PAMI aims and objectives

PAMI aims and objectives

Dementia is a neurocognitive disease with a high risk of social isolation due to loss of cognitive functions and consequently possibly symptoms of agitation or depression. Too often symptoms are treated medically without first trying the efficacy of psychosocial interventions. Adverse effects may be further social isolation, creating a vicious circle. Consequently, the research group aims to explore a psychosocial model of care based on a humanistic, person-centred theoretical approach, aiming to outline how mutual interactions lead to identity maintenance in persons with dementia.

Personhood is “a standing or a status that is bestowed on one human being, by another in the context of relationship and social being” (Kitwood 1997, p. 8) and for people with dementia, the concept of personhood offers them an ethical status and value that is central to the person-centred approach as understood by Tom Kitwood (1997) and in his way of defining concrete positive interactions. The concept of inter-action is key to a person-centred psychosocial approach and refers to the building of personal relationship and facilitation of mutual engagement. Seminal researchers have added to a psychosocial theoretical model of dementia (Brooker, 2007; Brooker et al., 2007; Moniz-Cook et al., 2011; Vernooij-Dassen et al., 2010) also by exploring psychosocial fixed factor (life events) and psychosocial tractable factors (mood, mental stimulation, personal and social psychology, and environment) (Spector & Orrell, 2010). McDermott, Orrell and Ridder (2014) explored these factors and the experience, meaning and value of music for people with dementia from the perspectives of family carers, staff, music therapists and people with dementia themselves. Music has the capability to engage, not only as an aesthetic product, but also as a basic means of human communication. This is not so much about what is communicated, but about how communication takes place and may be described in terms of for example tempo, phrasing, pitch, and melodic contours. In order to integrate a person-centred understanding of reciprocal non-verbal communication we use the term person attuned musical interaction, PAMI.

The research group aims to investigate which theoretical, clinical and methodological elements that define PAMI between persons with dementia and their carers. This is investigated through the following research questions:

  1. How can PAMI be formulated as concrete interdisciplinary methods for nursing home caregivers?
  2. Which elements of PAMI contribute to support identity maintenance and mutual interaction in persons with dementia? 
  3. How can caregivers implement PAMI and which learning and supervision models are relevant for the implementation process?
  4. How can PAMI theoretically be understood and related to current care philosophies and music therapy theory? 
  5. Which evaluation and assessment tools can be used to indicate change (or effect) due to PAMI?

The success criteria of the project are the following:

  1. Formulation of one or more clear and realistic clinical manuals to be implemented in the health care system. The manuals should include person-centred care values, clear concepts, interdisciplinarity, precise implementation plans, basis for evidence based practice, and precise method descriptions in an integrated approach.
  2. A contribution to international dementia care where there at present is a gap in valid, reliable and theoretically sustained methods to represent so-called non-pharmacological methods.
  3. A contribution to future rigorous international multicentre research studies where the manuals may serve as standardized treatment interventions.

Methodologically a qualitative, explorative study design is applied, integrating various data types (audio-/video material, interviews, workshops, consensus meetings and observation). The aim is to develop, evaluate and implement manuals for carers, specifying Person Attuned Musical Interaction.