PUMA
Person-centred Use of Music in residents living with dementia and Associated changes in behaviour in care homes (PUMA). A cluster randomised controlled trial to investigate whether personalised music reduces distress and changed behaviours in people living with dementia.
Background
Seven in ten older people living in care homes have dementia. Some experience distress, agitation or other changes in behaviour. These behaviours can be upsetting for residents and challenging for care staff and families. Medicines are often used to manage these symptoms but can cause serious side effects, including falls and strokes. Safer, non-drug approaches are therefore needed.
Music can improve mood and wellbeing, but it is often used informally in care homes rather than being incorporated into planned care. Only one in twenty care homes uses music strategically to support residents. Few trials have investigated the use of personalised music for people living with dementia in care homes; however, existing evidence suggests that it may help residents feel more relaxed and content.
During the development of the study, the PUMA team spoke to people living with dementia, their families and care staff. The interviewees generally supported using music more frequently as part of daily care. However, some felt that communal music sessions in busy environments could cause distress for some people living with dementia. This informed the decision to use music in a way that is personalised to each resident.
The study aims to answer the following question: In people living with dementia in care homes, does incorporating personalised music into care plans reduce distress, compared to usual care without a systematic personalised music intervention?
Study aims
- To train dementia care staff to use music in a personalised way as part of residents’ care plans.
- To investigate whether incorporating personalised music into care planning reduces dementia-related distress and changed behaviours among residents.
- To explore whether personalised music helps care home staff to support residents.
Design and methods
PUMA is a cluster randomised controlled trial involving 58 care homes and approximately 406 residents living with dementia. Around seven residents will be recruited from each participating care home.
The care homes, rather than individual residents, will be randomly allocated to one of two groups. In 29 care homes, staff will receive training on how to plan and use personalised music for residents living with dementia. This will include creating personalised playlists and incorporating music into residents’ care plans and daily routines.
The remaining 29 care homes will continue to provide usual care, and the residents will not receive the personalised music training during the study.
Care staff will provide information about participating residents at specified time points. The research team will compare outcomes between residents in care homes that receive the personalised music intervention and those in care homes that continue to provide usual care. This will help determine whether incorporating personalised music into care reduces residents’ distress and changed behaviours.
At the end of the study, the research team will interview care staff and managers to understand their experiences and views of using personalised music within care homes.
Planned Timeline
- Project start date: June 2025
- Expressions of interest: November 2025
- Site (care home) set-up: August 2026-May 2027
- Recruitment start: August 2026
- 12-month follow-up per resident
- Expected end date: November 2028
Funding and Sponsor
This £2.04 million study is funded by the National Institute for Health and Care Research Health Technology Assessment Programme (NIHR HTA). The research governance sponsor is Sheffield Health Partnership University NHS Foundation Trust.
Co Applicants and TMG Members
Name | Role | Organisation |
|---|---|---|
Dr Daniel Hind | Chief Investigator | University of Leeds |
John Osbourne | Co-Applicant/ Musician | Music Works |
Farai Pfende | Co-Applicant/Senior Lecturer | Nottingham Trent University |
Wendy Swann | Research Business Manager/ Sponsor Representative | Sheffield Health Partnership University NHS Foundation Trust |
Kirsty Haunch | Co-Applicant/Social Care Researcher | University of Leeds |
Hannah Gower | Co-Applicant/Mental Health Researcher | Sheffield Health Partnership University NHS Foundation Trust |
Zena Aldridge | Co-Applicant/Associate Director for Social Care, Nursing and Midwifery | NIHR |
Becky Dowson | Co-Applicant/Music Therapist | Anglia Ruskin University |
Christian Morgner | Co-Applicant/Senior Lecturer | University of Portsmouth |
Karen Spilsbury | Co-Applicant/Professor of Nursing | University of Leeds |
Orii McDermott | Co-Applicant/Senior Research Fellow | University of Nottingham |
Matthew Franklin | Co-Applicant/Senior Health Economist | University of Sheffield |
Fiona M Wilson | Lecturer of Nursing and Midwifery | University of Sheffield |
Sheffield Clinical Trials Research Unit Team
| Name | Role | Organisation |
|---|---|---|
Radwa Abdelatif | Study Manager | The University of Sheffield, CTRU |
Evelyn Burgess | Research Assistant | The University of Sheffield, CTRU |
Liv Hawksworth | Research Assistant | The University of Sheffield, CTRU |
Rebecca Adams | Trial Support Officer | The University of Sheffield, CTRU |
Stephen J Walters | Co-Applicant/Senior Statistician | The University of Sheffield, CTRU |
Naseeb Ezaydi | Co-Applicant/ PPIE | The University of Sheffield, CTRU |
Matthew Burnsnall | Co-Applicant/Statistician | The University of Sheffield, CTRU |
Katie Biggs | CTRU Oversight/Co-Applicant | The University of Sheffield, CTRU |
Kirsty J Pemberton | Data and Computer Systems Validation Manager | The University of Sheffield, CTRU |
Amanda Loban | Head of Data Management | The University of Sheffield, CTRU |
Contact details
PUMA study team email address: puma@sheffield.ac.uk.