How a YouTube Video Began a 33% Reduction in Antipsychotic Meds in Dementia Care
One man’s reaction to his favorite music changed the way the state of Wisconsin approaches dementia care.
In 2012, the Wisconsin Supreme Court upheld an important and somewhat controversial decision. Helen E. F., a woman with Alzheimer’s disease, was locked in a psychiatric unit where she was given psychotropic medications as a result of exhibiting behavioral issues. The court ruled that she was not a proper subject for involuntary commitment. Not surprisingly, Wisconsin made some changes in dementia care.
The state convened a stakeholder summit and redesigned their dementia care system in 2013. After viewing a YouTube video, The Department of Health Services decided to contact the Music and Memory Foundation. It was not just any video—it was a viral clip from the documentary Alive Inside of Henry showing the power of personalized music for people with dementia. By January of 2014, the state had implemented the Music and Memory Foundation iPod program, providing personalized music playlists to residents in 100 care facilities. The state now has 413 care facilities with the M&M program in operation.
The effects of this change are far reaching. In 2012, Wisconsin was ranked 43rd in the list of top states complying with CMS antipsychotic medication reduction goals. Today, the state is ranked 7th. These goals not only reduce medication costs, but perhaps more importantly, they represent a more palliative approach to dementia care.
Importance of Evidence Based Studies for Public Policy
The results seen in Wisconsin are more than anecdotal. As with any public policy shift, evidence-based practices are the key. In 2016, through a grant funded by Wisconsin’s Park Family Foundation, six assisted living homes, all members of Wisconsin Coalition for Collaboration in Assisted Living were supplied with iPods for personalized musical engagement. For the first time, Music & Memory also deployed iPads to engage people with other personalized actives, such as reminiscing with photos, sharing stories and using apps to reconnect with hobbies and interests.
The Centers for Health Systems Research Analysis at University of Wisconsin, Madison led the study. The preliminary results were discussed at the annual Aging in America Conference for the American Society on Aging in Chicago this March.
As can be imagined, researching Alzheimer’s and related dementias is complicated. There were a variety of complicating factors:
- Alzheimer’s and related dementias are degenerative diseases. This means that a decline in function is continual and is to be expected. Declines in function often result in loss of quality of life, increased agitation and more medication.
- The assisted living homes were responsible for data collection. Care staff had limited training and availability for data collection.
- There was some attrition of residents in the small study. The study started with 35 and ended with results from 29.
Summary of Findings
Key findings of the research include that the introduction of Music & Memory in Assisted Living Communities impacts residents and improves interactions with staff. The data showed a statistically significant increase in quality of life for the participating residents. The results also found favorable impacts in reduced agitation, although the study is relatively small (n < 29) and more research will be needed.
There is more work to be done, but the research continues to show what so many of us in the field have experienced - making personalized connections improves quality of life for both care recipients and caregivers. If you are interested in learning more about one of newest approaches to non-pharmacological care, take a look at our ongoing work with care organizations.