The Effect of Expressive and Instrumental Touch on The Behavior States of Older Adults with Late-Stage Dementia of The Alzheimer's Type and on Music Therapist's Perceived Rapport

Abstract

The purpose of this study was to examine the effect of music therapy interventions utilizing two types of touch, expressive touch and instrumental touch, on the behavior states of older adults who have late-stage dementia of the Alzheimer's type. A secondary purpose of this study was to examine the perceived effectiveness of the music therapist when expressive and instrumental touch was employed during music therapy sessions. A within-subject design was used with 9 participants receiving 3 sessions in each of the experimental conditions: no touch, expressive touch, and instrumental touch. Results of a one-way ANOVA revealed that expressive touch was significantly more effective during the initial session in eliciting and maintaining alert behavior states than the instrumental and control conditions; however, there were no significant differences between the experimental and control conditions during the first and second session repetitions. Rapport ratings revealed that the therapist's client rapport was perceived to be significantly higher during both the expressive touch and instrumental touch conditions than during the control condition. These findings have important implications for music therapy practice and the effective use of nonverbal communication.

Efficacy of music therapy in the neuropsychiatric symptoms of dementia: systematic review

“…Seven out of the 12 studies used a randomized method [9][10][11][12][13]16,19 , and the other trials used various designs such as withinsubject design 15 , controlled trial 17 , a longitudinal repeated measures design with an experimental and control group 18 , crossover study 20 . One study did not mention the method applied 14 .…”

“…Elderly with uncategorized dementia [9][10][11][12][13] , AD 14 , vascular dementia 14,17,20 , mixed 17 dementia, in mild 16 , moderate 9,11,13,15,[18][19][20] and severe 9,11,13,15,[18][19][20] stages, male and female, living in nursing [9][10][11][12][13][16][17][18][19] or residential 20 homes and in treatment in-day center 20 , tertiary hospital 14 and hospice program 15 . …”

“…The studies showed the use of active group 10,[12][13][14][17][18][19][20] , active individual 9,11 , receptive group 19 and receptive individual 9,15,16 MT interventions.…”

“…There was also significant improvement on delusions 17,20 , agitation 17,20 , anxiety 17,20 , apathy 17,20 , irritability 17,20 , aberrant motor activity 17,20 , night-time disturbances 17,20 , other neuropsychiatric symptom 20 , behavior 14 and depression 14 . One study showed positive results in eliciting and sustaining participants' alert behavior in the instrumental touch condition 15 . In three studies, there were no significant differences on agitated behaviors 12,18 and on neuropsychiatric problems 9 (Table 2).…”

“…Most studies exploring the benefits and efficacy of MT interventions among PwD are focused on the context of neuropsychiatric symptoms [9][10][11][12][13][14][15][16][17][18][19][20] , such as agitation 11,12,18,20 , depression 10,16 or anxiety 16,19 . Other studies are focused on cognitive functions 21,22 , quality of life (QoL) 23 and wellbeing 24 .…”