Using music to reduce distress on dementia wards

Anglia Ruskin University (ARU) is launching a major study with Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) to investigate how music therapy can reduce distress on NHS inpatient wards for people with dementia.

Called MELODIC (Music therapy Embedded in the Life of Dementia mental health Inpatient Care), the project is led by ARU's Cambridge Institute for Music Therapy Research and CPFT, working in partnership with Humber Teaching NHS Foundation Trust and Dementia UK.

The new 18-month project will involve creating a program of music therapy which will then be piloted on two NHS mental health wards. Finding ways to manage distress without drug treatments will benefit patients and NHS staff, and support improved quality of life for people living with dementia.

This new study will build on initial work carried out by the research team from ARU and CPFT, led by Naomi Thompson, and published earlier this year in BJPsych Open.

This research found a significant reduction in distress behaviors—which can include shouting, grabbing, pushing, hitting, kicking and spitting—on days when patients were provided with in-person group music therapy compared with no music therapy. Activities included singing familiar songs, supported by the music therapist on piano or guitar, and playing percussion instruments.

The initial study, which is believed to be the first of its kind, mapped music therapy sessions to incidents on these wards that had been logged on the NHS Trust's internal reporting system. It found that distress incidents happened on the ward on 7% of days when in-person music therapy was taking place, compared to 31% of days when there was no music therapy.

Researchers also spoke to ward staff, who stated that music therapy lifted mood and calmed agitation, with a change in atmosphere on the ward often lasting for the rest of the day.

Dr. Ming-Hung Hsu, Senior Research Fellow at ARU and Chief Investigator for the MELODIC project, noted, "Calming medications are often given to a person with dementia when distressed, but this is far from ideal, as research suggests that sedatives increase the risks of falls and death. Therefore, the positive findings of our initial study—fewer reported incidents of distress behaviors and feedback from staff about the joyful and calming effects of music therapy for patients and staff—are really encouraging.

"These results provide us with a platform to explore ways to use music therapy to better meet patient need on inpatient mental health dementia wards. This … will allow us to develop and trial a music therapy manual, which will provide additional music therapy time as well as support staff and family members to incorporate music interventions in everyday care, with the aim of reducing distress for patients and assaults on staff."

Dr. Ben Underwood, CPFT's Research and Development Director and the Principal Investigator for the study, added, "I am delighted that we are co-sponsoring this important project with Anglia Ruskin University to bring the benefits of music therapy to our NHS patients. Agitation in the context of dementia can be very distressing for patients, families, and staff, and current interventions are limited.

"All the early evidence, including some from our own research, suggests that music might be a powerful and enjoyable tool to help, so I am very excited to see this work progressing in partnership with the NHS to pilot new approaches on our wards."

MELODIC builds on the findings of previous studies in collaboration with CPFT, including the HOMESIDE international music therapy study to help people living with dementia, which is led in the UK by Professor Helen Odell-Miller OBE. In 2021, ARU was awarded The Queen's Anniversary Prize for their innovation in music therapy research for people with dementia.

More information:
Naomi Thompson et al, Investigating the impact of music therapy on two in-patient psychiatric wards for people living with dementia: retrospective observational study, BJPsych Open (2023). DOI: 10.1192/bjo.2023.20

Provided by Anglia Ruskin University