Can Music Therapy Help Improve Outcomes in Nursing Homes?

Three years ago, filmgoers were charmed by the story of a non-profit that helped nursing home residents relive their youths and improve their moods through music. Now, a team of Brown University researchers is setting out to discover whether the program could have concrete medical benefits for seniors — and operational opportunities for skilled nursing providers.

Music & Memory, a Mineola, N.Y.-based organization, provides iPods for nursing home residents to listen to their favorite music, with the goal of bringing back happy memories and boosting their overall quality of life. The group’s work was featured in a 2014 movie, “Alive Inside: A Story of Music & Memory,” which received positive reviews and won the Audience Award at the Sundance Film Festival.

While the film serves as anecdotal evidence of the program’s promise, Brown’s Center for Long-Term Care Quality & Innovation (Q&I Center) will soon launch a multi-year project to study the actual effects of the Music & Memory program on reducing antipsychotic drug use and improving behavior among nursing home residents.

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Funded by a $3.7 million grant from the National Institute on Aging, the Brown team will establish a pilot program at four nursing homes, with a planned expansion to 60 more in the years ahead. The goal, according to Q&I Center associate director Rosa Baier, is to build on previous research that provided less-than-detailed results.

A retroactive start

Baier and her colleagues at Brown examined the effects of Music & Memory on nursing home care in a retroactive study last year, comparing outcomes at nursing homes that had completed the non-profit’s certification program and those that hadn’t.

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The results were intriguing: Facilities that had gone through the Music & Memory process saw increased numbers of residents ending the use of antipsychotic drugs, as well as declines in behavioral problems, though there appeared to be no change in rates of depression.

But that analysis had limitations. Baier and the team only knew that the facilities had been certified or not — with no additional details about the certified SNFs’ programs, how many residents participated, or even what kinds of music they loaded onto their iPods. The new study will provide the Brown team with a wide variety of data points, including nursing home assessment information and the iPods’ metadata, as well as direct interviews with employees and residents.

“So while the retrospective evaluation was suggestive of an effect, doing this kind of work prospectively will allow us to more proactively capture information,” Baier told Skilled Nursing News.

Once the study gets past the pilot stage this year, Brown will partner with four large skilled nursing providers to conduct randomized tests: Some facilities within the networks will begin right away, while others will have the program phased in after a delay. Baier declined to name the providers, but said that working with larger operators allows them to more easily roll out the study in waves.

A philosophical fit

The new study fits in neatly with the Q&I Center’s mission — which, according to Baier, focuses primarily on searching for empirical backup to long-term care strategies that have shown promise in theory.

“This is an example of collaborating with someone with an intervention that has been adopted broadly but hasn’t been proven effective, and we do this often in collaboration with groups of providers who are interested in helping to establish the evidence base for interventions — and then spread success,” Baier said.

Aside from quality-of-life improvement, Baier said the program could show whether or not treating SNF residents with music can reduce the need for antipsychotic drugs, which in the past has been a key area of focus for the Centers for Medicare & Medicaid Services (CMS).

“I think people are really looking to non-pharmacologic approaches to working with residents with dementia,” Baier said. “[If the program can] improve some of the quality measures, it will be another tool in their arsenal to care for these residents.”

Written by Alex Spanko

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