The usability and feasibility of the Person Attuned Musical Interactions intervention – modified version (PAMI-M) for UK care home staff working with residents with dementia

Introduction

Research on music interventions in care homes to improve social interactions has shown inconsistent results, potentially due to insufficient guidelines and staff training. Person Attuned Musical Interactions (PAMI), an evidence-based music therapy skill-sharing training package, aims to integrate non-verbal and musical interactions into care routines with residents with dementia. A modified version (PAMI-M) was developed to make PAMI accessible to a wider UK care home population.

Method

Two studies evaluated PAMI-M to assess clinical appropriateness, usability, and readability. Study 1 assessed the feasibility of the study design and manual, and Study 2 evaluated the revised manual on feedback from Study 1. Care staff were trained in PAMI-M and applied the skills with a resident with dementia over 8 weeks in Study 1 and 18 weeks in Study 2, with fortnightly reflective sessions supervised by a music therapist. Data collection included reflective session transcripts and post-intervention staff interviews.

Results

Five dyads completed Study 1, and 10 completed Study 2. Staff demonstrated the tailoring of skills to meet their residents’ needs. The intervention materials were readable and usable despite implementation barriers, such as time restraints, staff illness and COVID-19. Staff recommended shortening the manual, dividing the training into small sessions, and in-person observations for better usability.

Discussion

The studies highlighted the plausibility of delivering PAMI-M remotely, though staff would prefer a hybrid approach with observational elements for practical assessment and support. While this paper evaluated PAMI-M’s usability and feasibility, findings could inform the development of other psychosocial interventions in care homes.