Community-Dwelling People Living With Dementia and Their Family Caregivers Experience Enhanced Relationships and Feelings of Well-Being Following Therapeutic Group Singing: A Qualitative Thematic Analysis

Abstract

The progression of dementia can severely compromise interpersonal connection and relationship quality between people living with dementia (PwD) and their family caregivers (FCG), leading to social isolation and poor quality of life for both. Therapeutic group singing (TGS) is a socially engaging, stimulating, and supportive pursuit that community-dwelling PwD and their FCG can participate in together. This study aimed to build on the findings from previous research by undertaking a thematic analysis of interviews with nine PwD (five women, four men; mean age = 79.1 years) and nine FCG (five women, four men; mean age = 75.7 years). The interviews explored participants’ perspectives and experiences of a 20-week TGS intervention, underpinned by Kitwood’s model of person-centered care. Inductive thematic analysis resulted in the emergence of five themes which described how TGS for PwD and their FCG: (1) included supportive therapeutic facilitation and design features; (2) made group singing more accessible; (3) fostered new empathic friendships; (4) enhanced relationships between PwD and FCG; and (5) led to personal feelings of wellbeing for both PwD and FCG. Affinity with others who had similar life experiences and challenges created a sense of mutual understanding and camaraderie, which made group singing accessible without fear of judgment and social stigmas. For some PwD/FCG dyads, TGS meant they could continue a lifelong passion for singing together, while others enjoyed participating in singing together for the first time. Both PwD and FCG participants described personal feelings of acceptance, improved social confidence, mood, and purpose. Further, participants valued mental stimulation from TGS such as learning new skills and memory support. A model explaining relationships between themes suggests that TGS with person-centered facilitation features for PwD/FCG dyads led to affinity among group members with ripple effects, which enhanced accessibility to group singing, the formation of empathic friendships, PwD/FCG relationship quality, and personal wellbeing for both PwD and FCG. Psychoemotional, social and cognitive benefits from TGS described by participants in this study are known to promote self-identity, healthy relationships, and quality of life. This research highlights a need for improved availability of TGS for community-dwelling PwD/FCG dyads.

Remini-Sing: A Feasibility Study of Therapeutic Group Singing to Support Relationship Quality and Wellbeing for Community-Dwelling People Living With Dementia and Their Family Caregivers

“…Results of the full thematic analysis of the qualitative interview data is published elsewhere ( 36 ). For the feasibility investigation, which is the purpose of the current paper, we will explore the qualitative results that pertain to the participants' experience of the Remini-Sing therapeutic singing group intervention, of participating in research and their experience of completing the quantitative measures.…”

“…Although we had intentionally attempted to look at the positive aspects of caregiving, rather than caregiver burden, based on the participant experience of the PACQ, we would choose to examine caregiver burden in a future study. Further, one of the major themes that emerged from our full qualitative analysis ( 36 ) was the effect of the group singing intervention on building new supportive relationships. Therefore, we would also include a measure of social connectedness in future studies in this area.…”

“…Our Remini-Sing model is based on therapeutic group singing as a form of community music therapy for people living with dementia and their family caregivers. Kitwood's 12 concepts of person-centered care ( 35 ) were used to guide the facilitation of Remini-Sing sessions [as described elsewhere ( 36 )]. As such, the Remini-Sing model is person-centered, strengths-based and process-oriented, rather than product or performance oriented, which distinguishes it from dementia-friendly community choir models ( 26 – 28 ).…”

Biopsychological Effects of Social Participation on Aging: The Role of Identity-Affirming Music and the Arts

“…Interview responses from participants in Studies 2 and 3 emphasized these findings, with frequent mentions of connecting with others, sharing personal struggles and triumphs, and feeling joy as a result of this bonding process. These social experiences are often reported in other studies of artistic interventions (Baker et al, 2018;Clark et al, 2018;Dingle et al, 2013) and it is postulated that they help promote the positive health outcomes that are also observed among study participants (Ronzi, Orton, Pope, Valtorta, & Bruce, 2018). This was especially evident in Study 6, when social identification was measured for each group membership reported by participants.…”

“…During this time, it is also important to involve caregivers if applicable, as they too can benefit from interactive, artistic programming. Indeed, social interventions can also provide caregivers with the opportunity to bond with their care recipient and to share their struggles with other carers (Baker et al, 2018;Clark et al, 2018;Dassa et al, 2018). As was observed during the reminiscence and music-making studies, caregivers enjoyed bonding with their care recipient through program activities.…”