MELODIC
Research type
Research Study
Full title
MELODIC: co-developing a Music therapy intervention Embedded in the Life Of Dementia Inpatient mental health Care to reduce agitation and related physical assaults
IRAS ID
323503
Contact name
Ming-Hung Hsu
Contact email
Sponsor organisation
Anglia Ruskin University
Duration of Study in the UK
1 years, 5 months, 28 days
Research summary
Distress is common for people with dementia on hospital mental health wards, but music might help. Distress may be a result of symptoms, like hallucinations, or because the care they receive does not meet their needs. If a person with dementia is so distressed that they put themselves or others at risk, they may be admitted to a hospital mental health ward. The aim of the stay is to understand and treat their distress.
It is hard to care for someone who is very frightened and distressed and both staff and patients can get hurt (physical assaults are common). Calming medications (antipsychotics) are often used to treat distress on these wards. This is a worry because research suggests that these increase the risks of falls and death.
Music therapy has helped lower distress for people with dementia living in care homes, and supported staff to understand why someone might be distressed. But we do not know enough about how music therapy can help people with dementia in mental health wards. We found that on the days music therapy took place there were fewer assaults and staff could see a positive impact. But not all mental health wards have music therapy.
In this eighteen-month project, we will create a music therapy manual for mental health wards together with people with dementia, their families and staff with the aim of reducing distress and assaults. We will do this by:
Stage 1. Talking to people with dementia, relatives and staff with experience of mental health wards about how distress and assaults are currently managed and their support needs.
Stage 2. Co-creating a music therapy manual with people with dementia, relatives and staff.
Stage 3/4. Testing the music therapy manual over four weeks on two mental health wards.Lay summary of study results: Music therapy, delivered by trained therapists, can include singing, playing or listening to music. The therapist can also identify specific ways that music can be used by families and carers in an individual’s daily care routine. It might help to reduce distress experienced by people with dementia.
We sought to co-design and test a new model for music therapy, called MELODIC, on mental health dementia wards. These wards care for people with dementia with the most complex distress in our communities. The model was developed with clinicians and families with lived experience of these wards. We conducted interviews with 49 healthcare professionals, patients, and their families about their experiences managing distress on dementia wards and using music in everyday care. Their experiences helped us co-design the intervention.
MELODIC was piloted on two NHS wards to see if it was possible to deliver and if we could conduct the research as planned. The pilot study involved a music therapist being embedded on hospital wards, the delivery of clinical music therapy sessions and the implementation of musical care plans for each patient. We found that MELODIC was possible to deliver, with patients, staff and family members telling us it was helpful to learn ways to use personalised music to prevent and reduce distress. Each patient had a personalised musical care plan that helped staff know what music to use and when to use it in their everyday care. It was also possible for us to deliver the research plan, meeting our recruitment and data collection targets.
During the study, patient data suggested a slight improvement in quality-of-life scores among patients and a reduction in the severity of distress symptoms and disruptiveness, although agitation scores increased slightly. There were no increases in routinely reported incidents, and no adverse events related to music therapy interventions were reported. This is relevant for future research on mental health dementia wards where limited studies have been conducted to date.
You can read more on our study webpage: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fwww.aru.ac.uk%252Fcambridge-institute-for-music-therapy-research%252Four-research%252Fhealthy-ageing-and-dementia%252Fmelodic%2FNBTI%2F57e_AQ%2FAQ%2F17c89440-d78b-4bca-a07a-04eaa706eb26%2F3%2FOc0vlcNsRC&data=05%7C02%7Cbradfordleeds.rec%40hra.nhs.uk%7C401b473521f34076c9fd08ddc47e3f95%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638882768713714687%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=u9jVNJqNb0VXKMEehh8nqpKcQ9XVmml76Q4Q2c6fttA%3D&reserved=0
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
23/YH/0155
Date of REC Opinion
26 Jul 2023
REC opinion
Further Information Favourable Opinion