1. Dementia

• Substantial decline in 1 or more cognitive domains
• Sufficient to interfere with independent daily living
• With or without behavioural disturbance

2. Interventions

The main aim for intervention:

• to prevent “excess disability” (i.e. more disability than associated with the actual degree of brain damage) 
• to promote functional improvement and self-sufficiency in patients’ daily life 
• to maintain QoL for both the patient and their family

2.1 Interventions for supporting memory

• Internal strategies
  ▸ Attention
  ▸ Time
  ▸ Repeating information
  ▸ Links
  ▸ Ordering information
  ▸ Thinking back or ahead
• External strategies
  ▸ Fixed places
  ▸ Notebook
  ▸ Agenda
  ▸ Digital alarms
  ▸ Whiteboard 

2.2 Interventions for supporting cognition

• Functional training
  ▸ Practising specific tasks, many repetitions 
• Memory training is driven by implicit memory/conditioning
  ▸ Errorless learning (ask for cues instead of guessing) rely on implicit association 
• Reality Orientation Therapy (ROT)
  ▸ Group sessions that include repeated information about time/location, personal information
  ▸ Gained negative reputation: too confrontational 
• Reminiscence Therapy
  ▸ Based on early memories, activities/events/experiences
  ▸ Use of pictures/music
  ▸ Involves family caregivers
  ▸ Highly rated by staff and participants

2.3 Methods of intervention

• Stimulation:  regular activity sessions, usually in groups, aimed at general enhancement of cognitive & social functioning
• Training: guided practice on a set of standard tasks, individual or in a group, intended to increase specific functionality
• Rehabilitation: personally relevant goals are identified, and an individual the plan is made to attain these goals, with an emphasis on increasing everyday quality of life
  However, the effectiveness of each intervention method is highly dependent on the stage of dementia. In addition, there is limited scientific literature to back up the effectiveness of these methods.

3. Sensory Stimulation

Dementia often results in changing sensory experiences. Thus, engaging stimuli has shown to be helpful for neuro-rehabilitation, focusing on activation, engagement, communication and enriching the environment. Unisensory stimulation encompasses therapies involving music, light and aromatherapy. 

Multi-sensory stimulation is a growing practice in dementia care. Examples include snoezelen, sensory garden, etc.

4. Music Intervention

Music psychology (or music cognition) investigates human musical responses and behaviour. Music is perceived by different regions of the brain acting together. Music intervention consists of several elements such as

• Emotion: Music has been well documented as a mood modulator. It can also be considered as an alternative mechanism for communication. Music has a great potential for facilitating communication and joint activity
• Attention: Music inherently tends to engage a person completely. The tendency for whole-body engagement can help facilitate movement regularization. Moreover, the inherent repetitive structure of music is ideal for supporting the movement. Music can also be used as a distraction from negative stimuli such as pain. It can also induce a predictive behaviour in an attempt to guess the evolution of a musical piece over time.
• Psychological: Music can help in neural activation as studies have shown that similar areas in the brain are activated for movement and processing music. This can also result in conditioning linked automatic responses.

4.1 Designing Music Intervention

Several factors have to be considered while designing a music intervention such as 

• Whether it is an active or passive intervention
• Whether it should be personalised depending on the person or a generic intervention
• Whether the music should be live or recorded
• If repetition of familiar or same tracks over time is better than the introduction of new tracks
• What is the end goal of the intervention

For our project, music is being used for several purposes:

• Bringing the user back to reality (attention)
• Linking music to different activities (psychological)
• Calming down the user (emotional)