Music and Non-Drug Approaches in Dementia Care

Work with family to find favourite songs from the person's teenage years and twenties. Play them during personal care, mealtimes, or moments of distress. Across trials, music-based therapy probably slightly improves depressive symptoms and may improve overall behaviour, but it is unlikely to reduce agitation or aggression on its own [1][2].

Bright light in the morning has been trialled for sleep and body-clock problems in dementia. A 2023 review found it reduced the number of night-time awakenings but did not clearly reduce agitation or depression [8]. No set brightness or session length is established by the evidence, so ask a GP or occupational therapist for advice before buying a lamp [8].

In two small trials, lemon balm reduced agitation in people with severe dementia (72 people) and lavender showed modest benefit (15 people). Both were single, small trials — the evidence is promising but not established [4][5]. Essential oils can cause skin reactions and must never be swallowed, so ask a pharmacist or doctor first, and avoid them if the person has asthma or another respiratory condition.

Gentle hand massage with lotion, given with calm reassurance, is widely used during personal care. Small trials report short-term reductions in agitation that are not sustained, so it is best treated as a low-risk comfort rather than a treatment for symptoms [13].

Touching soil, watering plants, or picking herbs can be meaningful, low-risk engagement and sensory stimulation. Evidence that it improves dementia symptoms is limited [13].

Art, craft, collage, and reminiscence activities using familiar objects (old photos, fabric, tools from a trade) can engage procedural memory, which is often preserved. Evidence that creative activity improves dementia symptoms is limited [13].

Contact with calm animals is often a source of comfort and connection. Evidence for symptom benefit is limited and mixed; if animals are involved, infection-control and animal-welfare steps still apply [16].

Exercise programs may improve the person's ability to carry out daily activities — this is the clearest exercise finding in people with dementia. There is no clear evidence that exercise improves agitation or other neuropsychiatric symptoms [6]. Suit the activity to the person's mobility and ask the care team or a physiotherapist.

Keeping mealtimes, personal care, activities, and rest at the same time each day gives a sense of safety and orientation. Non-drug, person-centred approaches are the recommended first step for behaviour changes, with routine as part of that approach [13][14].

Meeting the person in their emotional reality rather than correcting their confusion — for example, "It sounds like you're missing your mum; she must have been very important to you." A Cochrane review found no statistically significant benefit from validation therapy except for some behavioural improvements [7].