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  • 1.
    Engström, Gabriella
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Florida Atlantic University.
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Williams, Christine
    Florida Atlantic University.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Evaluation of communication behavior in persons with dementia during caregivers’ singing2011In: Nursing Reports, ISSN 2039-4403, Vol. 1, no 4, p. 15-20Article in journal (Refereed)
    Abstract [en]

    The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWDs

  • 2.
    Engström, Gabriella
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institute, Sweden .
    Williams, Christine
    Florida Atlantic University.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    The Impact of Singing in Caring for a Person With Dementia: Single Case Analysis of Video Recorded Sessions2011In: Music and Medicine, ISSN 1943-863X, Vol. 3, no 2, p. 95-101Article in journal (Refereed)
    Abstract [en]

    Music Therapeutic Caregiving (MTC), when a caregiver sings for or together with a resident with dementia, has been used to enhance communication between caregivers and residents. This single case study measured communication in a resident with dementia during “usual” and MTC morning care. Video observations of 8 weekly sessions, consisting of 4 recordings of usual morning care and 4 recordings of morning care with MTC intervention provided the data. The Verbal and Nonverbal Interaction scale was used for analysis. Under the MTC condition, the resident’s positive verbal and nonverbal communication increased by 23%. Furthermore, negative verbal and nonverbal communication, decreased by 80%, compared to the “usual” morning care sessions. Under the MTC condition, the resident was able to remember words to songs and singing with the caregiver occurred in 39 of the 40 observed minutes. The findings indicate that MTC could be an effective nursing intervention in dementia care.

  • 3.
    Eva, Götell
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Brown, Steven
    Ekman, Sirkka-Liisa
    The influence of caregiver singing and background music on vocally expressed emotions and moods in dementia care: a qualitative analysis2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 4, p. 422-430Article in journal (Refereed)
    Abstract [en]

     Background: Music and singing are considered to have a strong impact on human emotions. Such an effect has been demonstrated in caregiving contexts with dementia patients. Objectives: The aim of the study was to illuminate vocally expressed emotions and moods in the communication between caregivers and persons with severe dementia during morning care sessions. Design: Three types of caring sessions were compared: the "usual" way, with no music; with background music playing; and with the caregiver singing to and/or with the patient. Participants and setting: Nine persons with severe dementia living in a nursing home in Sweden and five professional caregivers participated in this study. Methods: Qualitative content analysis was used to examine videotaped recordings of morning care sessions, with a focus on vocally expressed emotions and moods during verbal communication. Results: Compared to no music, the presence of background music and caregiver singing improved the mutuality of the communication between caregiver and patient, creating a joint sense of vitality. Positive emotions were enhanced, and aggressiveness was diminished. Whereas background music increased the sense of playfulness, caregiver singing enhanced the sense of sincerity and intimacy in the interaction. Conclusion: Caregiver singing and background music can help the caregiver improve the patient's ability to express positive emotions and moods, and to elicit a sense of vitality on the part of the person with severe dementia. The results further support the value of caregiver singing as a method to improve the quality of dementia care.

  • 4.
    Götell, Eva
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thunborg, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Örebro University, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Can caregiver singing improve person transfer in dementia care2012In: Music and Medicine, ISSN 1943-8621, Vol. 4, no 4, p. 237-244Article in journal (Refereed)
    Abstract [en]

    Everyday person transfer situations involving persons with dementia and their caregivers can be reciprocally problematic. Group interviews with professional caregivers were conducted, focusing on the caregivers’ experiences of singing during person transfer situations with residents with dementia, and a qualitative content analysis was performed. The caregivers expressed that compared to everyday transfer situations without singing, there were obvious differences during singing. When the caregiver sang, communication was mutually enhanced between the caregivers and the residents. Caregivers reported that residents seemed to show their true personalities, were able to move more fluidly and easily, seemed to better understand what was going on, and reacted with a spirited cheerfulness. The caregivers experienced themselves as more competent in and motivated to provide care in addition to positive emotions and moods. Caregiver singing during transfer situations may be one of several suitable nonpharmacological interventions that can be utilized when caregivers need to assist persons with dementia in transfer.

  • 5.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Emami, Azita
    College of Nursing, University of Seattle, USA.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Communicating through caregiver singing during morning care situations in dementia care2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 1, p. 160-168Article in journal (Refereed)
    Abstract [en]

    It is well known that persons with dementia (PWD) have problems expressing and interpreting communication, making interaction with others difficult. Interaction between PWD and their caregivers is crucial, and several strategies have been investigated to facilitate communication during caregiving. Music therapeutic caregiving (MTC) - when caregivers sing for or together with PWD during caregiving activities - has been shown to enhance communication for PWD, evoking more vitality and positive emotions. The aim of this study was to describe how PWD and their caregivers express verbal and nonverbal communication and make eye contact during the care activity 'getting dressed', during morning care situations without and with MTC. Findings revealed that during the situations without MTC, the caregivers led the dressing procedure with verbal instructions and body movements and seldom invited the PWD to communicate or participate in getting dressed. Patterns in responses to caregivers' instructions included both active and compliant responses and reactions that were resistant and aggressive, confused, and disruptive. In contrast to the 'ordinary' morning care situation, during MTC, the caregivers seemed interested in communicating with the PWD and solicited their mutual engagement. Although verbal communication consisted of singing about things other than getting dressed, e.g. dancing, love, sailing, God, the PWD mostly responded to caregivers in a composed manner, by being active, compliant, and relaxed, though some were also resistant or incongruent. The authors conclude that MTC could be a way for PWD and their caregivers to successfully interact and co-operate during caring situations, as it seems to evoke enhanced communication for both partners in this context

  • 6.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Emami, Azita
    University of Seattle.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Finding the key to communion – Caregivers’ experience of ‘music therapeutic caregiving’ in dementia care: A qualitative analysis2011In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 10, no 1, p. 98-111Article in journal (Refereed)
    Abstract [en]

    ‘Music therapeutic caregiving’ (MTC), when caregivers sing for or together with persons with dementia (PWDs) during caring situations, has been suggested as a way to reduce PWDs’ behavioral and psychological symptoms of dementia (BPSD). An intervention was designed to elucidate what influences MTC might have on PWDs and their caregivers. The aim was to describe professional caregiverś experiences of caring for PWDs during morning care situations without and with MTC. Group interviews were conducted, and a qualitative content analysis was performed. Two themes were revealed. The first (without MTC), Struggling for care in communion, encompassed four sub-themes: Hampered communication; Physical and mental struggle with aggression; Struggling with ethical demands; and The reward — consolation and love. The second theme (with MTC), Consolidating care in communion, encompassed two sub-themes: awakening cooperation, and feeling of well-being. The authors conclude that MTC could be used to help caregivers provide improved care.

  • 7.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Emami, Azita
    College of Nursing, University of Seattle, USA.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations2010In: The Open Nursing journal, ISSN 1874-4346, no 4, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.

     

  • 8.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Emami, Azita
    Seattle Univ, Coll Nursing.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    The impact of caregivers' singing on expressions of emotion and resistance during morning care situations in persons with dementia: an intervention in dementia care2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 7-8, p. 969-978Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim was to describe expressions of emotions and resistiveness to care among persons with dementia (PWD), during morning care situations without and with music therapeutic caregiving (MTC). BACKGROUND: Effective caregiving is dependent on the interpersonal relationship between nurse and patient. PWD suffer from major cognitive impairment, making interaction with others problematic. Such patients often react with problematic behaviours such as resistance and anger towards the care activity and the caregiver. Earlier research suggests that MTC - when caregivers sing for or together with PWD during caregiving - can reduce resistance and evoke positive emotions in PWD. DESIGN: This was an intervention study whereby MTC was implemented during morning care situations while PWD were being cared for. METHOD: The study included ten, 66-92-year-old men and women with severe dementia living in a nursing home in Sweden. Video observations of eight weekly sessions, consisting of four recordings of usual morning care and four recordings of morning care with MTC, provided data. The resistiveness to care scale and the observed emotion rating scale were used for analysis. RESULTS: Pull away was the most common resistant behaviour under both conditions. The PWDs' expressions of resistant behaviour, such as pull away, grab object and adduction, were significantly reduced under the intervention situation. Positively expressed emotions, specifically pleasure and general alertness, significantly increased under the MTC intervention compared with the 'usual' morning care sessions. CONCLUSIONS: MTC can be an effective nursing intervention to provide PWD a more pleasant experience of morning care situations as it decreases resistant behaviour and increases positive emotions. RELEVANCE TO CLINICAL PRACTICE: MTC offers a potential non-pharmacologic treatment that can be used in caring for PWD.

  • 9.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Singing while caring for persons with dementia2011In: Arts & Health, ISSN 1753-3015, Vol. 3, no 1, p. 39-50Article in journal (Refereed)
    Abstract [en]

    Persons with dementia (PWDs) can suffer from major cognitive impairment, but are known to retain an ability to express both negative and positive emotions. Negative expressed emotions and resistance make caregiving problematic. Music Therapeutic Caregiving (MTC) – when caregivers sing for or together with PWDs during care – has been shown to decrease PWDs' negative expressed emotions and resistance, and increase positive expressed emotions. This single case study included two cases, two women with severe dementia, and measures expressed emotions and expressions of resistiveness to care during “usual” morning care situations and morning care situations with MTC. Video observations were conducted resulting in four recordings of usual morning care and four recordings of morning care with MTC. For analysis, the Observed Emotion Rating Scale and Resistiveness to Care Scale were used. Results revealed that in both cases, expressions of resistant behavior and negative emotions decreased, while expressions of positive emotions increased during morning care situations with MTC. The authors conclude that MTC may be an effective method for caregivers to use to facilitate care situations with PWDs, and also a way for PWDs to experience care situations as less unpleasant, and more joyful.

  • 10.
    Thunborg, Charlotta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ivarsson, Ann-Britt
    Örebro universitet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Development of a new assessment scale for measuring interaction during staff-assisted transfer of residents in dementia special care units2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, no 1, article id 6Article in journal (Refereed)
    Abstract [en]

    Background

    Mobility problems and cognitive deficits related to transferring or moving persons suffering from dementia are associated with dependency. Physical assistance provided by staff is an important component of residents’ maintenance of mobility in dementia care facilities. Unfortunately, hands-on assistance during transfers is also a source of confusion in persons with dementia, as well as a source of strain in the caregiver. The bidirectional effect of actions in a dementia care dyad involved in transfer is complicated to evaluate. This study aimed to develop an assessment scale for measuring actions related to transferring persons with dementia by dementia care dyads.

    Methods

    This study was performed in four phases and guided by the framework of the biopsychosocial model and the approach presented by Social Cognitive Theory. These frameworks provided a starting point for understanding reciprocal effects in dyadic interaction. The four phases were 1) a literature review identifying existing assessment scales; 2) analyses of video-recorded transfer of persons with dementia for further generation of items, 3) computing the item content validity index of the 93 proposed items by 15 experts; and 4) expert opinion on the response scale and feasibility testing of the new assessment scale by video observation of the transfer situations.

    Results

    The development process resulted in a 17-item scale with a seven-point response scale. The scale consists of two sections. One section is related to transfer-related actions (e.g., capability of communication, motor skills performance, and cognitive functioning) of the person with dementia. The other section addresses the caregivers’ facilitative actions (e.g., preparedness of transfer aids, interactional skills, and means of communication and interaction). The literature review and video recordings provided ideas for the item pool. Expert opinion decreased the number of items by relevance ratings and qualitative feedback. No further development of items was performed after feasibility testing of the scale.

    Conclusions

    To enable assessment of transfer-related actions in dementia care dyads, our new scale shows potential for bridging the gap in this area. Results from this study could provide health care professionals working in dementia care facilities with a useful tool for assessing transfer-related actions.

  • 11.
    Thunborg, Charlotta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ivarsson, Ann-Britt
    Örebro universitet, Sweden.
    Development of a new assessment scale measuring interactional transferrelated behavior in dementia care dyads2014In: Health, Social Welfare and Co-production at Mälardalen University, 2014Conference paper (Refereed)
  • 12.
    Thunborg, Charlotta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Reciprocal struggle in person transfer tasks: caregivers’ experiences in dementia care2012In: Nordic Congress of Gerontology in Copenhagen / [ed] Christine E. Swane, 2012Conference paper (Refereed)
  • 13.
    Thunborg, Charlotta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Reciprocal struggling in person transfer tasks: Caregivers’ experiences in dementia care2012In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 14, no 4, p. 175-182Article in journal (Refereed)
    Abstract [en]

    Purpose: This study describes caregivers’ experiences of person transfer situations involving people with dementia. Method: Qualitative focus group interviews were conducted with a total of 10 caregivers; two groups with five persons each, including two men and eight women. The resulting data were extracted and condensed into meaning units and codes using content analysis. Findings: One main theme was formulated that represents the caregivers’ experiences of person transfer situations involving people with dementia: “Reciprocal struggle in person transfer tasks”. Five categories were formulated: “Becoming familiar and making contact”, “Risking one's own body to protect the resident from injury”, “Focused yet aware of the surroundings”, “Identifying needs to facilitate the person transfer” and “Struggling to be understood”. Conclusion: Person transfer situations involving people with dementia are subject to sudden changes. The ongoing challenge is to ensure a dynamic approach that can be adapted to the needs of the person with dementia at any given time. There is a need for more studies within the field about care and rehabilitation among people with dementia. We suggest that assessment of person transfer situations involving people with dementia and their caregivers is an important issue for further investigation and physiotherapeutic interventions.

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