Project Investigators Dr. Margaret MacAndrew
Year: July 1, 2016
Partners Queensland University of Technology (QUT)
Walking is an enjoyable activity that provides health benefits. However, for a person with dementia who expresses wandering behaviour, they can walk so far that they cannot eat enough to meet their level of activity or navigation problems mean that they are not able to find their way back to a safe environment or the person may enter places that are dangerous or where they may not be welcome.
Under such circumstances walking becomes a risky activity and is known as ‘risky wandering’. Dementia-related wandering affects nearly all residents with dementia in aged care at some point in their admission and is known to result in malnutrition, exhaustion, sleep deprivation, injury from falls, and becoming lost or trapped. In addition, in residential aged care (RAC), wandering can result in the person with dementia entering other residents’ bedrooms, which can lead to verbal and physical altercations and reduced quality of life for the person who wanders and other residents. Despite there being strong evidence that a person with dementia who expresses wandering behaviour can experience potentially life threatening outcomes , there are few evidence based ‘best practice’ care guidelines for residents with dementia who wander in RAC and this vulnerable population remains at risk.
This pilot study is part of a program of applied research that will test if non-pharmacologic interventions that are effective at reducing other behaviours of dementia can be used to reduce ‘risky wandering’ in RAC. The evidence from this study will be used to refine intervention protocols that meet the unique needs of persons with dementia who wander in preparation for larger scale trials. Ultimately findings will inform guideline development for the RAC practice environment.
There is considerable evidence that listening to preferred music helps to reduce agitation in people with dementia. There is also evidence that agitation and wandering are very different. It therefore cannot be assumed that a person with dementia who wanders will respond to listening to music as a person with dementia who is agitated. Nor do we know if it is possible to use an intervention protocol designed for people with dementia who are agitated with people with dementia who wander.
This study aims to see if the listening to preferred music protocol previously trialled with people with dementia who are agitated can be adapted to meet the needs of people who express wandering behaviour and if this intervention reduces ‘risky wandering’ which includes excessive walking and entry into other resident’s private space.
The intervention will be conducted at two aged care facilities in Brisbane (12-15 participants: 6-8 per facility) and will run over six weeks per facility (weeks 1&2 baseline information; weeks 3-5 deliver intervention; week 6 post intervention information). Residents with a medical diagnosis of dementia, who enjoy listening to music, who are known to wander and intrude on the private space of others, will be invited to participate.
Each participant will listen to their choice of music for 20 minutes 5 days a week for 3 weeks. At facility 1, participants will listen to the music 30 minutes before their most active period and at facility 2, participants will listen to the music at randomly allocated times. To see if listening to preferred music reduces the frequency of walking as well as entry into other residents bedrooms, before and after intervention measures of frequency of walking (collected by a pedometer that will be worn throughout the 6 week program) as well as where the participant visits while walking (each participant will be observed for 2 hours 2 x per week throughout the program) will be collected.
We will also collect information about immediate pleasure from listening to music and agitation. Family member and staff perceptions of the impact of the intervention as well as feedback regarding possible modifications to make to the intervention to ensure continued use after the project is completed, will be sought through interviews at the completion of the program.Read the Final Report
Successful DCRC grant recipient 2016
Other team members:
Prof Ann Kolanowski, Pennsylvania State University (USA)
Prof Kimberley Van Haitsma, Pennsylvania State University (USA)
Dr Gerard Byrne, University of Queensland
Prof Nancy Pachana, University of Queensland