The ask: Department for Health and Social Care to embed music for dementia into social prescribing.
Dementia is one of the great public health and social challenges of our times. It is the leading cause of death in England and Wales. Across the UK, 850,000 people are estimated to be living with dementia, projected to be 1million by 2021, and 2+million by 2050. Two thirds of people live at home, alone or with family carers whose health and wellbeing are also affected. ¹
There is a growing body of national and international evidence that demonstrates the power of music to significantly improve the lives of people living and effected by dementia. It is the leading cause of death in the UK ², and a larger cost to the NHS than cancer and heart disease combined ³ for which there is no effective pharmacological solution. The Utley Foundation is determined to make music accessible to everyone living with dementia by 2020 through a variety of musical interventions. The range is wide; from participating in music therapy provided by a state registered music therapist, to live music with trained musicians to personalised playlists on devices. The latter is proven technology, ready for roll out on a national scale, and has the potential to make an immediate and significant difference to the social prescribing landscape.
What the DHSC can do now to achieve this:
- Back the Music for Dementia 2020 campaign. Work with the Utley Foundation Taskforce to develop a strategy by the end of 2020 to embed music for dementia into social prescribing
- Call now for everyone living with dementia to be supported in building a ‘personal playlist’
The likely outcomes of this will be:
- More time – Enable more GPs to manage the demand on their services by being aware of musical social prescribing options for people living with dementia.
- Personalised care – Enable GPs to further deliver personalised care around the needs of individuals living with dementia through the better use of resources.
- Quality of care – Improved quality of life for people living with dementia through providing greater choice around care e.g. reduced use of pharmacological interventions and improved access to nonpharmacological interventions.
- Building stronger communities – improving individual health and wellbeing to build stronger communities.
¹ Alzheimer’s Research UK – Leading charity calls for action as dementia becomes the UK’s biggest killer
² Alzheimer’s Research UK – Dementia Statistics Hub – Numbers of people in the UK
³ Alzheimer’s Research UK – Dementia Statistics Hub – Cost and projections in the UK and globally
Dementia and Social Prescribing
The recent NHS strategy was perceived by dementia charities to be silent on the condition although people living with it are appearing already in almost every part of the health and care systems, often treated by people without specialist geriatric or dementia training. No new drugs have been launched in decades and there are none anticipated soon. Concerns remain around the inappropriate use of psychotropic medication. The National Dementia Strategy calls for a reduction in medication nationwide within UK care settings and highlights the importance of non-pharmacological interventions.¹
Social prescribing is therefore a highly relevant and potentially transformative avenue for policy interventions within dementia, specifically, to increase the use of music. There is a growing evidence base for efficacy and a range of activities already exist that are well suited to referrals e.g. formal music therapy, live music schemes, personal playlists, community initiatives such dementia choirs and the Alzheimer’s Society ‘Singing for the Brain’.
For people living with dementia, music is a necessity. Neurologically it stimulates multiple parts of the brain at once, including areas among the last to be affected by dementia.¹ It is person-centred, enabling and empowering, and more costeffective when compared to the prescribing and administering of medications. ²
Two systematic reviews were published in 2017. The first found that ‘among sensory simulation interventions, the only convincingly effective intervention for reducing behavioural symptoms (specifically agitation and aggressive behaviour) was music therapy’.³ The second study showed “music intervention significantly reduces agitated behaviours in demented people.” 4
The Utley Foundation and the International Longevity Centre – UK, established the Commission on Dementia and Music which reported in January 2018.5 Chaired by crossbench peer Baroness Greengross, the Commission involved senior experts in health, dementia and music, and conducted two ‘sold out’ public evidence hearings at the House of Lords. The report confirmed the largely untapped potential of music to transform care and improve wellbeing of people living with dementia and those who care for them alike. It concluded the current landscape is ‘characterised by devoted advocates operating in a complex and poorly coordinated ecosystem’. The Utley Foundation is taking action on this by establishing the Music for Dementia 2020 campaign to coordinate efforts with the formation of a taskforce, strengthening of the evidence base (particularly around the health economy impact), and raising awareness of music’s powerful potential to change the lives of people living with dementia.
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¹ Health University Utah – Music activities regions of the brain spared by Alzheimer’s disease
² National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence – Joint publication: Dementia – Supporting people with dementia and their carers in health and social care
³ BMJ Journals – systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series
4 Pedersen, S. et al. (May 2019) Effects of Music on Agitation in Dementia: A Meta-Analysis. Frontiers in Psychology.
5 International Longevity Centre – What would life be – without a song or dance, what are we?