Experiences and management of distress and the use of music, including music therapy, on NHS inpatient mental health dementia wards: a qualitative study.

Thompson, Naomi; Hunt, Rachel; Odell-Miller, Helen; Olawale, Abdulwarrith; Pickering, Lucy; Pointon, Chris; Underwood, Benjamin R; Wilkinson, Alison; Wise, Christine; Wolverson, Emma; Hsu, Ming-Hung

Experiences and management of distress and the use of music, including music therapy, on NHS inpatient mental health dementia wards: a qualitative study.

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Thompson, Naomi, Hunt, Rachel, Odell-Miller, Helen, Olawale, Abdulwarrith, Pickering, Lucy, Pointon, Chris, Underwood, Benjamin R, Wilkinson, Alison, Wise, Christine, Wolverson, Emma and Hsu, Ming-Hung (2025) Experiences and management of distress and the use of music, including music therapy, on NHS inpatient mental health dementia wards: a qualitative study. International Journal of Geriatric Psychiatry. ISSN 0885-6230

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Official URL: https://onlinelibrary.wiley.com/doi/10.1002/gps.70...

Abstract

Background: Inpatient mental health dementia wards in the National Health Service (NHS) provide specialist care for people with dementia experiencing acute levels of distress. There is little research exploring how best to manage and prevent distress. Music therapy may be feasible to deliver and reduce the prevalence of distress behaviours.

Aims: To further understanding of experiences of distress in inpatient mental health dementia NHS wards, how distress is managed and ways music and music therapy is used.

Methods: Semi‐structured focus groups and interviews were co‐designed and conducted with people with dementia, families, staff, music therapists and managers with experience of this setting. Data were transcribed and analysed using reflexive thematic analysis, with findings corroborated with participants, a co‐design group and experts‐by‐experience.

Results: 49 people took part from 17 wards. Three overarching themes were identified, with 10 subthemes. The first theme highlighted the complex physical and mental health care needs of people on these wards, including high levels of distress. Secondly, staff and families aimed to personalise care to manage and prevent distress. Thirdly, music, including music therapy, could support the delivery of personalised care and help prevent and deescalate distress behaviours, potentially reducing the need for restrictive interventions. However, managers, staff, families and patients reported that care provision did not always
meet patient need and resource limitations often prevented delivery of personalised care.

Conclusions: NHS mental health dementia wards provide specialist care for people with dementia experiencing high levels of distress. Personalised care, including the use of music, was essential for preventing and managing distress, and could be enhanced through specialist support from a music therapist. Findings should inform best practice guidelines for NHS inpatient mental health dementia wards, including the use of music and music therapy, to support the prevention and management of distress for this client group.

Item Type:	Article
Keywords:	co‐design, dementia, distress, inpatient mental health dementia wards, music, music therapy, qualitative study
Subjects:	Medicine and health > Clinical medicine > Dementia
Date Deposited:	06 May 2025
Dates:	Date Publication status 30 September 2024 Submitted 23 April 2025 Accepted 2 May 2025 Published Online
School, department or research centre:	School of Medicine and Biosciences
Keywords:	co‐design, dementia, distress, inpatient mental health dementia wards, music, music therapy, qualitative study
URI:	https://repository.uwl.ac.uk/id/eprint/13520

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References

B. G. Edmans, E. Wolverson, R. Dunning, et al., “Inpatient Psychiatric Care for Patients With Dementia at Four Sites in the United Kingdom,” International Journal of Geriatric Psychiatry 37, no. 2 (February 2022): 1–4, https://doi.org/10.1002/gps.5658.

E. Wolverson, R. Dunning, G. Crowther, G. Russell, and B. R. Underwood, “The Characteristics and Outcomes of People With Dementia in Inpatient Mental Health Care: A Review,” Clinical Gerontologist 47, no. 5 (2022): 684–703, https://doi.org/10.1080/07317115.2022.2104145.

I. A. James, K. Reichelt, E. Moniz‐Cook, and K. Lee, “Challenging Behaviour in Dementia Care: A Novel Framework for Translating Knowledge to Practice,” Cognitive Behaviour Therapist 13 (2020): e43,https://doi.org/10.1017/s1754470x20000434.

Dementia Australia, “Dementia Language Guidelines [Internet],” (2021): [cited 2022 Nov 1], https://www.dementia.org.au/sites/default/ files/resources/dementia‐language‐guidelines.pdf.

E. Wolverson, E. Moniz‐Cook, R. Dunn, and R. Dunning, “Family Carer Perspectives on the Language of Behaviour Change in Dementia: An Online Mixed Methods Survey,” Age and Ageing 51, no. 3 (March 2022), https://doi.org/10.1093/ageing/afac047.

E. Wolverson, H. Birtles, E. Moniz‐Cook, I. James, D. Brooker, and F. Duffy, “Naming and Framing the Behavioural and Psychological Symptoms of Dementia (BPSD) Paradigm: Professional Stakeholder Perspectives,” OBM Geriatrics 3, no. 4 (September 2019): 1, https://www.lidsen.com/journals/geriatrics/geriatrics‐03‐04‐080.

E. Wolverson, R. Dunn, E. Moniz‐Cook, D. Gove, and A. Diaz‐Ponce, “The Language of Behaviour Changes in Dementia: A Mixed Methods Survey Exploring the Perspectives of People With Dementia,” Journal of Advanced Nursing 77, no. 4 (April 2021): 1992–2001.

“Mental Health Act 2007,” (2007): [Internet], https://www.legislation.gov.uk/ukpga/2007/12/data.pdf

R. Kate and D.‐S. Sarah, Psychological Best Practice in Inpatient Services for Older People (British Psychological Society, 2017).

R. Low, F. Rahman‐Ali, and S. Paget, “Standards for Older Adult Mental Health Services 5 th Edition Artwork: Ellington Ward, Central and Northwest,” London NHS Foundation Trust (2019): [Internet], www.rcpsych.ac.uk/improving‐care/ccqi/quality‐networks‐accreditation/older‐.

E. L. Wolverson, K. H. Dening, R. Dunning, G. Crowther, G. Russell, and B. R. Underwood, “Family Experiences of Inpatient Mental Health Care for People With Dementia,” Frontiers in Psychiatry 14 (2023): 1093894, https://doi.org/10.3389/fpsyt.2023.1093894.

E. Wolverson, S. Appleyard, S. Stirland, and Z. Gower, “The PalliativeCare Symptoms of People With Dementia on Admission to aMental Health Ward,” International Journal of Geriatric Psychiatry 38,no. 9 (September 2023), https://onlinelibrary.wiley.com/doi/10.1002/gps.5995.

National Institute for Health and Care Excellence, “Dementia,”Quality standard 184. 39, (June 2019), https://www.nice.org.uk/guidance/qs184/resources/dementia‐pdf‐75545721373381.

World Health Organisation, A Blueprint for Dementia Research,(2022): [Internet], https://www.who.int/publications/i/item/9789240058248.

A. Nørgaard, C. Jensen‐Dahm, T. Wimberley, et al., “Effect of Antipsychotics on Mortality Risk in Patients With Dementia With and Without Comorbidities,” Journal of the American Geriatrics Society (November 2022): 1–11.

P. L. H. Mok, M. J. Carr, B. Guthrie, et al., “Multiple Adverse Outcomes Associated With Antipsychotic Use in People With Dementia: Population Based Matched Cohort Study,” BMJ (April 2024): e076268, https://www.bmj.com/lookup/doi/10.1136/bmj‐2023‐076268.

D. E. C. Leme, K. Mathias, A. Mofina, R. Liperoti, G. S. Betini, and J. P. Hirdes, “A Longitudinal Treatment Effect Analysis of Antipsychotics on Behavior of Residents in Long‐Term Care,” Journal of the American Medical Directors Association 25, no. 11 (November 2024): 105255, https://doi.org/10.1016/j.jamda.2024.105255.

N. Thompson, M. H. Hsu, H. Odell‐Miller, B. R. Underwood, and E. Wolverson, “Characteristics, Outcomes, Facilitators and Barriers for Psychosocial Interventions on Inpatient Mental Health Dementia Wards: A Systematic Review,” BMC Geriatrics 24, no. 1 (December 2024): 364, https://doi.org/10.1186/s12877‐024‐04965‐8.

N. Thompson, H. Odell‐Miller, B. R. Underwood, E. Wolverson, and M. H. Hsu, “How and Why Music Therapy Reduces Distress and Improves Well‐Being in Advanced Dementia Care: A Realist Review,” Nature Mental Health 2, no. 12 (November 2024): 1532–1542, https://www.nature.com/articles/s44220‐024‐00342‐x.

N. Thompson and H. Odell‐Miller, “Audit of Music Therapy in Acute National Health Service (NHS) Settings for People With Dementia in the UK and Adaptations Made Due to COVID‐19. Approaches,” An Interdisciplinary Journal of Music Therapy (May 2022).

N. Thompson, H. Odell‐Miller, C. Pointon, B. R. Underwood, E. Wolverson, and M. H. Hsu, “Music Therapy Embedded in the Life of Dementia Inpatient Care (MELODIC) to Help Manage Distress: A Mixed Methods Study Protocol for Co‐designing a Complex Intervention,” Nordic Journal of Music Therapy (December 2024): 1–17, https:// www.tandfonline.com/doi/full/10.1080/08098131.2024.2435869.

M. Calvo and M. Sclater, “Creating Spaces for Collaboration in Community Co‐design,” International Journal of Art and Design Education 40, no. 1 (2021): 232–250, https://doi.org/10.1111/jade.12349.

G. Hickey, S. Brearley, T. Coldham, et al., Guidance on Co‐Producing a Research Project (NIHR Involve, 2018).

V. Braun and V. Clarke, Thematic Analysis: A Practical Guide (SAGE Publications Ltd, 2021), 0–376.

V. Braun and V. Clarke, “Reflecting on Reflexive Thematic Analysis,”Qualitative Research in Sport, Exercise and Health 11, no. 4 (2019):589–597, https://doi.org/10.1080/2159676X.2019.1628806.

COREQ, (COnsolidated Criteria for REporting Qualitative Research)Checklist.

Lumivero, NVivo (Version 14), (2023), www.lumivero.com.

T. Kitwood, Dementia Reconsidered: The Person Comes First, (1997). M. J. Santana, K. Manalili, R. J. Jolley, S. Zelinsky, H. Quan, and M.Lu, “How to Practice Person‐Centred Care: A Conceptual Framework,” in Health Expectations, Vol. 21 (Blackwell Publishing Ltd, 2018), 429–440, https://doi.org/10.1111/hex.12640.

J. Tropea, D. Logiudice, D. Liew, C. Roberts, and C. Brand, “Caring for People With Dementia in Hospital: Findings From a Survey to Identify Barriers and Facilitators to Implementing Best Practice Dementia Care,” International Psychogeriatrics 29, no. 3 (March 2017):467–474, https://doi.org/10.1017/s104161021600185x.

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Experiences and management of distress and the use of music, including music therapy, on NHS inpatient mental health dementia wards: a qualitative study.

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