Global Ageing Network Excellence in Applied Research

The Global Ageing Network Excellence in Applied Research recognizes research focused on understanding and/or solving challenges and needs in provider settings or that can influence service and supports. Research must demonstrate a commitment to “giving back” to the field by sharing research findings with peers.

The Integrace Institute is the nonprofit research and education arm of Integrace, a family of vibrant senior living communities in Maryland, recently affiliated with Acts Retirement-Life Communities. The Integrace Institute’s mission is to transform neurocognitive living through person-centered research, education, and partnerships. With over 20 years of expertise, the Integrace Institute serves Integrace’s communities by building an evidence-based platform for care practices and education. In addition, it partners with universities, technology, pharmaceutical companies, and other senior living organizations outside of Integrace to conduct community-based research studies, provide interactive learning experiences for professionals and caregivers, and consult with other organizations to build innovative models that support meaningful living. Recently, the Institute has shifted its focus to an internal investment in applied research that is shared with the greater community through internal and external learning opportunities.

One of the Institute’s research projects is the Effects of Personally Meaningful Music on Mood and Behavior in Individuals with Dementia study aimed to determine if personally-meaningful music is effective in improving mood and behavior, and if a person-centered approach to music-based interventions is feasible in individuals with dementia. This project took place from 2017-2019. Driven by inspiration from colleagues of Integrace, the study was designed around an operational challenge about what music is best to play for residents with dementia: a person’s personal preference or a staff selection of a genre or style of songs based on an individual’s generational identity. The Institute sought input from the Johns Hopkins Center for Music & Medicine in 2017 to design a scientifically rigorous, person-centered methodology. Results are currently being shared with all stakeholders internally and externally through adult-centered learning opportunities. The research had unique approaches to design, engagement, and operational relevance in a provider setting prior to and during implementation. Due to our unique location and investment within a senior living community, partnership and engagement with staff was advantageous. They were the inspiration of the development of this question: what kind of music is appropriate to play in our setting? After the study team collected meaningful songs from each of the participants and their families, nursing staff’s music preferences were incorporated by having them choose the song. This may be the only music study has been designed with this as a control. Integrace’s approach to engagement was unique in that individuals who have dementia are not often offered choice in provider settings when a part of an intervention, and the engagement allowed for one-on-one communication and interaction in a private area. Nursing staff were also able to adapt to a time that suited the resident according to their natural rhythm in a person-centered manner while also using assent procedures to obtain permission prior to engaging with them in the study.

The results from the study were translated into practice internally amongst staff, throughout the greater community, and externally to providers and researchers in other long-term care settings. Internally, playlists and songs were shared with recreation and engagement staff to implement into resident daily routines, including small group activities and one-on-one engagement. Most Integrace residents and families consider music important and being able to visually see responses to a specific song has helped the staff see the benefits of this intervention in residents with dementia.

By translating this research into practice, one key discovery is that exposure to personally-meaningful music results in increased opportunities for meaningful living, engagement and independence for our residents living with dementia, as well as their families and our staff. As mentioned previously, Amazon Echos have been installed throughout Integrace, and residents are now encouraged to ask the Echo to play their personally-meaningful playlist, which includes the song used in the study and other artists and genres they personally enjoy, rather than just generic music from their era. Residents are benefitting from this new technology, regardless of the stage of their disease. Those who have experienced a decline in verbal communication as their disease has progressed have been able to react to the music and show emotion by smiling, tapping their feet or calling out in joy. Families have been empowered to listen to personally-meaningful music with their loved one and are using their playlists to travel back in time and recall fond memories together. Integrace colleagues have been using the Echos to listen to playlists during group activities, like preparing for meals, as well as portable Echos to play meaningful music for one-on-one activities of daily living, such as bathing or dressing, to reduce anxiety and stress for the residents. As we are uniquely positioned to be able to observe Integrace residents using the Observed Emotional Rating Scale, we have been able to monitor how incorporating personally-meaningful music into daily activities and engagement is continuing to generate an increase in expressions of emotion and general alertness in this population.

Integrace Institute will receive the Excellence in Applied Research Award at the 2019 Global Ageing Network/OLTCA Conference which takes place on September 18-20 in Toronto, ON, Canada