Alzheimer's disease or related dementias (ADRD) are often accompanied by behavioral and psychological symptoms, such as agitation. This course will describe agitation and its impact on the individual and families. It will provide strategies on how to decrease and/or prevent the frequency and severity of agitated episodes in older adults who are diagnosed with dementia.
Learning Outcomes:
- Identify the negative impact of agitation on an older adult with dementia, his/her family caregiver, and the nursing staff.
- Discuss the conceptual foundation for the effects of stress on persons with Alzheimer's disease or related dementias (ADRD) as postulated in the Progressively Lowered Stress Threshold (PLST) model.
- Recognize indicators of agitation and identify at least one method to assess and monitor agitation in patients with dementia.
- Discuss the mid-range theory that underlies the use of individualized music for the management of persons with ADRD.
- Identify assessment measures to determine the appropriateness of individualized music as an alternative intervention for the management of agitation.
- Identify the evidence-based guideline for implementing individualized music.
- Discuss the importance of including family in the planning of care.
Author and Content Reviewer Biographies:
Linda A. Gerdner PhD, RN, FAAN
Linda Ann Gerdner PhD, RN, FAAN pioneered the use of individualized music as a nonpharmacological intervention to manage agitation in persons with Alzheimer's disease and related disorders (ADRD) in the early 1990s. To advance this work, she published the Mid-Range Theory of Individualized Music Intervention for Agitation (IMIA) that includes testable propositions. This was followed by a rigorous study to test the mid-range theory using an experimental repeated measures pretest-posttest crossover design to compare the immediate and residual effects of individualized music to classical “relaxation” music relative to baseline on the frequency of agitated behaviors in older persons with ADRD. Thirty-nine subjects were recruited from six long-term-care facilities in Iowa. A repeated measures analysis of variance with Bonferroni post hoc test showed a significant reduction in agitation during and following individualized music compared to classical music. This study was the recipient of an International Psychogeriatric Association / Bayer Research Award at the 1999 conference in Vancouver, Canada and published in International Psychogeriatrics. In 2009, this manuscript was identified as the 4th most highly cited article in this journal. A follow-up article with accompanying commentary by N. T. Lautenschlager was published to recognize this achievement.
In 1996, Gerdner initially published an Evidence-Based Protocol for Individualized Music Dementia. This 61-page guideline is now in its 7th edition and includes 146 references. An extensive appendix includes all the tools necessary for implementation of individualized music, including two versions of the copyrighted “Assessment of Individualized (Personal) Music Preference” originally published in 2000 and updated by Gerdner, Hartsock and Buckwalter in 2021. The first version of the questionnaire may be answered by the care recipient directly. If the degree of cognitive impairment prevents this, a family version is also available.
The intervention has been empirically and clinically tested by scholars in an expanding number of countries. Japanese researchers expanded the evaluation of individualized music to include biophysiological measures and concluded the findings supported Gerdner's Mid-Range Theory. Individualized music been empirically and clinically tested by scholars in an expanding number of countries. Gerdner authored, an illustrated story book to teach the basic principles of individualized music to children and their family. This knowledge is translated into an age-appropriate story that is engaging and empowering to the child. The book is intended to help children cope with the challenging behaviors associated with Alzheimer's disease and to provide a new model of support to assist in promoting a positive relationship with a person diagnosed with Alzheimer's disease. Author notes directly relate to and build on contents presented in the story strengthen its educational value. Gerdner formerly served as Chief Science Officer, Director of reMindA.I. Music Therapeutics in New York, NY and is currently patron to the Music and Brain Foundation in Victoria, Australia.
Lindsay Guertin MSN Ed, RN, CNE, CNEcl has been a registered nurse for 17 years. She has worked in various settings including medical-surgical, sub-acute, long-term care and nursing education. Her passion includes educating others on dementia and Alzheimer's care since this is a unique population with specific needs. She participates in the Walk for Alzheimer's every year to raise money towards finding a cure for Alzheimer's disease.
Tiago Manuel Horta Reis da Silva, MSc, MBA, MScTCM, RN, FRSM, SFHEA is a Lecturer in Nursing Education (AEP) in the Department of Adult Nursing. Before joining King's in August 2019, worked in other HEI and NHS. Tiago qualified as BSc (HONS) in Nursing and Traditional Chinese Medicine (TCM). He holds an MSc in Emotional Intelligence, Counselling and NLP and MBA. An MSc in TCM and multiple post-graduations in Higher Education. Tiago holds the following qualifications: MSc, MBA, MScTCM, PGDipSFC, PGDipHE, PGCertHE, PGDipTCM, PGDip TNM, BSc (HONS) (Nurs), BSc (HONS) (TCM), RN, FRSM, SFHEA, MBAcC. Interests in Nursing Care of Older People; Emotional Intelligence and Integrative Medicine.
