‘Silver Song Music Box’ found to be a “Fantastic Asset” within Older People Mental Health Wards

3 Apr 2013

 Intro:In September 2012, ‘Sing for your Life’ lent Kent and Medway NHS Partnership Trust (KMPT) a ‘Silver Song Music Box’ for 3 months. This was to allow us to trial its use on 2 wards that provide mental health continuing care to older people.  The majority of people on these wards have moderate to advanced dementia and additional physical, emotional and behavioural difficulties. Ward A is for men only, who typically are more active than those on ward B, which looks after a number of very frail individuals.The intention was that the Music Box would be shared evenly between these two wards for the three month period, with the uses and effects of the Music Box being continuously evaluated.These wards have had regular weekly input from a music therapist for several years. He was able to support them, in addition to the very helpful introductory session provided by Adrian Bawtree. Evaluation: As part of the evaluation, staff were asked to record each time they used the Box and to note down information concerning who participated, how they engaged, song requests and comments made by participants.  Staff, patients and relatives were also asked for their views on the impact of the Box.Over the three month trial period at least 45 sessions were held overall. On ward A three staff primarily used the Box in regular structured sessions; on ward B a number of different health care assistants used the Box in a less formal way.  The comments made by staff indicated that the Box allowed very flexible engagement for patients. Some people participated regularly and for the entire session, others engaged in an “on-off “way, taking a break when needed. Some people rarely participated.  People (staff, patients and relatives) engaged in a variety of ways, whether it be singing, clapping or using instruments alongside it. Many also listened and watched.The Box was also incorporated into a variety of events and celebrations, such as tea parties, Christmas and Halloween parties.Feedback: A variety of comments were collected, with themes emerging such as the Music Box’s effect on increasing social stimulation, stimulating memory and helping to improve care on the wards by providing staff with the opportunity to provide “one-to-one attention” or be more “aware of the potential for patients”. A number of comments were further collected regarding the “calmer” and more “relaxing” atmosphere of the ward during the trial and suggestions that everyone’s mood had been lifted by the sessions,Comments by staff included: “I’d never seen her speak until that session ““The best equipment on the ward for many years”“It’s the most animated some of them get” “Some lovely responses”“When patients respond to song and dance I feel as if I am doing something positive which lifts my mood”“If you see them happy, then it’s sort of infectious and catches to you”.One member of staff commented that relatives had been moved to tears to see their loved one joining in and singing along. Comments from relatives included how the music had a calming and relaxing impact on the ward“It’s a great conveyor of feelings when speech is limited”“Brilliant”“It’s something you can do together”“I see him doing things I don’t always see him doing”“It makes a change; everyone joining in together”“It does lift my mood”Relatives commented that it provides them with a shared activity which is particularly valued when their relative has limited speech.Impact on “Challenging behaviour”:Alongside the introduction of the Box  we compared   the  number of reported  incidents of  ‘challenging behaviour’  displayed by or affecting  patients and staff on each ward ,   in the 3 months prior to  and during the Music Box trial  . It was found that on the ward which used the Box more regularly and in a more structured way (ward A) there was a   76% decrease in these types of incidents during the trial period. In particular, the number of” incidents “associated with the 4 individuals whose behaviour was most challenging dropped from 150 during the first 3 months to 65 during the Music Box trial period. This is an 80% difference.  Whilst we cannot prove that this was due to the Music Box, no other significant changes took place during this time. So this provides food for thought.The levels on the other ward changed very little, which may reflect the patients’ lower levels of activity and fewer incidents overall on this ward.  Outcome: These very encouraging results have meant that funding has been obtained to purchase the Box this year. This means that sessions with the Music Box can continue to be held on both wards for a long while yet!Emily PettiforPsychology Placement Student at KMPT