Problem Identification and Description Using PICOT Format Essay

Since I’ve been a nurse in hospital settings for the past 20 years, either in acute care or long-term acute, I have always noticed that my patients both young and old, all enjoyed and appreciated that I play music for them when I’m in the room longer than 5 minutes.  They also enjoy a quick back rub when it’s time to turn or a 5-10-minute back massage when they can’t seem to fall asleep or get comfortable.  I feel that music and touch has been very therapeutic in relaxing the patients and for this next few weeks, I would like to focus on the benefits and healing influence they have on people with Alzheimer’s or other dementias in a board and care settings that are under hospice care or services. Problem Identification and Description Using PICOT Format Essay

The problem that I see here is that not all Alzheimer’s patients are introduced to this service and some are still using pharmacological measures to help manage their behavior, therefore, my PICOT question here is:  For people with dementia, do non-pharmacological interventions such as music and massage therapy compared to pharmacological treatments produce benefits in the quality of end of life care?

It is estimated that by 2025, there will be approximately over 16 million Americans with dementia or Alzheimer’s Disease and by 2050, there will be two types of people, the dementia and the ones caring for the dementia.  There are many stages of AD and they progress differently but not all stages are experience by all persons with AD.  Dementia or AD is diagnosed when that individual is gradually developing difficulties with memory, thinking, language and daily activities.  Predominantly, people with dementia exhibit behavioral symptoms such as disruptive vocalization (screaming), repetitive questions, restlessness, wandering, pacing and physical aggression towards self or others.  These associated issues with behavioral and emotional problems are what tend to reduce elderly with dementia quality of life. Problem Identification and Description Using PICOT Format Essay

Currently, there are a wide range of treatment and interventions being use by healthcare professional and caregivers including chemical and physical restraint for behavioral symptoms, but these can lead to risk for falls in the elderly with AD, therefore it is better to incorporate non-pharmacological intervention such as music and massage therapy.

It has been confirmed that when the dementia is severe, it may be difficult for the ones suffering from AD or dementia to communicate verbally.  According to some research, it has been proven that even when people with “dementia may no longer speak, they may still be able to hum or play along with music.”

Music is known to be the universal language that people of all ages can relate to and enjoy.  Its value however can go beyond simple listening.  Music can bring out certain memories, feelings and evoke different sensations.  It has been found to be very beneficial for older adults with various type of dementia.  According to the founder and executive director of Center for Music Therapy in New York, elder clients either meeting individually or within a group “express themselves and recall the memories that music sparks and stimulates.”  John Carpente, the founder of the Center for Music Therapy believes that by listening to live music and being involved in live music-making experiences, a greater quality of life is possible.   He also found that music “empowers his clients to emerge from the isolation imposed by Alzheimer’s disease and dementia.”  He also noted that music therapy is used to improve the overall mental and physical wellbeing of the dementia clients including memory recall, positive changes in moods and emotional states.  In addition, it improves a sense of control over one’s life, it manages pain and discomfort and stimulates and promotes interest even when other approaches are ineffective.  It also promotes periodic and continuous movement or vocal articulacy and allows for opportunities to intermingle socially with others. Problem Identification and Description Using PICOT Format Essay