Summary: A new feasibility study shows that embedding a music therapist on dementia wards can reduce severe distress and improve quality of life for inpatients with dementia. The MELODIC approach—Music therapy Embedded in the Life Of Dementia Inpatient Care—combines clinical music sessions with personalised musical care plans and staff and family support.
Results from the pilot indicated modest improvements in wellbeing and fewer severe distress incidents, with no adverse events linked to the intervention. Because the model is low-cost and scalable, it offers a compassionate, non-pharmacological alternative to psychotropic medication for managing distress in complex inpatient settings.
Key Facts:
- Improved wellbeing: MELODIC was associated with small but meaningful improvements in patient quality-of-life scores and reductions in distress and disruptive behaviours.
- Low-cost and scalable: The intervention required an estimated £2,025 per month for the embedded therapist and a one-off equipment cost of around £400, suggesting affordability for wider adoption.
- Safe in practice: No adverse events were reported during the pilot, and routine incident reports did not increase while the intervention was in place.
Source: Anglia Ruskin University
Music therapy embedded on dementia wards offers a practical option to support patients and staff
Researchers from Anglia Ruskin University (ARU), working with the Cambridgeshire and Peterborough NHS Foundation Trust, piloted the MELODIC intervention across two NHS inpatient dementia wards. The study aimed to test whether a standardised, co-designed music therapy package could be delivered in this challenging environment and whether the research methods were practical for a future trial.
MELODIC places a trained music therapist within the multidisciplinary team to deliver clinical music sessions, develop personalised musical care plans for each patient, and provide training and guidance to staff and families so music can be used consistently in daily care routines. Music therapy can include singing, listening, instrument playing and other music-led activities tailored to individual preferences and needs.
Over a four-week period, the embedded therapist recorded interactions and treatment activities, while research questionnaires and routinely collected ward data were used to measure outcomes. Recruitment targets were met: the pilot included 28 patients, 13 family members and 48 staff participants, with high data completeness and adherence to the intervention protocol.
Quantitative findings reported a slight improvement in patients’ quality-of-life scores and reductions in the severity of distress and disruptive behaviour. Agitation scores showed a small increase in this short pilot, but importantly there was no rise in safety incidents and no adverse events attributed to music therapy. Qualitative feedback and the therapist’s diary supported refinements to the intervention and highlighted practical ways staff and families could continue using music in care.
Naomi Thompson, lead author and researcher at the Cambridge Institute for Music Therapy Research at Anglia Ruskin University, explained that people admitted to inpatient mental health dementia wards often experience very high levels of distress, and that staff face significant pressure to manage this in safe and compassionate ways. She described MELODIC as a promising alternative to pharmacological approaches for severe distress and emphasised the tool’s suitability for complex ward environments.
The intervention was co-designed through interviews with 49 healthcare professionals, patients and family members about their experiences of distress on dementia wards and how music is used in everyday care. Those development findings were published in the Journal of Geriatric Psychiatry, and the pilot feasibility study is published in Frontiers in Psychiatry.
Dr Ben Underwood, Research and Development Director and Honorary Consultant Psychiatrist at the Cambridgeshire and Peterborough NHS Foundation Trust, noted the difficulties of caring for people with dementia who are very confused or distressed and said the study provides an encouraging route for NHS teams to improve patient, family and staff experiences using music.
This feasibility study was funded by the National Institute for Health and Care Research (NIHR). The authors conclude that the MELODIC protocol is acceptable and deliverable in a real-world inpatient setting and recommend a controlled trial to test clinical effectiveness.
About this music and dementia research news
Author: Jamie Forsyth
Source: Anglia Ruskin University
Contact: Jamie Forsyth – Anglia Ruskin University
Image: The image is credited to Neuroscience News
Original research (open access):
“Music therapy Embedded in the Life Of Dementia Inpatient Care (MELODIC) to help prevent and manage distress: a feasibility study to inform a future trial” by Naomi Thompson et al., published in Frontiers in Psychiatry. DOI: 10.3389/fpsyt.2025.1618324
Abstract
Music therapy Embedded in the Life Of Dementia Inpatient Care (MELODIC) to help prevent and manage distress: a feasibility study to inform a future trial
Introduction: Mental health dementia wards in the UK provide specialist inpatient care for people with dementia who experience acute distress. Evidence from these settings is limited, but existing research suggests music therapy can reduce distress in the short term. This co-designed study aimed to test the feasibility of delivering a standardised music therapy protocol (MELODIC) on such wards and to assess the suitability of trial methods.
Methods: MELODIC supports personalised music use to prevent and manage distress by: 1) embedding a music therapist within the multidisciplinary team; 2) delivering clinical music therapy sessions; 3) creating individual musical care plans; and 4) offering training and support for staff and families. Two NHS mental health dementia wards with differing prior experience of music therapy were selected. The intervention ran for four weeks, and the therapist kept a diary of all interactions to measure adherence. Questionnaires for patients, families and staff were collected before and after the intervention, with additional routine ward data and post-intervention interviews.
Results: The MELODIC intervention proved acceptable with high treatment adherence. Recruitment and data collection targets were met (28 patients, 13 family members, 48 staff) and datasets were complete. Quantitative measures showed no increase in distress symptoms or safety incidents during the intervention. Qualitative data and therapist records supported further refinement of the approach.
Conclusion: In a highly complex clinical setting caring for vulnerable patients, it was possible to co-design and deliver a novel, protocolised music therapy intervention. The methods were feasible and acceptable, and the authors recommend a controlled trial to evaluate clinical effectiveness.
Registration: ISRCTN86317609