New research out of the United Kingdom suggests that music therapy – when it’s carefully implemented as part of everyday care on NHS mental health dementia wards – might provide a better alternative to managing distress among patients.
The study, published in Frontiers in Psychiatry, looked at the feasibility of a co-designed music therapy intervention dubbed MELODIC (Music therapy Embedded in the Life Of Dementia Inpatient Care). The goal? Alleviate patient distress by using personalized music in conjunction with trained therapists, ward staff, and family members.
A Critical Need
These dementia wards are usually home to people experiencing the highest levels of distress. And that can manifest in aggressive behavior, intense withdrawal symptoms, and even resistance to care. Care teams normally manage these behaviors with psychotropic medications. Evidence-based guidelines recommend non-drug psychosocial interventions as the first line of treatment. But, to date, clinicians haven’t been able to try anymore than a handful of standardized options in NHS inpatient settings.
MELODIC backers want to change that. This new approach places a trained music therapist on the ward for 15 hours a week and oversees both individual and group therapy sessions. This therapist also drafts musical care plans tailored to each patient while offering ongoing support for staff and families.
A New Approach
The MELODIC feasibility study included two NHS sites in England in 2024, each with different levels of prior music therapy exposure. One site already offered limited music programming; the other had never tried it.
Despite these vastly divergent starting points, both wards implemented the four-week intervention successfully. Over the course of the study period, researchers collected extensive data, including questionnaires from patients, family members, and staff. The research project also incorporated routine clinical incidents and in-depth, post-intervention interviews.
Perhaps most importantly, the researchers didn’t document any uptick in safety concerns or distress-related incidents. Patient participation exceeded expectations. But the most encouraging observation included staff enthusiasm for integrating music into daily care.
The Right Notes
Participant feedback also helped researchers adjust on the fly. For example, after low attendance plagued mandatory staff training sessions in the first ward, the team pivoted to offer shorter, voluntary workshops and one-page guides in the second ward, which drove better engagement.
Clinicians also simplified musical care plans while boosting visibility by hanging literature in patient bedrooms.
“People with dementia on inpatient mental health wards are often experiencing very high levels of distress, and staff are under immense pressure to manage this in ways that are safe and compassionate,” lead author and Anglia Ruskin University researcher Naomi Thompson explained. “Our study yielded promising results and importantly showed that the MELODIC tool can be used effectively in these highly complex settings, giving an alternative option to current ways of managing severe distress, such as psychotropic medication.”
The researchers also discovered that while the music therapist played a pivotal role in delivering clinical sessions, unplanned musical interactions and building relationships with the staff appeared to be just as important. This informal support system helped foster a more musical atmosphere on the ward, encouraged staff buy-in, and helped facilitate the use of music in moments of agitation or restlessness.
Next Steps
The paper’s authors also reported that the cost to implement these interventions was relatively modest (at least by contemporary health care standards), coming in at about £2,425 a month per ward. This included the therapist’s time and the necessary equipment, such as percussion instruments and audio devices.
In a care landscape dominated by pharmaceutical interventions, MELODIC offers a relationship-centered alternative. By embedding music into the normal rhythm of ward life – and training those who know the patients best – clinicians can deliver compassionate, personalized dementia care.
Further Reading
US Dementia Cases Will Double By 2060
Researcher Sounds Off On The Power of Music
Your Chances of a Dementia Diagnosis Depend on Where You Live
