Research

Research – Java Music Club

The research for the Java Music Club program was carried out through the Department of Gerontology at Simon Fraser University in British Columbia, Canada.1 The study was funded in part by the Michael Smith Foundation for Health Research and the Social Sciences and Humanities Research Council of Canada.

A mixed methods qualitative process evaluation was used, encompassing focus groups, systematic observation of six resident groups, individual resident interviews (N=65) and staff interviews (N=7) in three long-term care homes and an adult day centre. Staff received training and followed a manual which enhanced their ability to facilitate standardized group sessions.

Study participants reported positive benefits and themes generated included spending time together (versus being lonely), getting to know one another better, gaining new respect and understanding for one another, giving and receiving support, unloading their burdens and learning new coping skills. Group observations showed increased active participation during and after the sessions. In their interviews, staff revealed an overall positive experience and described how the unique program structure fostered sharing on a deeper level and how it empowered residents with moderate to severe cognitive impairment.

Read the abstract of the research published in the Journal of Applied Gerontology here: http://jag.sagepub.com/content/early/2012/06/13/0733464812446866

Participation of those with Cognitive Impairment
Almost all participants in the research study had some form of cognitive impairment and close to half had moderate to severe cognitive impairment. Observations of six individuals with indicators of severe cognitive impairment revealed that they were comfortable in the groups even though their communication skills were limited. They were able to respond to concrete questions, engage with the music and remain attentive to the sharing as it went around the group. There were observed signs of empathy from the more able residents toward those with impairment and this appeared to contribute to the positive engagement of all participants.

Further Research
Since the completion of the study in 2010, the Java Music Club program has been implemented across Canada and in the US in over 500 organizations. These include long term care homes (including memory care), adult day centers, assisted living and retirement centers, affordable housing, independent living and hospitals.

A one year outcomes-based study was conducted at the University of Waterloo in Ontario (Schlegel-UW Research Institute for Aging) with six care homes as research sites where 9 out of 10 quality of life indicators improved.

The University of Alaska Anchorage has also conducted a randomized controlled trial of the program in an Adult Day Center in an experimental design to assess the participation effects of 8 clients for 26, one hour sessions. The results of this pilot study presented at the Alzheimer’s Association International Conference in Copenhagen, Denmark (2014), demonstrated the value of the Java Music Club Program in providing the participants with the opportunity of sharing their feelings and providing peer support to one another, adding to their quality of life. Read more here: http://hosting.uaa.alaska.edu/afpmc/JavaMusicClub.pdf

Research – Java Memory Care

Following the implementation of the Java Music Club in numerous homes across Canada and the US, repeated request were made by the staff facilitators for an adaptation of this program for those living with more advanced dementia.

The Java Memory Care program was created and in development over a period of two years with input from staff in several long term care homes in British Columbia, Canada.

Although there were anecdotal indications of the benefits of the program, more rigorous empirical evidence was needed to produce credible evidence about the outcomes that it produced with residents living with more advanced cognitive impairment.

Thus, a two-month pilot in four nursing homes was launched in early January of 2015 to further evaluate the program and provide input for revisions.

The purpose of this pilot was to provide preliminary evidence for a feasibility study to assess the efficacy of the intervention in collaboration with the Hearthstone Institute and the LeadingAge Center for Applied Research. The aim was twofold: 1) to examine the implementation of the Java Memory Care program within residential care, and; 2) to evaluate the initial effect of the intervention with residents and staff facilitators within these settings.

Further research is underway (2015-2016) with the University of Alaska where the Java Memory Care program is the subject of a randomized controlled trial in two long term care homes in Anchorage.

Research – Java Mentorship Program

The Java Mentorship Program is a novel peer support intervention in which community volunteers and family members (from outside the residential facility, i.e., external mentors) and resident volunteers (from inside the facility, i.e., internal mentors) form a supportive team and provide mentorship and visitation to residents that are lonely or socially isolated (visitees). 2

In collaboration with the Schlegel-UW Research Institute for Aging (RIA), doctoral student Kristine Theurer is conducting a 6-month study to examine the implementation of this program in 10 Schlegel Village homes.

The aim of the present proposal is threefold: 1) to evaluate the outcomes produced by the provision of the Java Mentorship Program intervention; 2) to explore individuals’ experiences with the intervention and perceived outcomes, and; 3) to collect feasibility data to inform a future experimental study.

Design, Setting, Participants. A mixed-methods pre-post design is proposed to look at the outcomes associated with the Java Mentorship Program among 120 mentors and 120 visitees in 12 residential care settings. Using a cyclical process to provide additional understanding of the intervention, qualitative data will also be collected using a combination of observations, individual interviews with mentors and visitees, an evaluation survey among staff and mentors and staff focus groups.

Outcomes and Analysis. The primary outcome measure for mentors will be depression and secondary outcomes will be measures of loneliness, sense of purpose, sense of belonging and social identity using a pre-post test. For residents visited, the primary outcome will be depression and the secondary outcomes loneliness and social engagement using a pre-post test. Outcome measures will be assessed at baseline, 3 months and 6 months. A repeated-measures analysis of variance will be performed to analyze these data. The qualitative data analysis will include identifying a thematic framework, making comparisons within and between cases, rearranging the categories under themes and mapping and interpreting the data as a whole.

Implications. It is predicted that participation in the Java Mentorship Program will decrease depression and loneliness enhance social engagement in resident mentors and visitees as well as enhancing sense of belonging, sense of purpose and social identity among the mentors.

Published Refereed Papers – Kristine Theurer

1 Theurer, K., Wister, A., Sixsmith, A., Chaudhury, H., & Lovegreen, L. (2012). The development and evaluation of mutual support groups in long-term care homes. Journal of Applied Gerontology, 33(4), 387-415. doi: 10.1177/0733464812446866

2 Theurer, K., Mortenson, B., Stone, R., Suto, M., Timonen, V., & Rozanova, J. (2015). The need for a social revolution in residential care. Journal of Aging Studies, 35, 201-210. doi: 10.1016/j.jaging.2015.08.011

Theurer, K., & Wister, A. (2010). Altruistic behavior and social capital as predictors of well-being among older Canadians. Ageing & Society, 30(1), 157-181. doi: 10.1017/S0144686X09008848

Cook, M., Gutman, G. M., O’Rourke, N., Theurer, K., Bachner, Y., & Kasprow, P. (2007). Cognitive status and the psychological well-being of long-term care residents over time. Paper presented at the Annual Conference of the Canadian Association on Gerontology, Calgary, Alberta.

O’Rourke, N., Gutman, G. M., Theurer, K., Cook, M., Kasprow, P., Bachner, Y. G., & Caspar, S. (2009). Cognitive status and the psychological well-being of long-term care residents over time. Aging & Mental Health, 13(2), 280-287. doi: 10.1080/13607860802154549

Books

Theurer, K. (2002). The bells are ringing: The Magic of Using Handchimes in Music Therapy for People Living with Dementia. RR Donnelley, Vancouver.