Feasibility of Sonas Programme in Australian Context: A Pilot Randomised Controlled Trial

Arm 1: Sonas Programme Materials: The Sonas Programme is a multi-sensory, communication-focused intervention. This pilot study will include residents who speak English only. Eligibility criteria: (1) have communication difficulties or have a confirmed/probable diagnosis of mild to moderate cognitive impairment, indicated by a Mini-Mental State Examination (MMSE) score >10 and < 24 (Folstein et al., 1975); and (2) able to understand simple instructions in English, with or without communication support (e.g., verbal prompts, visual aids). Participants who are people with mild to moderate dementia and/or with communication difficulties will be identified by residential aged care facility staff based on their eligibility for the Sonas Programme. Initial contact will be made by the facility staff, who will approach the person with mild to moderate dementia and/or with communication difficulties to inform them about the research project. If the resident expresses interest, a member of the research team will provide the Participant Information Letter and Consent Form to the residents. The Sonas intervention will be delivered in a group format of 8-12 over 16 weeks, with a 45-minute session per day, two days per week. This intervention schedule is informed by previous multisensory programs implemented for people with dementia (Octary et al., 2025). The Sonas Programme is a multi-sensory stimulation intervention that engages all five senses - touch, smell, taste, hearing, and sight. However, hearing is the primary focus, particularly through the use of music in this program. For example, each session includes familiar songs designed to stimulate memory and encourage engagement in participants with dementia. The activities are pre-determined and structured, delivered via pre-recorded sessions. However, a research assistant or Chief Investigator (CI) will be present at each session to facilitate delivery and provide individual support. Intervention sessions will be conducted in the mornings of week 1, 3, 5, 7, 9,11,13, and 15, and in the afternoons of week 2, 4, 6, 8, 10, 12, 14, and 16. They will be rotated to ensure each participant receives the intervention at different times to avoid any confounding medication effect. Sessions will be held in designated spaces, such as meeting rooms or facility living areas. The program content features multisensory activities, including music and group singalongs. Session attendance is required to assess adherence to the intervention. To assess this, session attendance checklists will be used. Before data collection, the CI will undergo training to become a Sonas Programme Licensed Practitioner (SPLP). The session will be supported by a facility staff or a research assistant (RA). Pre-recorded audio in English will be used during sessions to ensure consistency. Data will be collected at seven time points to monitor changes throughout the intervention and follow-up period: baseline (T0), Week 4 (T1), Week 8 (T2), Week 12 (T3), and Week 16 (T4), three weeks post-intervention (T5) and six weeks post-intervention (T6) using the Engagement of a Person with Dementia Scale (Jones et al., 2018), Visual Analog Mood Scale (VAMS) (Stern et al., 2010), Neuropsychiatric Inventory - Nursing Home (NPI-NH) version (Wood et al., 2000), quality of life measured by Dementia-Related Quality of Life (DEMQOL) (Smith et al., 2007), Cornell Scale for Depression in Dementia (CSDD) (Alexopoulos, et al., 1988) , Holden Communication Scale (Strøm et al., 2016), The Rating Anxiety in Dementia, Mini-Mental State Examination (MMSE) (Folstein et al., 1975), and Abbey Pain Scale (Abbey et al., 2004).