The HOMESIDE Music Intervention: A Training Protocol for Family Carers of People Living with Dementia

Abstract

Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads.

The Influence of Home-Based Music Therapy Interventions on Relationship Quality in Couples Living with Dementia—An Adapted Convergent Mixed Methods Study

“…This study uses some elements of the HOMESIDE research protocol, and the same music training program [ 26 ]. In HOMESIDE, dyads randomised to the music therapy intervention, in which one member of the dyad has dementia, share music experiences two to five times weekly for 12 weeks in their homes [ 32 ].…”

“…The difference in delivery modality may be seen as a study limitation. However, all music therapists followed the same intervention protocol with a personally tailored program for each couple [ 26 ].…”

“…This gave highly individualized programs for each couple, within a person-centred and resource-oriented frame [ 35 , 36 ]. Four main music activities were offered and explored: singing, movement to music, playing instruments, and relaxation to music [ 26 ]. During the training sessions the music therapist and the couple or CG planned together what kinds of activities the couple should try out and use by themselves before the next training session, the planned duration and frequency of their music activities, and the music therapist advised them on useful approaches and techniques.…”

“…Some couples used all four activities, while others used one or two, based on their personal preferences and the assessed needs. The couple’s own musical preferences always guided the music therapist’s instructions and advice [ 26 ]. To document the couple’s use of music at home when the music therapist was not present, the couples were to record their music activities in a diary.…”

“…Research shows how music therapy and engagement in music activities support people with dementia to maintain and improve social engagement in close relationships and with their local community [ 21 , 22 , 23 ]. Shared music experiences between couples have been shown to be beneficial for quality of life and well-being, mood, and communication within home-based settings [ 24 , 25 , 26 ], institutional settings [ 27 ], and community group therapy settings [ 28 , 29 , 30 ]. Relationship quality is thematised and discussed in all these studies, though not necessarily as the primary outcome.…”