Progressive and future modifications
cognitive impairment
SAID
During the 12-week intervention, some changes were made by ACs to help residents adapt well to the intervention. Progressive modifications that care home staff found helpful in facilitating the programme included making participation a part of the care home schedule with an allocated time slot, playing music at the start of sessions, and briefing and encouraging residents before the start of sessions. These were expressed as:"Well, I (AC) adopted an early pattern, about the 11:30 mark in the morning once everybody was up. They would have had their morning snack, the coffee and that time before lunchtime was always a good time. Before lunchtime is when I (AC) like to get the group together for activities. Whether crafts, music or live entertainment, it was a good period to get people together".and:"We (care home) would always put the music on first, to lift their moods and try to get them to engage more in the exercises."and:"We (care home) definitely found telling them in advance helped, so that they knew it (the intervention) was going to be happening the next day. Also, like I (AC) said, we did the music part first before the exercises to try and lift their mood and hope that more residents would take part."and:"I (AC) spend lots of time trying to encourage people. I had to go and speak to them (residents)."Additionally, focus group discussions pointed to other alterations and actions that could be made to enhance the feasibility and future implementation of the intervention in care homes, leading to future modifications. It was suggested that the number of sessions be reduced from four sessions a week to two or three sessions a week to recruit residents with low or no cognitive impairment and to play background music during movement sessions. Comments on future modifications included:"Yeah, I (AC) would run the programme again, but not for four times per week. It is a little bit too much and you have to do other activities as well, not just sing and dance all the time. I will probably be doing it again once or twice per week. I think it is more than enough."and:"I (AC) have noticed the music work. It is always better when they can hear songs they are familiar with. I think it would be better if there was louder music at the back in the background."and:"I (AC) definitely we would maybe choose a different group of people now because we have had different residents come in that I feel would probably be more suitable for it now than the initial ones we started with but certainly we would do it (intervention) again".