Evaluating the Efficacy of Evidence-based Music Interventions for Certified Nursing Assistants Caring for Nursing Home Residents with HIV-associated Neurocognitive Disorders (HAND) and Depressive Symptom

In recent years, HIV-associated neurocognitive disorders (HAND) have become more common as people with HIV are living longer due to advances in anti-retroviral medications. Experiments have demonstrated that symptoms of HAND are often associated with mild to severe cognitive impairment and depression. These symptoms might lead to burden and burnout in caregivers of individuals with HAND. Music-based interventions provided by caregivers have been shown to have positive effects for people with cognitive impairments, depression and HIV. However, little is known about the benefits of music-based interventions for people with HAND and depression. For this dissertation study, it was hypothesized that adding music interventions to caregiving activities would reduce depression symptoms in nursing home residents with HAND, which, in turn, might decrease burden in the certified nursing assistants who are responsible for providing care. In this concurrent nested mixed method experiment, 12 nursing home residents with HIV-associated neurocognitive disorders and depression participated in 4 weeks of music-assisted caregiving that included singing and listening to background music with 5 certified nursing assistants. The music-assisted caregiving intervention significantly decreased depression symptoms in the nursing home residents. Furthermore, the music intervention improved personal achievement for the certified nursing assistants. The findings suggest that the effect of music-assisted caregiving on depression symptoms may originate from certified nursing assistant's ability to create a relaxed environment and understand their residents' feelings. This study supports the effectiveness of the music-assisted caregiving intervention in reducing depression symptoms in nursing home residents with HIV-associated neurocognitive disorders and provides directions for research to further explore interdisciplinary approaches for people with HIV and related cognitive disorders.