Music Use as Therapy for Institutionalized Elderly

Francisco Fábio Marques da Silva1, Maria do Carmo Andrade Duarte de Farias2, Antônio Fernandes Filho1, Francisca Bezerra de Oliveira1, Maria Lúcia de Oliveira Bezerra1, Anúbes Pereira de Castro1, José Gleyson Pereira Moura3, Micneias do Nascimento Ferreira3, Gabriel Alexandre da Silva3, Francisco Demóstenes Abrantes Viana3, Cláudia Jeane Lopes Pimenta3, Danilo Temóteo da Silva3, Ane Iara Nonato de Sousa4, Joab Rodolfo Abreu de Farias4, Wanderson Wylly Ferreira5, Jackeline Batista de Lima5, Isadora Leite Alves Dantas4


Introduction
the world population aging has intensified rapidly in recent decades, especially in developing countries, like Brazil, which is estimated that in 2025 will be the sixth country with the highest number of elderly.
Attributed to this factor as the reduction in fertility rates and birth rates and increased life expectancy of the population [1][2].
this increase in life expectancy joined with sedentary life style of the population, caused the emergence of chronic degenerative diseases, which result in Functional Disabilities (FD) that directly influence the quality of life of individuals and are responsible for many hospitalizations, especially when regarding the elderly [1].
Functional capacity is understood as an individual's ability to perform simple day-to-day activities and includes physical, psychological and social aspects [3]. the ability in carrying out these activities reveals the level of a person's ability to be able or not to take care of himself and perform his functions and basic daily tasks.
Functional loss, lack of caregiver, presence of diseases, unfavorable socioeconomic conditions, poor family support, physical inactivity and poor health levels appear to be the main reasons that lead to institutionalization.
It is worth emphasizing that the institutionalization makes the elderly isolated from society, leads to decreased self-esteem, loss of identity and consequent devaluation of their own identity [4].therefore, the therapy, especially music and its elements, promotes better learning conditions, communication, mobility, expression and organization (physical, mental, emotional, social and cognitive) [5] and as a result, improves the relationship and social interaction within the Long-Stay Institution (LSI) [6].
the objective is to evaluating the use of music as therapy for promoting the quality of life of elderly in a Long-Stay Care Institution in the city of Cajazeiras -PB.

Method
this is an exploratory and interventionist study with a quantitative approach, performed in the elderly Home Luca Zorn in the city of Cajazeiras -PB, as a LSI which were used music and its elements, for a period of two years, for members of a research group/extension.the population consisted of all the elderly residents in this LSI and the selection of participants was completed by the inclusion/exclusion criteria, totaling 17 individuals.
Inclusion criteria were: being 60 or older and be the LSI resident for more than two months.the elderly who did not have conditions to express measurable reactions to situations evaluated in the study were excluded.
Data collection was conducted through the individual records and also observed the aspects related to the moments of musical performances (evaluation of social interactions and FD).
the research project was approved by the Research ethics Committee at the teacher's training Center/Federal University of Campina Grande in CAAe: 39138414.9.0000.5575and Opinion number 926.540.

Characterization of the sample
the study included 17 elderly, most of which was composed of women (82.3%), with ages ranging between 71 and 114 years old and duration of hospitalization greater than five years (47%).On levels of schooling, 70.6% were illiterate, 23.6% studied until the fifth grade of elementary school and 5.8% had completed high school.About marital status, it was identified that 53.9% were single and 47.1% widowed.the reasons for hospitalization were lack of care and/or presence of disease (76.5%) and 23.5% abandonment.
It was observed that in the course of music therapy activities, the elderly showed no decrease in their levels of FD, even with increasing age, being observed the re-establishment of some of these.

Use of music and the promoted modifications in the IFs of seniors
the use of music as therapy promoted improvement in mobility through the observation of three things: activities related to travel (70.6%); percussion music (82.3%); and displacement/dance (76.5%).
In the evaluation about the Communication during the musical performances, analyzed activities such as speaking (76.5%); sing or chant songs (82.3%) and vocal interaction (88.2%).On Memoryforming activity, was investigated: experience reports related to songs played (76.5%); presence of emotions during the performance of some specific songs (88.2%) and suggest or request songs related to some event experienced in their youth (70.6%).

Discussion
Studies that indicate the predominance of women in Long-Stay Institutions [7][8].Increasing age and the emergence of physical dependence in highgrade results in the need for special care, which many families do not have conditions to supply, thus causing the institutionalization of this elder [9].
the low education level increases inequalities and hardships for the elderly follow the changes that occur constantly in the contemporary world and becomes a factor influencing negatively the quality of life of these [10].therefore, it is evident that illiteracy or low educational level is an important social determinant for both FD and the emergence of diseases, and for the institutionalization of the individual.
Widowhood has significant importance in the emergence of diseases/FD leading the individual to institutionalization. the widower or single elderly are more prone to isolation situations and less concerned about their own health, which impacts negatively on their functional capacity, and favors the emergence of diseases [11].
Institutionalized elderly have poorer health, low levels of independence, lower satisfaction with life and higher percentages of depression [12].thus, the development of recreational activities in these environments is intended to eliminate the deficits present in the LSI and promote interdisciplinary care quality.
Studies [12][13] found that the institutionalization seems to take the elderly to a progressive process of deterioration of functional capacity.thus, it is believed that the institutional dynamics can lead them to a gradual loss of ability to perform the activities of daily living and hence their autonomy and independence.In addition, the sedentary lifestyle creates physical dependence, negative feelings in the face of old age and vulnerability, and predisposes to stress, depression and the emergence of chronic diseases [14].
to public health, the term functional capacity is a concept that represents very well instrumentalization and operationalization of health care for the elderly.thus, alternative therapies of preventive, care and rehabilitation are key to the improvement or maintenance of functional capacity and hence the quality of life of older people [5,15].the performance of the musical activities can promote social approach and the development of affections between members of the LSI, promoting a better quality of life for seniors in active global mobility, functional performance and motor skills of the elderly, as well as increased body movements and decreased difficulty in achieving these [16][17].
the lack of social relations in institutionalized elderly cause negative effects on their cognitive ability, favoring depression [18].the absence of these relationships is considered a risk factor as harmful to health, as high blood pressure, smoking, obesity and physical inactivity.In this sense, one notes the importance of alternative therapies that can improve the socialization of institutionalized elderly, particularly the use of music, which provides an extension of communication, personal development and social interaction [5].therefore, it is necessary to develop recreational activities, intellectual, social and religious who are able to reduce the physical inactivity of institutionalized elderly, improving their socialization and rescuing their subjectivity [19].thus, music emerges as a new form of treatment that can be used in these environments, providing a new perspective on life for the elderly as it is an important form of treatment for people with chronic diseases, as this therapy has the power to affect all the brain of the individual, promoting the body's functioning in sync with the music even in cases of unilateral akinesia [20].
Important is the music associated with functional exercises such as dancing, which can be crafted from health promotion and disease prevention to rehabilitation, acting in the transformation needed to promote, improve and adapt, maintaining autonomy and social independence functional and the elderly, contributing to healthy aging.

Conclusion
It was observed that music therapy minimizes the effects of institutionalization and improves the ratio of the elder to himself and everyone around him, gives the rescue of self-esteem and creates new relationships and emotional bonds, reducing thus the effects of this isolation within institutions.the use of music as therapy is an important agent in the improvement of social interaction, the development of new relationships, quality of life and the re-establishment of functional capabilities of physical, social and psychological.In this sense, it is essential to the development of recreational activities in order to provide the cultural growth, the re-establishment and development of potential lost as a result of aging.Where Doctors exchange clinical experiences, review their cases and share clinical knowledge.You can also access lots of medical publications for free.Join Now! http://medicalia.org/

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