Addenbrooke's Charitable Trust
Award amount: £117,045
The following patient story demonstrates the impact that Dancing for Health sessions can have on patient well-being and positivity, as well as its effects on family and the wider hospital environment:
“My elderly father, Frank, spent extended periods in Addenbrooke’s Hospital during 2018-19 as he was treated for various infections. As well as congestive heart failure and hip mobility problems, he suffered the distressing confusion and agitation that comes with vascular dementia. The weekly music and movement sessions on his ward offered rich moments of escape into a different world as he participated in a small group setting with fellow patients and as he listened to favourite music, sometimes even dancing with his body. When I asked him what made these sessions so special, he commented as follows: “The music makes me remember places and people that I’ve known – I find myself resting…”
As his daughter, watching day by day his painful distress and diminishment over many weeks and months, I find it hard to express my deep gratitude for the moments of peace and respite my father found through the beauty and power of music, through the caring touch of staff and residents, and through the gentle companionship of these sessions. They were – and they remain – a blessing.” – Family member of a CUH patient and Dancing for Health Participant
“The minute she got into the session she was smiling, she was up. Everyone was in a circle and she was in the middle dancing, just having a lovely time, and it was amazing. At the end she was like ‘That was great, I had such a lovely time’ and it just changed her mood. She wasn’t agitated, pacing up and down anymore – “ CUH Staff Member
Organisation: Addenbrooke’s Charitable Trust
Addenbrooke’s Charitable Trust is the only registered charity dedicated to supporting innovation in patient care across Cambridge University Hospitals NHS Foundation Trust. Through the work of Addenbrooke’s Charitable Trust, supported by its donors, Addenbrooke’s and Rosie hospitals can provide a level of patient care beyond that which can be delivered by NHS funding alone and can make projects happen sooner or to a greater degree than might have otherwise been possible.
Research has shown that when older people spend extended periods of time in hospital there is a significant detrimental effect on their overall health, well-being, confidence and mental health. This effect still exists even where medical teams successfully and fully treat the initial presenting need or condition. Spending extended periods of time in bed has a negative effect on muscle strength, balance and coordination leaving older people more frail and so more likely to fall or have accidents and less likely to continue with positive activities that help maintain mobility. Similarly, the pain, frustration, boredom and sense of helplessness associated with a hospital stay can leave older people less confident and less positive about their ability to return to their previous levels of independence.
The effect of this is that an initial period of care in hospital can leave people more likely to be readmitted, creating a downward spiral of deteriorating physical and mental health. Most commonly, when an older person has a fall they become significantly more likely to experience further falls. Despite this, comparatively little has been developed to ensure that the time people spend in hospital also provides empowering and enjoyable opportunities, which help older people regain their physical strength, their confidence and improve their well-being.
The Dancing for Health project aimed to address this deficit by improving the hospital experience for older patients, to help them regain their independence and confidence and improve their overall well-being and physical strength and, subsequently, avoid readmission to hospital.
Dance and movement workshops were provided to older patients in Addenbrooke’s hospital on a weekly basis. The underpinning philosophy of the Dancing for Health project is that it is about dance and enabling people to be creative and expressive rather than being just an exercise programme or a therapeutic intervention. The sessions are introduced as Music and Movement sessions, there is no exercise regime imposed and no choreography, but patients are invited to move and express themselves. The sessions are scheduled for an hour on each ward involved and usually take place in the ward day rooms. The activity is done in a circle formation so participants are close to each other and can see all the people taking part. The sessions always start with the Dance Artist introducing the session and stating the day of the week and the date, followed by the location of the activity. Participants are then asked to introduce themselves.
Participants are encouraged to start some gentle music as the first track is played and are then asked if they would like to choose a piece of music. Generally, the middle section of the sessions are livelier with more upbeat music and participants moving and singing to each song. Towards the end of the session, slower and quieter music is played to cool down participants and relax them. During the relaxation time, which indicates the end of the session, each participant is given a gentle massage to their neck and shoulders.
Alongside the group sessions, informal bedside sessions are take place when group sessions aren’t possible – for example, when there is a norovirus outbreak, or when clinical support staff aren’t available.
Is it working?
Overall, Dancing for Health had 3,027 participants over a total of 601 sessions. Key outcomes from the project were:
- Improved mobility and physical strength – patients described the benefits of the sessions not just in terms of the effects on muscles, which could be stiff and painful and were loosened throughout the session, but also in terms of improved mobility as a result of taking part.
- Reduced feelings of isolation through opportunities to engage and interact with other patients and staff – Dancing for Health provides the opportunity for a safe place for shared experiences and meaningful interactions. Often, participants would hold hands and move together when listening to the music. Some participants also chose to stay and chat with each other after the sessions had finished.
- Relief from tension, anxiety and stress through opportunities for self expression – whilst many of the participants found the sessions relaxing, the sessions were also found to be enjoyable, uplifting and inspiring. In the majority of sessions laughter was observed by participants. For patients with dementia, sessions seemed to bring some mental clarity, with patients who had previously been very agitated immediately calming down during the Dancing for Health sessions.
- Improved confidence and ability to regain independence – some patients, on returning to the ward, were more active and motivated then they had been previously. For example, one participant walked to the toilet rather than asking for a commode, as he usually would, after taking part in Dancing for Health. Patients who had refused to take part in physiotherapy were happy to take part in Dancing for Health sessions.
The Arts Observation Scale (ArtsObs), a tool validated for the use of evaluating performing arts activities in healthcare settings, was used to unobtrusively record the impact of the sessions without interfering with the creative process. ArtsObs data was collected for 310 participants and collected data on mood, relaxation, distraction, creative expression and relationships of participants. The results showed that out of the participants taking part:
- 67.5% appeared happier at the end of the session than at the start;
- 79.3% were relaxed;
- 66.1% were focused entirely on the session;
- 65% were spontaneous and improvised their own moves or started singing along to the music independently of others;
- 90.7% interacted with other members of the group.