Tejal Somvanshi
A new treatment using music therapy shows promising results for easing distress in dementia patients on NHS hospital wards. Researchers at Anglia Ruskin University (ARU) and Cambridgeshire and Peterborough NHS Foundation Trust have piloted an approach called MELODIC—Music therapy Embedded in the Life Of Dementia Inpatient Care—across two NHS dementia wards, with results published in the journal Frontiers in Psychiatry in July 2025.
The intervention comes at a critical time when alternatives to psychotropic medication are increasingly needed for managing severe distress in dementia patients. Music therapy, conducted by specially trained professionals, can include singing, playing instruments, or listening to music, with therapists also identifying specific ways music can be incorporated into daily care routines by families and caregivers.
“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,” said lead author Naomi Thompson, a researcher at ARU’s Cambridge Institute for Music Therapy Research. “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.”
What the Data Shows
The pilot study involved embedding a music therapist on hospital wards, delivering clinical music sessions, and implementing personalized musical care plans for each patient. Patient data suggested modest but meaningful improvements.
During the study, researchers observed a slight improvement in quality-of-life scores among patients and a reduction in the severity of distress symptoms and disruptiveness. Interestingly, agitation scores increased slightly, though this may reflect increased engagement rather than genuine distress. There were no increases in routinely reported incidents, and no adverse events related to music therapy interventions were reported—an important finding for research in mental health dementia wards, where limited studies have been conducted to date.
The MELODIC approach was shaped by interviews with 49 healthcare professionals, patients, and their families about their experiences managing distress on dementia wards and using music in everyday care. These findings were published in the International Journal of Geriatric Psychiatry in May 2025. A specific article titled “Experiences and Management of Distress and the Use of Music, Including Music Therapy, on NHS Inpatient Mental Health Dementia Wards: A Qualitative Study” by Thompson et al. was published in May 2025 (volume 40, issue 5, article e70091).
Cost-Effective Alternative
A significant advantage of the MELODIC approach is its cost-effectiveness. At just £2,025 per month for the therapist and a one-time equipment expense of £400, the intervention represents an affordable alternative to traditional medication-based approaches. This economic benefit is particularly noteworthy given the well-documented side effects of psychotropic medications.
Dr. Ben Underwood, Research and Development Director and Honorary Consultant Psychiatrist at CPFT, emphasized the potential impact: “Some people with dementia can get so confused and distressed that we need to admit them to hospital to keep them safe. It can be difficult to manage distress in a ward environment and hard for patients, families and staff. I am very excited that it may now be possible for NHS staff to improve their experience on dementia wards using the power of music, and we look forward to working with ARU to develop this further.”
How Music Therapy Works in Practice
The MELODIC intervention operates through three key components:
- An embedded music therapist on the hospital wards
- Regular clinical music sessions tailored to individual needs
- Personalized musical care plans that can be implemented by healthcare staff and family members
This approach builds on previous research, including the HOMESIDE international music therapy study and other investigations into non-pharmacological interventions for dementia care. In 2021, ARU was awarded The Queen’s Anniversary Prize for its innovative music therapy research for people with dementia, highlighting the growing recognition of music-based interventions in healthcare settings.
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The Science Behind Music’s Impact
Research suggests that music therapy can benefit people with dementia because musical memory is often preserved even when other cognitive functions decline. According to a December 2024 realist review published in Nature Mental Health by Thompson et al., music can activate the limbic system and subcortical circuits, inducing feelings of well-being. This review explored the neurological mechanisms behind music’s effects on dementia patients.
The Nature Mental Health review indicates that music therapy stimulates neuroplastic changes in the adult brain, potentially creating new neural connections that could help compensate for areas damaged by dementia. The review, titled “How and why music therapy reduces distress and improves well-being in advanced dementia care,” shows that when properly tailored to individual needs, music therapy can deliver immediate, short-term reductions in agitation and anxiety while improving attention, engagement, and mood. As highlighted by lead author Naomi Thompson in this review, the benefits include “meeting the person’s need for stimulation, supporting familiarity through memories, encouraging relationship and emotional expression, and crucially helping with the reduction of distress and anxiety.”
Global Context
The development of effective, non-pharmacological interventions like MELODIC is increasingly important given the growing prevalence of dementia worldwide. According to the World Health Organization, as of 2021, approximately 57 million people worldwide were living with dementia, with nearly 10 million new cases each year. This number is expected to increase significantly in coming decades, placing greater pressure on healthcare systems to find effective and compassionate care approaches.
The MELODIC study builds on previous research like the HOMESIDE international music therapy study. The HOMESIDE study, completed in October 2023, found that while family caregiver-delivered music at home did not consistently reduce psychological symptoms of dementia over the long term, it did show improvements in caregiver resilience and relationship quality between caregivers and people with dementia. These findings suggest different mechanisms may be at work in professional versus home-based interventions, highlighting the value of having trained music therapists like those in the MELODIC study.
Conclusion
The MELODIC music therapy approach offers a promising alternative for managing distress in dementia patients on NHS wards. With its embedded music therapist model, personalized care plans, and modest implementation costs, this intervention provides healthcare professionals with a practical tool that complements existing care approaches.
Patient data from the pilot study showed improvements in quality-of-life scores and reductions in distress symptoms without adverse events. While agitation scores increased slightly, this may reflect increased engagement rather than distress. The approach was developed through consultation with healthcare professionals, patients, and families, ensuring its relevance to real-world care settings.
At a cost of just £2,025 per month plus initial equipment expenses, MELODIC represents a potentially scalable model that could be implemented across more NHS facilities. As research continues, this music-based intervention may help transform dementia care, offering a more compassionate approach to supporting patients experiencing severe distress.
