The goal of this single-arm feasibility study is to learn whether group music therapy is feasible in a rural area for people living with dementia and their companions. The main questions are:

1. Is a group music therapy intervention feasible in a rural community setting? 1a. Are there preliminary changes in health and well-being outcomes following participation in a 10-week community music therapy group?
2. What were participants' experiences and preferences regarding the different components of the music therapy programme?
3. What is the role of peer support in participants' experiences of a community music therapy intervention?

Participants living with dementia and their companions will be asked to take part in 10-weeks of music therapy in the community. Before and after each music therapy session, they will be asked to answer an easy-read satisfaction survey to gather information on the 'in the moment' experiences of music therapy.

Participants will also be asked to complete surveys on quality of life, loneliness, depression and well-being on three occasions:

• Before music therapy starts
• During week 5 of music therapy
• After music therapy

After music therapy, participants will also be asked to

• Complete a survey about their experiences of different parts of the music therapy programme
• Take part in an individual feasibility interview
• Take part in an interview exploring the role of peer support within the music therapy groups

If a person does not have the capacity to answer any questions, their companion will be asked to provide the information on behalf of the individual living with dementia.

Support in Sound is a 14-week research project for people living with dementia and their carers in Tarporley and the surrounding villages. The project explores how community-based group music therapy may support quality of life, social connection, depression and well-being for participants.

Research suggests that music therapy can have positive emotional and social benefits for people living with dementia. A study found that group music therapy significantly reduced anxiety and depression compared to usual care, with improvements still present three months later, suggesting possible longer-term mental health benefits. A Cochrane review also found that music-based therapeutic interventions may improve social behaviour, depressive symptoms, and overall behavioural symptoms in people with dementia. In addition, music therapy may help facilitate positive emotions and strengthen connections with significant others.

However, less is known about the practicalities, accessibility, and acceptability of delivering group music therapy in rural communities. People living in rural areas may have fewer opportunities to access support groups, wellbeing activities and meet with peers than those living in towns and cities. There is also limited research exploring the role of peer support and shared social experiences within group music therapy for people living with dementia and their carers.

Participants will be recruited from Tarporley and the surrounding villages in line with supporting the health and well-being of local residents living with dementia and their companions in the community. Recruitment posters will be advertised around the village and circulated with care groups in the area. Consent will be obtained from caregivers and individuals living with dementia if they have capacity to do so. Where a person does not have capacity, a consultee will complete a declaration form on behalf of the person living with dementia. Demographic data will be collected before the study commences.

The project consists of 2 weeks for baseline data collection, 10-weeks of group music therapy including data collection during week 5 and 2 weeks of data collection at the end of the study.

The music therapy will be delivered by a HCPC registered music therapist with experience of working with people living with dementia. The sessions will include singing, listening to music, playing with instruments and using music to enable social engagement. Sessions will include an opportunity for peers to socialise over tea, coffee and cake before and after each music therapy session. The team aims to recruit between 6 - 7 dyads.

Feasibility data will be collected to understand the practicality and acceptability of the study using the following data:

• Recruitment rates: Monitoring the number of people recruited
• Retention data: Monitoring the number of people who completed the study
• Adherence rates: Marking an online register each time a person attends a session
• Collecting current mood before and after each music therapy session and satisfaction at the end of each session
• An end of study feasibility interview with participants focused on the implementation, mechanisms of impact and context.

The potential preliminary changes in health and well-being of both persons living with dementia and their companions will be measured using the following data:

• Quality of life - DEMQOL and DEMQOL Proxy
• Loneliness - UCL Loneliness 3-point scale
• Depression - Short Geriatric Depression Scale
• Well-being - Short Warwick-Edinburgh Mental Wellbeing Scale

All participants will be asked to complete each of the outcome measures before music therapy, during week 5 of music therapy and at the end of music therapy to measure potential changes during the course of participating in music therapy.

Additional information will be requested to:

1. Learn about the perceived satisfaction and value of each of the components of the music therapy programme. This data will be conducted using a survey designed on Microsoft Forms
2. Learn about the potential role of peer support within the music therapy programme using a semi-structured interview guide.

Descriptive data will be analysed and there will be a repeated measures analysis. Interview data will be analysed qualitatively.

Inclusion Criteria:

• One person must have a clinical diagnosis of dementia and be accompanied by a companion
• Participants must be able to attend the 10-week programme, recognising that unavoidable absences (e.g., illness or unforeseen personal circumstances) may occur
• Be willing to provide data on health and well-being and take part in interviews.
• Be able to speak and understand the English language

Exclusion Criteria:

• Individuals, as dyads are the participants being recruited
• Dyads were neither person has a clinical diagnosis of dementia
• Are unavailable to generally commit to the research programme including music therapy sessions
• Are unable to speak or understand the English language

All data collected including demographics, participants and information sheets, feasibility data, questionnaire data and interview data will be shared within the research team.

In the first month of the study up until the research has been published ~ 2 years.

The research team will be able to access all IPD throughout the study. The data will be stored on a password protected OneDrive folder. The folder will be shared with the research team only and they will have the password to access the folder. There will be one Excel sheet with participants names and demographic information, where a unique ID code will be assigned to each participant. All survey and interview data will be labelled with the participant's unique code rather their name.