement intervention that contributes to their delivery of person‐centred care. Further research focused on caregiver self‐efficacy, empathy, and caregivers' own personhood is needed as well as determining the most effective strategies to ensure maximum uptake and sustainability in the sector.Patient or Public ContributionFormal caregivers participated in this study, both attending the training and implementing the singing protocol with residents in their care at their respective care homes. The people living with dementia residing at the care home were recipients of the singing protocol but not included as participants in the research.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Person‐centred caregiver singing for people living with dementia in South Africa: A mixed methods evaluation of acceptability, feasibility, and professional caregivers' experiences

Stuart‐Röhm,

Clark,

Baker

2023

Health Expectations

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“…The experiential nature of learning is also identified by Ridder and Bøtker ( 59 ) in providing Person Attuned Music Intervention (PAMI) training for professional caregivers, who note that “knowledge may seem irrelevant until they experience how it works” ( 59 ). Krøier et al ( 60 ) also identify helpful areas of focus for learning to attune through music: tempo, timing, and dialogue. For family dyads, this learning process is made more complex by the personal nature of the proposed intervention, and the challenges of integrating intentional approaches to music in the home-based setting.…”

Section: Discussionmentioning

confidence: 99%

Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study

et al. 2023

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An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3–6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads’ supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.

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“…Attunement is linked to the person-centered approach to care and understood as an emotional phenomenon where carers relate to the needs and emotions of the person with dementia. In addition, adjustments in tempo and timing within the interaction between carers and person with dementia are described as essential for attunement to happen ( 49 ).…”

Section: Research Processmentioning

confidence: 99%

Person-attuned musical interactions (PAMI) in dementia care. Complex intervention research for constructing a training manual

et al. 2023

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IntroductionMusic is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the “caring culture” but often lack professional training in verbal and non-verbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in non-verbal communication with persons with late-stage dementia in residential care home contexts.Research processWith a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centered dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation.ResultsThe result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory.DiscussionWith increased knowledge about caring values and non-verbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed.

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Conceptualizing attunement in dementia care: a meta-ethnographic review

Cited by 13 publications

References 36 publications

Person‐centred caregiver singing for people living with dementia in South Africa: A mixed methods evaluation of acceptability, feasibility, and professional caregivers' experiences

Person‐centred caregiver singing for people living with dementia in South Africa: A mixed methods evaluation of acceptability, feasibility, and professional caregivers' experiences

Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study

Person-attuned musical interactions (PAMI) in dementia care. Complex intervention research for constructing a training manual

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