Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia

Abstract

Objectives The objective of this study was to compare resident outcomes before and after implementation of an individualized music program, MUSIC & MEMORYSM (M&M), designed to address the behavioral and psychological symptoms associated with dementia (BPSD). Design: Setting 98 nursing homes (NHs) trained in the M&M program during 2013 and 98 matched-pair comparisons. Participants Long-stay residents with Alzheimer’s disease and related dementias (ADRD) residing in M&M participating facilities (n=12,905) and comparison facilities (n=12,811) during 2012–2013. Intervention M&M is a facility-level quality improvement program that provides residents with music specific to their personal histories and preferences. Measurements Discontinuation of anxiolytic and antipsychotic medications, and reductions in behavioral problems and depressed mood in 2012 (pre-intervention) and 2013 (intervention), calculated using Minimum Data Set (MDS) assessments. Results The proportion of residents who discontinued antipsychotic medication use over a six-month period increased from 17.6% to 20.1% among M&M facilities, while remaining stable among comparison facilities (15.9% to 15.2%). The same trend was observed for anxiolytic medications: discontinuation of anxiolytics increased in M&M facilities (23.5% to 24.4%), while decreased among comparison facilities (24.8% to 20.0%). M&M facilities also demonstrated increased rates of reduction in behavioral problems (50.9% to 56.5%) vs. comparison facilities (55.8% to 55.9%). No differences were observed for depressed mood. Conclusions These results offer the first evidence that the M&M individualized music program is associated with reductions in antipsychotic medication use, anxiolytic medication use, and BPSD symptoms among long-stay NH residents with ADRD.

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