Melbourne Conservatorium of Music - Theses
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ItemAn exploration of people with dementia and their family care partners’ experiences of shared home-based music( 2023-06)This dissertation describes an emergent project exploring how people living with dementia and their family care partners experience shared musical activities. With an increasing number of people with dementia residing in the community, family members play a key role in providing support for daily living as family care partners. There is, therefore, a recognised need to support the wellbeing of both people living with dementia and their family care partners. Music interventions uniquely support mood, memory and communication for people with dementia. However, little is known about how sharing music might support people with dementia and their family care partners as dyads. This thesis sought to address this gap through two qualitative studies: a thematic synthesis of the literature and a hermeneutic phenomenological study. This research was situated within a larger study examining a 12-week home-based music intervention (HOMESIDE), where I played dual roles as a researcher and music therapist. The thematic synthesis was conducted first to inform later stages of the research. My thematic synthesis explored how dyads experience shared musical activities across a range of contexts, including community settings, residential aged care, and the home. An analysis of 13 qualitative studies found that shared musical activities supported the individual and collective wellbeing of dyads through fostering connection. The findings informed the development of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. This model captured the relationship between dyads’ contexts, their experiences of sharing music, and their wellbeing. In my second study, I conducted a hermeneutic phenomenological exploration of the shared musical experiences of six dyads participating in HOMESIDE. I recruited dyads I had worked with as a music therapist to utilise the rapport we had developed. Data was collected through music-based interviews to capture dyads’ musical and non-verbal experiences in the moment. Additional data was collected from the HOMESIDE study including dyads’ intervention diaries and semi-structured interviews. To explore and build on the Contextual Connection Model, this data was analysed using an abductive and relational-centred approach to hermeneutic phenomenological analysis. Through this analysis, I developed fifteen themes to capture dyads’ experiences of shared home-based musicking. These fifteen themes 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. These findings added depth, nuance and novelty to the Contextual Connection Model, leading to the development of the Revised Contextual Connection Model of Musicking for People Living with Dementia and Their Family Care Partners. This revised model conceptualises dyads’ experiences of musicking as cyclical and ecological, with nuanced outcomes including supported wellbeing, changed relationships to music, and challenging experiences. This study also provided insights into dyads’ process of learning to use music as a resource. This thesis provides theoretical and practical insights into dyads’ experiences of sharing music in the home and broader contexts. My research highlights the complexity of dyads’ shared musical experiences, and the central role of connection through musicking in supporting their wellbeing. It also locates the unique role of music therapy within the evolving landscape of music in dementia care. These understandings may support future development and refinement of therapeutic music interventions for dyads.
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ItemThe accumulative effects of music therapy on dementia-related speech deficits in a sub-acute hospital setting( 2011)A single blinded randomised control trial was conducted to determine the accumulative effects of Music Therapy on dementia-related speech deficits. The hypotheses to be tested whether a programme of MT will result in greater improvement in dementia-related spontaneous speech deficits (in particular naming), than a programme of DT and 2) whether a programme of either MT or DT will result in a reduction in dementia-related spontaneous speech deficits (in particular naming) compared to a non intervention (control) group. Fifty-one participants with moderate to severe dementia, were randomised into 3 groups, one being the control group, the other two groups receiving either Music Therapy (MT) or Diversional Therapy (DT) (referred to as Recreational Therapy in the USA). The 45 to 60 minute Music Therapy and Diversional Therapy sessions were run concurrently every Monday, Wednesday and Friday morning for 3 weeks by the author, a Registered Music Therapist or a Diversional Therapist. The Music Therapy sessions consisted of MT techniques previously used in Music Therapy dementia-related language studies, which included singing familiar songs, word cueing, instrument playing, music and reminiscence and music and movement. The Diversional Therapy activities were based on cognitive activities, physical stimulation and creative expression through arts and crafts activities. Data was collected at baseline and within 48 hours of the final session by the chief investigator and the research assistant. Data was generated by the following validated and standardised tools for the field of dementia: the Boston Naming Test Short Form (Mack, Freed, Williams, & Henderson, 1992), the Animal Naming Test (Spreen & Strauss, 1998), the Mini Mental State Examination (Folstein, Folstein, & McHugh, 1975), Geriatric Depression Scale, short version (Sheikh, 1986; Yesavage et al., 1983) and the Digit Span Test (Hunsley, Hanson, & Parker, 1988). Using a one-way repeated ANOVA the changes in the scores of the MT group were compared to the DT group (hypothesis 1), and score changes in both the MT and DT group were compared to the non-intervention (NI) group (hypothesis 2). Results of the one way repeated ANOVA did not support the two hypotheses. Changes in the scores of the secondary outcome measures using a one way repeated ANOVA also did not support the two hypotheses. Possible reasons for the null hypotheses are discussed including the research design, choice of research tools, and the challenges faced when conducting research studies within the dementia population. This study, with its large participant numbers and stringent research design significantly contributes to MT research literature. This study is also the first of its kind to define the MT technique of “word cueing”. Recommendations for future MT and dementia-related language deficits are discussed.