Is it feasible to use the digital music and movement resources of the danceSing Care company to improve wellbeing in the resident care home population?

Executive Summary

• We wanted to find out if digital music and movement resources could be delivered in care homes. We rolled out a 12-week programme to 10 care homes and had 47 care home residents take part in the research.
• We also wanted to find out under what circumstances the digital music and movement resources would be most effective for the health and wellbeing of the care home residents.
• A survey measuring the number of falls in the past three months, activities of daily living and health, psychosocial wellbeing (anxiety, depression, stress and loneliness), sleep satisfaction and frailty measures such as appetite and weight loss) was completed before and after the intervention. Also, interviews with residents and focus groups with staff were done after the intervention to find out how they felt about the programme.
• The involved staff and residents noted improved mood, physical health, job satisfaction, and social support. The survey scores showed improvements in anxiety, depression, loneliness, perceived stress and sleep quality after the intervention.
• We discovered several challenges during the programme, such as:
  • lack of motivation and engagement at the start of a session,
  • cognitive impairment and disabilities of the residents,
  • limited resources to deliver the programme as intended
• We were able to refine the programme and delivery strategies to tackle these challenges and better measure the effectiveness of the resources in future interventions.
• We are undertaking further research to be able to build on our conclusions about the effects of the resources. This is due to the small number of involved residents and because we had no comparison group that did not receive the intervention.

Who carried out this study?

Researchers from the SPARKLE team from the University of Stirling in Scotland collaborated with the danceSing Care company from September 2021. The aim was to evaluate the impact of danceSing Care’s digital music and movement provision on the health and wellbeing of older people in care homes.

What are the danceSing care resources?

danceSing Care is a creative health and wellbeing company that offers the care sector bespoke, on-demand music and movement resources. The danceSing care resources are tailored to suit older adults with or without physical and cognitive impairment. For this study, we used a 12-week danceSing care programme. We asked people to join the sessions four times per week. Movement sessions include chair and standing fitness, which started with a warm-up and finished with stretching exercises. The music sessions include singing songs well-known to the Scottish care home population.

Why is this collaboration useful?

The care home resident population is ageing in the UK, with residents often diagnosed with more than one long-term health condition. Previous research rightly focused on producing physical activity programmes in care homes to improve the health of care homes residents. With advancements in communication technology, knowing if digital physical activity resources work and how they impact wellbeing in the care home residents deserves more research attention. Therefore, it is important to find out if the danceSing care resources can be offered to residents in care homes.

What did we want to find out?

First, we wanted to see whether the program could be delivered in care homes. We wanted to identify how this programme would work and under what circumstances this would be most effective.

We also wanted insights into whether and how the outcomes were affected to refine the programme and implementation strategies. This was to better measure the effectiveness of the resources and tackle these challenges in future interventions.

What did we do?

We asked ten care homes from the Balhousie Care group in Scotland if they were interested in participating in our study. From these care homes, we asked the care home staff to help recruit interested residents that were able to participate in digital music and movement sessions (47 residents were recruited).

We asked all older adults that wanted to join to complete questionnaires measuring aspects of their health and wellbeing (specifically anxiety, depression, stress and loneliness), sleep satisfaction and frailty measures such as appetite and weight loss) before and after the programme.

We interviewed residents (four residents) who took part in the programme. We also held a focus group with the involved staff (seven activity coordinators).

We used the feedback we collected to refine the programme and delivery strategies (training, delivery, and content) to tackle any challenges we encountered during the programme.

What did we find?

Adherence

Residents satisfactorily engaged in the sessions provided by the care home staff (see Table 1 for adherence data). However, care home staff struggled to offer the recommended four sessions (three-movement and one music) a week to residents due to some challenges. As discussed in the focus groups, these challenges include;

• Covid 19 restrictions
• Residents’ health conditions (cognitive impairment and physical disabilities)
• Less motivated and engaged residents
• Death and hospitalization of residents
• Lack of adequate delivery resources (e.g. staff time and technology (large screen TV, good wifi connectivity) in the care homes

Feedback from staff and residents

An essential part of the study was collecting feedback from involved staff and residents to find out what we can do to improve the programme in the future.

Overall, the programme was very well received, and staff and residents noted improved mood, physical health, job satisfaction and social support.

Positive feedback examples:

“ [residents] loved danceSing”.

“it is a purposeful and meaningful activity; I really liked it”.

“It (the intervention) definitely improves moods. The difference in mood between the session’s start and end was quite a big change.”

“really good feeling” it was “good for the soul” even if it is for just “a few minutes”.

Residents with dementia were noted as “calm” and “content” and in a “happy place”, 

“Probably for one resident, I (an activities coordinator) would say as the sessions went on, …. she did a little bit more each time. So I think it did make her physically a bit stronger.”

Residents were always a lot happier at the end of the session compared to at the start.  This was a “big, big change “.

Relationships between staff and resident improved, “we feel it’s built some friendships”.

“I think it made us feel good to see them happy and made you think that you have done a good job. So it is just a feel-good thing and makes you go home at night and think I have had a good day.”

“I (an activities coordinator) think just like the social kind of bonding, it has brought us (staff and residents) all a bit closer, I think.”

How are we refining the programme

We also looked at all the suggested changes or areas for improvement. We discussed these among the research team and the managers from danceSing care. The barriers and challenges we identified and the feedback from staff and residents have helped us improve the programme and delivery in many ways, such as:

• Intensively training involved care home staff;
• Ensuring adequate resources are available (internet access, display screens, on-duty activity or wellbeing coordinator, unoccupied room/space);
• Starting movement sessions with music;
• Recommending two to three sessions (including one music session) a week.

How can we enable more residents to join?

The attendance was best when the programme was given two to three times/week. Some strategies to enable more residents to join in are:

• Training the involved staff to better understand the resources and encourage the residents more effectively;
• Making the danceSing care resources part of the regular care home schedule, with an allocated time slot;
• Playing music at the start of the sessions;
• Briefing and encouraging residents before the start.

What was out of our control?

Regarding the care home setting, we had no control over the Covid restrictions placed by the government. Further, we could not control staff availability and the time allocated to deliver the sessions. They are therefore not included in this programme refinement.

However, before future implementation of the danceSing care resources, we will factor in:

• tech issues (e.g., fast internet access and display screens), and
• staff issues (e.g., a dedicated activities coordinator with back-up for when they are absent).

How could we better measure the effectiveness in future studies?

• Extra physical function tests, such as measuring the time needed from sitting to standing or the distance walked in 6 minutes, could give more information about the residents’ physical function.
• We could also benefit from using objective measurements, such as tests for measuring specific hormones in saliva that reveal important information about the health of older adults.

What’s next?

This study will be submitted for publication in a scientific journal. We will make the findings of the study available to a broad range of people. Further, we will conduct another study dedicated to finding out the effectiveness of these danceSing Care resources.

Where can I read more?

This is a very brief summary of the research. If you would like a copy of the full report, please contact the researchers from the SPARKLE team of the University of Scotland: esther.ofosu@stir.ac.uk or Len.de.nys@stir.ac.uk. We will be able to release the academic write-up this once it is accepted by a scientific journal.

This lay summary was written by Len de Nys, Esther Ofosu, Gemma Ryde and Anna C. Whittaker