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Pilot dementia program helping residents and carers alike

Harmony in the Bush project supporting people with
Photo: Pilot dementia program helping residents and carers alike
With rising rates of dementia placing immense pressure on residential aged care facilities, a new pilot program is making a big difference to the lives of both residents and staff.

The researchers behind Harmony in the Bush, a study led by Flinders University in five nursing homes in Queensland and South Australia, developed a person-centred, non-pharmacological program which incorporates different interventions, including personalised music selections.

“The music intervention makes them calmer, and it makes them happy…  you see smiles on their faces. And of course, they sing along.”

“[One] particular person I’m talking about – when the music is played, you can see she lights up and her mood level is quite high, and she’s engaged with what’s going on”, said one staff member in anonymous feedback.
Lead researcher Dr Vivian Isaac told HealthTimes that “we started this program in response to community consultation feedback on the need to improve care for persons with dementia in nursing homes.”

“We looked at meaningful ways to help those living with dementia to live full, with dignity, and enjoy their lives.”

“We realised the value of co-designing interventions with residents and their families and therefore developed the program based on principles of person-centred care and personalised music.”

More than one-third of the residents reported mild-severe pain and mild-severe sadness before the intervention.

The focus on resident-centered therapies, rather than drug interventions, led to less dysfunctional behaviours and psychological symptoms in the trial group of 74 people living with dementia and reduced stress reported by the 87 staff in aged care homes who took part in the study.

“The Harmony in the Bush model is effective in reducing agitation among dementia residents with the important spinoff of significant reduction in staff stress levels in nursing homes in rural Australia,” said Dr Isaac.

Another staff member commented that “[from] when we started the program, I’ve seen a huge improvement – the residents are calmer now.”

They added that “behaviours have nearly completely stopped with some of them.”

“We had, what, four or five residents on ‘wanderers’, and we’ve only got two on now. So, that’s a big difference. That’s a big ‘yee-ha!’”.

In Australia, 60-70% of the people residing in nursing homes have dementia and about 70-90% of residents with dementia suffer from psychiatric or behavioural symptoms.

“The study found that the model gives staff a structure to learn person-centred practice over about one month to reduce the impact of behavioural and psychiatric symptoms of dementia”, Dr Isaac said.

“The results show a statistically significant decline in aggressive behaviours, physically non-aggressive behaviours, and inappropriate verbal behaviour, hiding or hoarding – with a similar reduction in staff stress and resident safety when resources for specialised dementia care may be limited”. 

For another carer involved in the pilot, the impact on stress reduction has been profound.

“It’s not so stressful or overwhelming working there anymore”, they said.

“And trying to keep to task, you feel better when you go home because at the end of the day they’ve had a great time and they’ve gone to bed. I am happy and contented”.

Dr Isaac said there are several reasons behind the success of Harmony in the Bush.

“Staff education and training on person-centred dementia care; awareness of the impact of stress on behaviours provided the carers with the knowledge and skills to care for persons with dementia.”

“Also, that the intervention can be easily implemented by nursing and aged care staff with limited resources ensured the success and sustainability of the program.”

Further studies will now explore the cost-effectiveness and reliability of the model in more detail.

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Charlotte Mitchell

Charlotte is a published journalist and editor, with 10 years of experience in developing high-quality content for national and international publications.

With an academic background in both science and communications, she specialises in medical and science writing. Charlotte is passionate about creating engaging, evidence-based content that equips the community with important information on issues around healthcare, medicine and research.

Over the years, she has partnered with organisations including the Medical Journal of Australia, Cancer Council NSW, Bupa, the Australasian Medical Publishing Company, Dementia Australia, MDA National, pharmaceutical companies, and state and federal government agencies, to produce high-impact news and clinical content  for different audiences.