More is learned every day in the field of medicine and nursing, and articles such as this one serve to point out that there is much more that needs to be learned. Serving the elderly population with Alzheimer's disease and treating them for their problems is often quite difficult, but the information in the article regarding what behaviors to look for in individuals that cannot express their pain verbally is very important for many that work in nursing homes, and for others that work with elderly Alzheimer's disease patients.
The article also helps to reinforce existing knowledge in that the instruments that are used to report pain in the elderly population have been seen for some time to be largely insufficient for many patients. For those that still communicate relatively well, this is not so much of a problem, but for patients that cannot verbally and correctly express where they hurt and how severe their pain is, the current instruments are not designed in such a way that they diagnose the problem well and provide the elderly patient with relief in most cases.
When information of this type is presented, it serves as a reminder of the problems that are being faced by the elderly, and as the elderly population grows with the longer life-spans seen by many and the aging of the baby-boomer population, the problem will only become more severe in the future. It is important, therefore, to address the problem now, before it becomes so overwhelming that many more elderly individuals with Alzheimer's disease must suffer with chronic pain because they are unable to verbally express themselves enough to receive treatment.
One of the alternative therapies that is being tried today is the combination of hand massage and calming music. A study that was conducted into this issue looked at the effect of calming music, the effect of hand massage, and the effect of both of these things together on a sample population of elderly nursing home residents (Remington, 2002). These individuals were chosen because aggressive behavior on the part of these individuals raises the cost of their healthcare, and stopping or lessening some of this behavior could keep these individuals from experiencing as many problems in the future, which will also help those that care for these Alzheimer's disease patients in their remaining years.
The method for the study exposed these individuals to either the music, the massage, or both for 10 minutes at a time in order to see whether it affected the Alzheimer's disease patients' behavior and whether the effect lasted after the treatment or therapy had ended (Remington, 2002). The results of the study indicated that nonphysical aggressiveness did decrease somewhat during and after the treatments, but that combining the music and the massage had no greater effect than simply using one or the other of the therapies (Remington, 2002). As for those patients that were involved in physically aggressive behavior, however, none of the therapies used appeared to have any significant impact on reducing this type of behavior (Remington, 2002). It seemed as though only the nonphysical behavior was helped by the music or the massage that these Alzheimer's disease patients were subjected to.
Other studies have also looked at the use of music to control fear, pain, nervousness, and other issues. Bally, Campbell, Chesnick, & Tranmer (2003) did a study that dealt with music when it came to older people undergoing frightening procedures such as those for heart problems and other troubling issues. They found that those who could listen to music (and control what they listened to) did better, had less discomfort and fear, and were not as worried when they were undergoing the procedure, showing that music therapy does work to reduce fear and agitation - something that is commonly experienced by patients with Alzheimer's disease, since they are often forgetful and uncertain about where they are, who other people around them are, and what's happening to them.
Music appears to be the most promising therapy for many people that are over the age of 65, as many of them have trouble sleeping, even if their problems are not related to Alzheimer's disease (Johnson, 2003).. A study that was conducted by Johnson (2003) was based on women that were over 70 years of age and met the criteria, both in the International Classification of Sleep Disorders and the Diagnostic and Statistical Manual of Mental Disorders, for a sleep disorder of some kind. In Johnson's (2003) study, fifty-two women made up the sample, and all of them had either trouble falling asleep, or problems with waking up frequently during the night. Some had both issues to deal with. The results of the study showed that women that were exposed to music at bedtime fell asleep faster and stayed asleep better than those that were not exposed to music, and the ability of these women to turn the music back on if they awoke during the night and it was not playing helped them to fall back into a good sleep pattern faster than they would have without the music (Johnson, 2003).
Studies like the three discussed here provide a strong indication that many older people, whether or not they are Alzheimer's disease patients, have problems that can be eased somewhat by music. Whether they are aggressive because they have Alzheimer's disease, whether they have trouble sleeping, or whether they must undergo some procedure that they are frightened of, the individuals in the studies discussed all showed in various ways that the music made them feel better about themselves and about what was going on around them. Clearly, this is something that would warrant further study in the future because of the many possibilities that could be addressed and the many people whose lives could be affected by it.
The theoretical framework for this study deals with the idea that there is much more that can often be done for individuals then is currently and commonly known to modern science and medicine. In other words, individuals that work in this area should be able to broaden their horizons to the point that they are able to accept new and different ideas of what has been and what should be, instead of simply looking only to what has already been done before. When this takes place, much more can be learned (Shankle & Amen, 2004). Individuals that work with medicine, especially nurses who spend much more time in general with patients than doctors do, should therefore look to their own willingness to examine new and interesting ideas that are safe and effective and might help some of the patients that they work with. When they do this, they also help the families of those patients and the advancement of science, but this can only take place if nurses and others are willing to suspend their original thinking about a problem and its solution so that they can take part in new and innovative treatments that can help others (Shankle & Amen, 2004). Many of these treatments are simple things that are easily done, and they can provide a great many benefits to those that utilize them. This does not mean that they will work for everyone, but since they are noninvasive, there is no real reason why they should not be tried.
Alzheimer's Foundation of America. (2008). http://www.alzfdn.org
Bally, K., Campbell, D., Chesnick, K., & Tranmer, J.E. (2003). Effects of patient-controlled music therapy during coronary angiography. Critical Care Nurse, 23(2): 50-58.