Home-based family caregiver-delivered music Interventions for people living with dementia.

INTERVENTION: Music Intervention (MI) will be provided to participant dyads allocated to the first intervention. Family caregivers (CGs) will receive a 2‐hour home‐based MI training session where a music therapist will instruct the CGs on methods and strategies for using music to assist the person living with dementia (PwD) to become calmer (if agitated) or more energised (if apathetic). CGs will be instructed on how to choose music and engage the PwD in effective and respectful discussions with the aim of evoking autobiographical memories and sharing meaningful experiences. Strategies to engage PwD and create opportunities for meaningful dialogue with the PwD will be provided, as well as training CGs to notice the PwD’s positive and negative responses to music. The activities to be taught comprise: a) singing familiar/preferred music followed by CG‐facilitated discussions about the meaning of the songs for the dyad, the PwD, and significant others, and any associated memories; b) movement to music (e.g. upper body and arms imitating familiar dance movements to music) to assist in regulating arousal; and c) listening to familiar/preferred relaxing or enlivening music dependent upon behavioural and psychological symptoms of dementia (BPSD) present at the time to assist in regulating arousal. The PwD will not be present during the training session. Following training, the CG will try out some of the methods learned with the PwD while the music therapist is still present, and the music therapist will offer feedback and further guidance to enable the CG to experience the activities in action with immediate support from the music therapist. The session will take at least 60 minutes and up to 90 minutes and will continue until the CG feels confident to deliver the intervention unsupported. CGs are then instructed to deliver the MI at least 5x per week for approximately 30 mins over a 12‐week period. At 3‐weeks and 6‐weeks post allocation, the MI trainer will return to the dyad’s home f CONDITION: behavioural symptoms of dementia;depression;psychological symptoms of dementia;Lewy Body's Disease; ; behavioural symptoms of dementia ; depression ; psychological symptoms of dementia ; Lewy Body's Disease Neurological ‐ Alzheimer's disease Neurological ‐ Dementias Neurological ‐ Other neurological disorders PRIMARY OUTCOME: behavioural and psychological symptoms of participants living with dementia as assessed by changes in Neuropsychiatric Inventory Questionnaire[baseline, 12 weeks (primary time‐point), and 6 months after intervention commencement] INCLUSION CRITERIA: 1) dyads where one member of the dyad has a diagnosis of: dementia (Alzheimer’s Disease [AD], Frontotemporal Dementia, Vascular Dementia [VD], Lewy Body Disease, or mixed dementia) 2) people living with dementia 3) family caregivers of people living with dementia who are at least 18 years of age 4) family caregivers who are co‐habitating with the person living with dementia who are providing primary care for the person with dementia for more than 5 hours per day, for at least 5 days per week. 5) dyads are living at home and not in supported residential care SECONDARY OUTCOME: Assessment of resource use of both family caregiver and person living with dementia as measured by the Resource Utilization in Dementia.[baseline, 12 weeks, and 6 months after intervention commencement] assessment of the quality of adjusted life‐years of family caregiver and person living with dementia as assessed by the EuroQoL instrument[baseline, 12 weeks, and 6 months after intervention commencement] changes in family caregiver resilience as measured by the Resilience Scale[baseline, 12 weeks, and 6 months after intervention commencement] changes in levels of depression in people living with dementia as assessed by Montgomery Asberg Depression Rating Scale[baseline, 12 weeks and 6 months after intervention commencement] changes in quality of life in the participant living with dementia as assessed by the Quality of Life‐Alzheimer's Disease[baseline, 12 weeks, and 6 months after intervention commencement] changes in the quality of caregiver and person with dementia's relationship as assessed by the Quality of the Caregiver‐Patient Relationship.[baseline, 12 weeks, and 6 months after intervention commencement] Family Caregiver sense of competence in caregiving as measured by Sense of Competence Questionnaire Short Form[baseline, 12 weeks, and 6 months after intervention commencement] Quality of Life of family caregiver as assessed by the Assessment of Quality of Life‐6D[baseline, 12 weeks, and 6 months after intervention commencement] symptoms of depression in the family caregiver as assessed by the Patient Health Questionnaire‐PHQ‐9[baseline, 12 weeks, and 6 months after intervention commencement]