JMIR Publications

ABSTRACT

Background:

Individuals with Alzheimer’s disease or related dementia (ADRD) represent a significant and growing segment of the older adult (65+) population. In addition to physical health concerns, including comorbid medical conditions, these individuals often exhibit behavioral and psychological symptoms of dementia (BPSD). The presence of BPSD in long-term care residential facilities can disrupt resident care and impact staff. Non-pharmacological interventions such as personalized music and tablet engagement maintain cognitive function, improve quality of life (QOL) and mitigate BPSD for older adults with dementia. Evidence of the impact of such interventions in Assisted Living Communities (ALCs) is needed for widespread adoption and sustainment of these technologies.

Objective:

The goal of this evaluation was to assess the impact of Music & Memory’s personalized music and tablet engagement (PMATE) program on QOL, agitation and medication use for residents living in six Wisconsin ALCs.

Methods:

The data collected was on the utilization of iPod’s and iPad’s by resident. Resident outcomes were assessed using the Pittsburgh Agitation Scale (PAS), the Quality of Life in Late Stage Dementia (QUALID) scale, and self-reported medication use. A mixed methods approach was utilized to examine the impact of the PMATE program on these outcomes. Descriptive statistics were calculated. A paired t-test explored changes in resident QOL. A one-way analysis of variance (ANOVA) was utilized to examine changes in resident agitation and QOL based on resident utilization of the PMATE program. Qualitative interviews were conducted with the individuals responsible for PMATE implementation in the ALC. Residents excluded from the analysis were those who passed away, were discharged or refused to participate.

Results:

Five apps, based on average times used by resident, were identified. Four of the five apps were rated as being useful to promote resident engagement. PMATE utilization was not associated with changes in resident agitation levels or antipsychotic medication use over time. Over a three-month period, the change in resident QOL was significant (p=0.047) and the differences across ALCs was also significant (F = 3.76, p = 0.018). High utilizers of the PMATE program (> 2,500 minutes over three months) show greater improvements in QOL as compared to low utilizers (a change of -5.90 points versus an increase of 0.43 points). The difference was significant (p = 0.03). Similar significant findings were found between the high and mid utilizers.

Conclusions:

The study is one of the first to explore the impact of Music & Memory’s PMATE program on residents living in ALCs. Findings suggest that higher utilization over time improves resident QOL. However, a more comprehensive study with improved data collection efforts across multiple ALCs is needed to confirm these preliminary findings.