Pilot Randomized Clinical Trial of A Multimodal Music Therapy Intervention for Engaging Persons With Severe Dementia (AMUSED)

Inclusion Criteria

PARTICIPANT Inclusion Criteria: * 65 years or older * late-onset dementia diagnosis from a physician * stable at facility long enough to establish residency and routine at the facility (about 2 months prior to start of study) * English is primary language (for pilot study practicality and ensure straightforward evaluation of our aims) * Dementia is severe: As in the feasibility study, residents' charted score on the Brief Inventory of Mental Status (BIMS) \< 7 will be used and no independent function in community affairs, hobbies, chores, or personal care. The BIMS is a component of the Minimum Data Set (MDS), a federally mandated clinical assessment for all residents in US Medicare and Medicaid certified care facilities. It is completed periodically and interpreted by a licensed health care professional employed by the facility who has completed requisite training on the assessment. PARTICIPANT Exclusion criteria: * music therapy recipient * co-occurring movement disorder * preexisting cognitive disability * Milder dementia (BIMS 7+); Persons with more significant cognitive decline could arguably respond differently to the intervention than those with milder dementia, a notion that is supported by past music therapy research with this population. FACILITIES - Inclusion Criteria: * Any facility in Kentucky that provides residential care for persons with severe dementia (up to 8 facilities). * At least 5 residents must enroll to make the best use of our resources. * At least 1 facility staff member available to help with recruitment and periodic observable data collection * Can accommodate consistent session days and times between lunch and dinner, 2 times per week for 40 minutes, for 12 weeks. * Willing to communicate questions, concerns, and changes in safety protocols to the research team. * Can provide a space appropriate for a small group activity (3-5 residents plus a group leader). * Can ensure staff support is available for safely transitioning participants to/from sessions at the agreed upon session days and time. * Can assert that music therapy from a credentialed music therapist (MT-BC) is not offered by the facility, to prevent "double dosing" (music entertainment is ok). FACILITIES - Exclusion Criteria: -Does not meet one or more inclusion criteria.