Prescribe music and gardening for dementia, NICE recommends

The recommendation comes in updated quality standards published today by the National Institute for Health and Care Excellence (NICE).

“As a society there’s so much more we can do to help people live well with dementia”

Matt Hancock 

Under the guidance, healthcare professionals working with people living with dementia including community psychiatric nurses, care homes nurses and dementia advisers are expected to discuss people’s life experiences and interests to help identify activities that can help with their condition and overall wellbeing.

Nurses, healthcare assistants and others should be “aware of the activities to promote wellbeing that are available locally and, based on this discussion…help the person with dementia to choose activities that suit their preferences and needs”, said the document.

Art, baking, reminiscence therapy, music therapy and animal-assisted therapy are among the types of activities mentioned in the updated standards.

Enabling people to access stimulating and creative activities can play a key role in helping them stay healthy and independent, explained Professor Gillian Leng, deputy chief executive and director of health and social care at NICE.

“People with dementia can find it harder to take part in activities, to engage socially, to maintain their independence, to communicate effectively, to feel in control and to care for themselves. Providing enjoyable and health-enhancing activities like music or reminiscence therapy can help with this,” she said

“Understanding the activities that a person prefers and thinks are suitable and helpful, and adapting them to their strengths and needs, will make a person more likely to engage with the activities offered and therefore more likely to benefit from them,” Professor Leng added.

The quality standard also highlights the need to offer training to carers for people with dementia.

This could include education about dementia and its symptoms and the changes carers can expect to see as the condition progresses.

Skills training for carers could also include personalised strategies to help them look after their loved one, including how to respond to what can be distressing changes in behaviour.

Crucially, the standard stressed the need to provide informal carers with the support they need to manage the stresses and strains of their caring role.

“Providing enjoyable and health-enhancing activities like music or reminiscence therapy can help”

Professor Gillian Leng

The standard features seven core “quality statements” in all including those covering diagnosis and the management of distress in people with dementia.

Other statements cover efforts to raise awareness of the condition and steps that can be taken to reduce the risk of dementia.

The guidance flags up the fact there is “limited awareness among both the public and practitioners “ that making lifestyle changes can help cut the risk of developing some types of dementia, delay the onset of the condition or stop it getting worse.

Under the standard, people accessing services such as help to quit smoking should get information and advice on dementia risks.

“Making this clear in interventions and programmes that promote behaviour change, such as NHS health checks and stop smoking services, should encourage changes in behaviour in mid-life, which could lead to fewer people developing dementia in later life,” said the document.

The guidance highlights the need to ensure people with suspected dementia are referred to a specialist dementia diagnostic service.

It also emphasises the need for health and social care professionals such as nurse consultants, advanced nurse practitioners and palliative care teams to ensure people with dementia and their carers can discuss advanced care planning early on and whenever care is reviewed.

The updated standards were welcomed by health and social care secretary Matt Hancock.

“It’s important to offer tailored support as every diagnosis of dementia is as individual as those who receive it”

Paul Edwards 

“As a society there’s so much more we can do to help people live well with dementia. Whether joining a choir, gardening or enjoying art classes, so many activities can help people live and can trigger precious memories and help reconnect them with their communities,” he said.

“So I wholeheartedly endorse this new guidance, which supports the ambitions of our NHS Long Term Plan and its move to a more personalised and person-centred care,” he added. 

The new guidance as also supported by Paul Edwards, director of clinical services at charity Dementia UK. 

He said: “A diagnosis of dementia can be an isolating experience, not only for the person diagnosed but also for family carers. Activities fostering connection can make all the difference, which is why we welcome these recommendations wholeheartedly.

‘In dementia care however, it’s important to offer tailored support as every diagnosis of dementia is as individual as those who receive it,” added Mr Edwards. “Activities which take into account likes and past experiences of people with dementia can be discussed as part of a care and support programme with our dementia specialist nurses.”

https://www.nursingtimes.net/news/policies-and-guidance/prescribe-music-and-gardening-for-dementia-nice-recommends/7029519.article