When (if) to stop?: Music therapy with persons living with severe dementia – Reflections on years of care and connection

ABSTRACT

Introduction

Working with a person living with dementia over the years presents a significant challenge for the music therapist, particularly in determining the appropriate duration of intervention. This challenge is compounded by the evident deceleration process experienced by the person, necessitating a high degree of sensitivity and adaptability from the therapist.

Method

This article draws on the author’s extensive experience as a music therapist, spanning individual sessions lasting from 6 to 14 years with the same person. Insights gleaned from clinical moments over this duration highlight challenges inherent in long-term therapeutic interventions.

Results

The therapeutic relationship developed over the years enables the music therapist to adjust the intervention progressively to the client’s evolving needs and remain attuned despite challenges in interpreting the person’s responses during severe dementia.

Discussion

This reflection emphasizes the relevance of music therapy in providing continuous care for persons with severe dementia, acknowledging the inherent challenges of such interventions.

KEYWORDS:

• Music therapy
• severe dementia
• palliative care
• caregiving
• ethical considerations

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ “the inner voice of music therapist as an internal supervisor” (Darnley-Smith, 2014, p. 59).

² The specific scales for dementia that currently exist show some difficulty in capturing these subtle and sporadic signals such as Hillebrand et al. (2023); O’Kelly and Bodak (2016); McDermott et al. (2014a).

Additional information

Funding

No funding was received for this study.

Notes on contributors

Maria Gabriela Nicolau

Maria Gabriela Nicolau is an experienced certified music therapist in the field of aging, dementia, and palliative care. She has extensive experience in intergenerational interventions with persons with dementia and in providing long-term support for those living with dementia. She provided training for formal and informal caregivers of persons with dementia. She has presented her clinical work at music therapy conferences and is the author of the book “Através da Música – uma perspectiva terapêutica [Through music – A therapeutic perspective]”. Chiado Editora, 2017.