Long-term Care Workers Find Stress Relief in Music

MEADVILLE, PA (November 14, 2003) — The employee dissatisfaction, burnout and rampant turnover that threaten one of America's most stress-prone industries – long-term care – may have a solution in one of man's oldest activities, according to a new scientific study. Researchers have found that a specific Recreational Music-making (RMM) program drastically reduced employee burnout and mood disturbances with huge projected economic benefits for the long-term care industry.

Barry Bittman

A groundbreaking study, funded by Yamaha Corporation of America with participation by REMO and published in the Fall/Winter 2003 issue of Advances in Mind-Body Medicine, demonstrates that a six-week program of Recreational Music-making not only reduced burnout in long-term care workers, but also reduced Total Mood Disturbance by 46 percent. Using industry-wide human resources data, researchers projected that this improvement could result in an 18.3 percent reduction in employee turnover, which would save the average 100-bed facility more than $89,000 a year-and the entire long-term care industry as much as $1.46 billion annually. Actual reductions in turnover at Wesbury United Methodist Retirement Community, the center where the study took place, exceeded the research projections.

"The positive link between Recreational Music-making and stress reduction has been firmly established," says Terry Lewis, senior vice president, Music Marketing Group, Yamaha Corporation of America. "This is the latest study to illustrate the incredible impact that music has in individuals who live and work in a stressful environment. We are especially pleased that Yamaha musical instruments were chosen for the study."

Barry Bittman, M.D. (seated at piano) sits in with a group of employees for a music-making session at Wesbury United Methodist Retirement Community in Meadville, PA. Bittman led a study that found a specific protocol of group music-making sharply reduced employee burnout and turnover at the facility; applied across the entire long-term care industry, the finding could save billions of dollars.

"This is the first study to address the practical human-resource applications of Recreational Music-making in a specific and quantifiable manner-a first in music, and a first in business," said neurologist Barry Bittman, MD, medical director of the Mind-Body Wellness Center in Meadville, PA and lead author of the study. "Employee turnover is threatening the ultimate viability of the long-term care industry. The impact of stress in the workplace has incredible implications in other arenas as well. What company in this day and age does not rank stress among its leading problems?"

According to data from more than 40 states, employee turnover in the long-term care industry ranges between 40 percent and 100 percent annually. The study used 60 percent as a benchmark for its projections with employee turnover amounting to about $8,100 per person according to industry data.

Emotional burnout is considered a major factor in this turnover rate. Industry surveys show that emotional factors, rather than economic ones, account for 81.7 percent of employees' decisions to stay or leave. Even among long-term care workers who stay in their jobs, emotional burnout can detract from the quality of the care they provide and even heighten the risk of elder abuse.

The turnover problem has particularly serious implications for long-term care. Enrollment in nursing and related training programs is down, while the number of older Americans who will need care is on the rise. Unlike other businesses that have the option to combat employee turnover by increasing salaries, long-term care facilities operate under Medicare and Medicaid reimbursement caps that ultimately constrain their wage scales.

"This is not a minor issue – rather it's a problem that's threatening the future of the long-term care industry," Bittman says. "This could be one of the salvations of the industry."

Recreational Music-making is distinct from "regular" music making as its purpose is the enjoyment and well-being of the participant and the group, not an artistic or aesthetic outcome. Of particular importance is the fact that participation does not require talent or training. RMM can bridge linguistic and cultural divides in ways that verbal activities alone cannot. Indeed, the Merriam Webster dictionary notes that the word "recreation" is derived from the Latin root "recreatio," meaning "restoration to health."

The study's protocol was based upon Group Empowerment Drumming, coupled with exercises on a digital piano, for 112 employees at Wesbury United Methodist Retirement Community, which is home to 400 residents in Meadville, PA. In addition to breathing, imagery and movement components, participants used simple percussion instruments to establish a sense of camaraderie while expressing their feelings non-verbally at first. Many discovered a refreshing sense of group nurturing and support, coupled with heightened interpersonal awareness and respect, which prompted ongoing meaningful dialogues.

The resulting improvement in affect was measured and quantified using Total Mood Disturbance, a derived composite index of several mood states that was measured with written questionnaires before and after participation in the experimental and control groups.

An independent consulting group, Tripp Umbach Healthcare Consulting of Pittsburgh, PA, used survey data from the national long-term care industry to translate the study participants' 46 percent improvement in Total Mood Disturbance into a projection that the RMM protocol could reduce turnover by 18.3 percent, thereby saving 11 positions each year in a typical 100-bed facility. Industry-wide data on human resources costs indicated that this reduction in turnover would save such a facility $89,100 per year, and would save the entire long-term care industry $1.46 billion. Notably, the actual improvement in employee turnover at Wesbury exceeded the projections of the published study.

Bittman commented that the application of specifically-tailored RMM protocols could potentially result in substantial cost savings for many industries worldwide. He and his research team are preparing to extend this research to build upon the results of this study in a host of other arenas.

For more information on Yamaha Clavinova Digital Pianos, write Yamaha Corporation of America, Piano Division, P.O. Box 6600, Buena Park, CA 90622; telephone (714) 522-9011 or e-mail infostation@yamaha.com.