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Introduction: Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the “caring culture” but often lack professional training in verbal and nonverbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in nonverbal communication with persons with late-stage dementia in residential care home contexts. Research process: With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centred dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation. Results: The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory. Discussion: With increased knowledge about caring values and nonverbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed. Introduction: Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the “caring culture” but often lack professional training in verbal and non-verbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in non-verbal communication with persons with late-stage dementia in residential care home contexts. Research process: With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centered dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation. Results: The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory. Discussion: With increased knowledge about caring values and non-verbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed.

Public interest in the benefits of music for people with dementia has rapidly increased in recent years. In addition to clinical work with clients, music therapists are often required to support and train staff, families, and volunteers and skill-share some music therapeutic skills. Six music therapy researchers from six countries agreed it was timely to organize a roundtable and share their indirect music therapy practice and examples of skill-sharing in dementia care. This article was developed following the roundtable at the World Congress of Music Therapy in 2017 and further discussion among the authors. This process highlighted the diversity and complexity of indirect music therapy practice and skill-sharing, but some common components emerged, including: 1) the importance of making clinical decisions about when direct music therapy is necessary and when indirect music therapy is appropriate, 2) supporting the transition from direct music therapy to indirect music therapy, 3) the value of music therapy skill-sharing in training care home staff, 4) the need for considering potential risks and burdens of indirect music therapy practice, and 5) expanding the role of music therapist and cultivating cross-professional dialogues to support organizational changes. In indirect music therapy practice, a therapist typically works with carers and supporters to strengthen their relationships with people with dementia and help them further develop their self-awareness and sense of competence. However, the ultimate goal of indirect music therapy practice in dementia care remains the wellbeing of people living with dementia.

A person who has dementia may also have aphasia and severe communicative disabilities with the risk of leading to social isolation. This study explored the music therapeutic process with a person with dementia and aphasia in order to understand how music therapy may facilitate communication and dialogue. In an explorative hermeneutic case study, new understandings to the music therapy process were added and led to the identification of the improvisation method known as extemporizing described by Tony Wigram. In a subsequent literature review extemporization was explored and is suggested as a valuable method for providing a safe ground for the person with dementia and hereby facilitating engagement in communicative dialogues and in this way meeting psychosocial needs.

A person who has dementia may also have aphasia and severe communicative disabilities with the risk of leading to social isolation. This study explored the music therapeutic process with a person with dementia and aphasia in order to understand how music therapy may facilitate communication and dialogue. In an explorative hermeneutic case study, new understandings to the music therapy process were added and led to the identification of the improvisation method known as extemporizing described by Tony Wigram. In a subsequent literature review extemporization was explored and is suggested as a valuable method for providing a safe ground for the person with dementia and hereby facilitating engagement in communicative dialogues and in this way meeting psychosocial needs.

to the 9th European Congress of Music Therapy in Oslo 7 - 10 August 2013TitleModel of learning for practitioners in dementia care with music therapy and interdisciplinary collaboration as the joint focal point- With focus on enhancing quality of life and wellbeing for persons with dementiaThis presentation is based on a PhD research project in progress, which aims to develop a model of learning for practitioners in dementia care, which has music therapy as the joint focal point and focus on the relational meeting. Through development of an interdisciplinary collaboration between the music therapist and the care providers in connection with a course of music therapy, following areas will be elucidated: How can the musical and interpersonal competencies of the individual care provider be developed with the purpose to effect the relational meeting with persons suffering from dementia, in a way that the care provider is able to develop and transfer new knowledge and acquired skills to the daily nursing and care through the application of tangible tools from the musical activities? And further: What impact does the emphasis on development of the care provider’s musical and interpersonal competencies have on quality of life and well-being among persons suffering from dementia?The model of learning includes using the Dementia Care Mapping Method and the theoretical frame of reference for the project; e.g. theory of senses of self, forms of vitality, retrogenesis and the recent research on mirror neurons. Methodically the project is organized as a case study of a music therapy course, which includes process data, outcome data and follow-up data.Preliminary results indicate that the care providers are able to develop and transfer new knowledge and acquired skills to the daily nursing and care through the application of tangible tools from the musical activities.References: Brooker, D. og Surr, C. (2007). Dementia Care Mapping: Principper og praksis. Oversættelse og udgivelse: Danmarks Institut for Ældrepædagogik (Daniæ). 1.udgave. 1.oplag 2007.Nors, A., Ottesen, Aa. M. & Weberskov, B. (2009). Demens - den anden frekvens: Inspiration for pårørende (1. udgave). Kbh. Fænø Lighthouse Projects. Ridder, H.M. & Ottesen, Aa. M. (2012). Vitalitetsformer og spejlneuroner – anvendt i læringsmodel for professionelle omsorgsgivere. Tidsskriftet Dansk Musikterapi 9 (2), p. 3 – 13.Ridder, H. M. O., Wigram, T., & Ottesen, Aa. M. (2009). A pilot study on the effects of music therapy on frontotemporal dementia–developing a research protocol 1. Nordic Journal of Music Therapy, 18(2), 103-132. This contribution aims to give insight in what actually happens in clinical music therapy with people suffering from dementia. Starting from a psychodynamic point of view, the focus is laid on how musical improvisation can contribute to the development of a therapeutic relationship with this specific population. Findings from an ongoing phenomenological study on video-fragments of individual music therapy-sessions with people with dementia will be used to present important clinical phenomena. The advantages of a conceptualization of these phenomena for clinical work and the necessity of it for interdisciplinary collaboration will be illustrated.

Nogle demenssygdomme rammer især de forreste dele af hjernen, hvilket hos den enkelte person kan medføre svære psykiatriske symptomer. Der findes ingen specifik behandling af grundsygdommene for disse frontotemporaledemenstilstande, og symptomatisk medikamentel behandling af de psykiatriske symptomer er vanskelig og kræver høj faglig specialisering. Fra Rigshospitalets Hukommelsesklinik anbefales at behandling af personer med frontotemporal demens primært bør have karakter af psykosociale tiltag. Da der ikke er tilstrækkelig dokumenteret forskning, der undersøger den effekt non-farmakologisk behandling kan have på målgruppen, søges der i et pilotprojekt en afprøvning af kombinerede dataindsamlingsmetoder med henblik på at udvikle en forskningsprotokol der undersøger relationelle møder i terapeutiske behandlingssituationer. Projektet er rettet mod både klinisk musikterapi såvel som det gerontopsykiatriske sundhedsprofessionelle omsorgsarbejde. I en litteraturgennemgang udvælges ADRQL som et anvendeligt demensspecifikt instrument til måling af livskvalitet. Instrumentet afprøves i pilotprojektet med to personer med frontotemporal demens. På baggrund af erfaringerne fra projektet, hvor der trianguleres med CMAI, NPI og videoanalyser, gives anbefalinger til en protokol til effektvurdering af musikterapi.