Published: 29 June 2023
NIHR has funded a new major study investigating how music therapy can reduce patient distress and physical assaults on NHS inpatient wards for people with dementia.
The study is called MELODIC - Music therapy Embedded in the Life of Dementia mental health Inpatient Care. It’s being led by Anglia Ruskin University’s Cambridge Institute for Music Therapy Research, alongside Cambridgeshire and Peterborough NHS Foundation Trust.
The researchers are also working in partnership with Humber Teaching NHS Foundation Trust and Dementia UK.
Distress and dementia
Distress is common for people with dementia on hospital mental health wards. There are lots of reasons why people get distressed. Sometimes it is a result of symptoms like hallucinations. It may also be because the care they receive does not meet their needs.
If a person with dementia is so distressed that they behave in a way that puts themselves or others at risk, they may be admitted to a hospital mental health ward. The aim is to understand and treat their distress so that they can be discharged with an appropriate support plan. This can take a long time.
These hospital wards can be very different to general hospital wards or care homes. It is hard to care for someone who is distressed and both staff and patients can get hurt. Calming medications (antipsychotics) are often given to people with dementia on these wards. This is a worry because research suggests that these increase the risks of falls and death.
Building on a previous study
The researcher's initial study found that patients’ distress was reduced when provided with in-person group music therapy. Distress behaviours included shouting, grabbing, pushing, hitting, kicking and spitting.
Music therapy activities included singing familiar songs, supported by the music therapist on piano or guitar, and playing percussion instruments. This initial study was published earlier this year in the Royal College of Psychiatrists’ Journal.
Results found that distress incidents happened on the wards on 7% of days when in-person music therapy was taking place, compared to 31% of days when there was no music therapy.
Ward staff also stated that music therapy lifted mood and calmed agitation. The change in atmosphere on the ward often lasted for the rest of the day.
The new study will build on this work to create a programme of music therapy which will then be piloted on two NHS mental health wards at Cambridgeshire and Peterborough NHS Foundation Trust.
Researchers say that finding ways to manage distress without drug treatments will:
- benefit patients and NHS staff
- support improved quality of life for people living with dementia
Dr Ming-Hung Hsu, Senior Research Fellow at ARU and Chief Investigator for the MELODIC project, said: "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 behaviours 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 new funding from the National Institute for Health and Care Research 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."