Friday, September 14, 2012

No Time for Guitar

Today, I went to visit someone who seemed to be a bit of crisis. She has dementia, so she get confused. This is a common symptom in any dementia diagnosis and can result in a number of behaviors. Sometimes, people are quite happy with their situation. I call these people "pleasantly confused" in my documentation. Sometimes, however, they get to be very anxious. Imagine yourself in a place you don't know, surrounded by people you don't recognize, and you have no idea how to leave. I think that would definitely make me anxious. Usually, I find the best thing to do in this situation is refocus their attention or just distract them long enough to "reset" their emotions. This brings me to my client today.

When I arrived, she was sitting in the common area. The client was really tearful, crying out, and working herself into frenzy. She had a CNA next to her, trying to calm her down, and looking rather exasperated herself. I offered to sit with her and, before I could even get my guitar out, the client grabbed my hands and I could not get loose. The CNA turned to me and said, "She's got quite a grip today." Occasionally, this will happen and I've learned to "roll with the punches." I started to sing and she initially stopped to listen. It didn't take long, though, for her to get back to crying. I realized that if I sang 2 or 3 songs and alternated between them quickly, I could keep her attention. I sang "Shenandoah", "Amazing Grace", and "Red River Valley" while alternating verses. It was really comforting to see her really start to settle down

When I left, she was sitting calmly in her wheel chair. The facility staff came to get her for lunch and said, "I don't know what you did and I don't know how long it will last but thank you!" It's nice to see some very observable signs that what I'm doing helps so quickly and drastically sometimes!

Tuesday, September 4, 2012

Once a Conductor...

Wow. It has been way too long. I guess it's safe to say that I've lost track of time. Some exciting things in my life have been happening. One of those things, and a main reason that I am adding this post, is that I was interviewed by The Songwriting Podcast recently. If you are new to my blog from that episode, welcome! I promise I'll make a point to update this more regularly!

Not to mince words, I'd like to just tell a story that way I usually do [or did, as it were]. Last week was the end of the month. As anybody in the health care field knows, this is the time when it gets a little hectic. I have monthly frequencies for all my clients and, when things work out well, I get everybody seen and do not feel rushed at all. Last month was one of those months. It worked out really well, then, that this particular story comes from my last visit of the month.

My client in this session was a long-time band and choir conductor. He claims to have only taught for 23 years, but I know that he did much longer than that. Many students have been musically trained by this man and now I get a chance to improve his life in a nursing home with music. Being a vocal trainer, but also having dementia, I need to be sure that the songs I'm choosing are songs that are both familiar but not too easy. I end up choosing a lot of hymns, but also mixing it up with some folk tunes. I have to choose carefully because, when he sings, he sings loud and proud. I could liken his voice to that of the Cowardly Lion from the Wizard of Oz. Even if he doesn't remember the words. I close the door, but I'm sure that does little to muffle our music to the ears of the other residents.

Aside from the song choice, I also need to be careful where I sit because, as a conductor, my client gets very exuberant with his gestures. This, I think, is the key to our sessions. He becomes who he has been for a long time. He directs again. I make sure I follow his tempo, volume, and entrance cues while playing and this seems to bring back a life into his eyes again. Needless-to-say, he is always conducting forte [loud, for all you non-music geeks out there] and just as expressive as we can muster. It's really neat to see this little man become a giant in a sense. His actions are broad, his face expressive, and his posture upright. It's a very distinct transformation.

I guess when you've made a living with music [either professionally or not], once you're hooked into music, you always will be.

Saturday, June 30, 2012


My apologies for not posting recently. I guess life caught up with me a bit the last few weeks and I didn't get to the blog. I'll try my best to not let it happen routinely!

This last week was rare in that I didn't have a ton of people to see at the end of the month, so I could take my time with each client I did see. One client in particular was especially enjoyable. She's one of those people who is either in a great mood or extremely anxious. She was in a good mood that day, but had been pretty anxious most of this week. We talked a lot about how she could cope when she is anxious and she stated that she will close her eyes, pray, and then sing silently to herself. I asked her what she sings and she stated that she sings old hymns. That lead to a nice time of reminiscing and discussion of her faith. She spoke of times when her faith has helped her cope with other things in her life. She was really talking a lot, which was fun for her and gave me a lot of good information.

I finally got into the music portion of our session by suggesting that we sing some songs that she can easily recall when she gets anxious again. She thought that was a good idea and I played and sang hymns with her that recalled portions of our conversation. "Nearer My God to Thee", "What a Friend We Have in Jesus", and "God Be With You 'Til We Meet Again" were some of her favorites that we identified as some that she could use and enjoy. While I sang, she stared at a picture of Jesus praying very intently. It was quite touching to see.

I guess the main thing I took from this session is just an affirmation of something I think we all know on some level. Regardless of faith or religion, our spiritual well-being is drastically tied to our sense of quality of life. Take some time this week to explore more how your beliefs affect your current sense of well-being and how you can take care of yourself spiritually today. It may mean praying, reading, taking a walk, talking with a friend, or just sitting quietly for a while. Whatever it means for you, take care of yourself this week!

Sunday, June 10, 2012

One More Reason

I met with a fairly new client this week. I've never seen him awake, really. He's always been sleeping or unresponsive. He does have several family members who, although they seem to rarely get along, are very loyal to him and are around pretty much constantly. They are the ones who actually requested my visit this week. They connect very well with the music and are able to release their emotions through singing and talking about their father between songs.

When I got there this time, true to tradition, he was sleeping. He had recently been placed on RLC care, which is a designation we give to people who the nurses feel are imminent, or close to being to it. His family hadn't seen him awake for quite some time. He had 2 daughters with him and they began sharing memories, singing with me, and shedding some tears. Although it was hard emotionally, it was actually why I got in hospice care. Then, the coolest part happened. He started to wake up. When I left, he had his eyes open and he said the only thing I've heard him say: "Thank you, buddy. I enjoyed it." It was really touching to me. It meant that: a] he had heard me and b] he used whatever limited energy he had to let me know my visit meant a lot to him.

I think that people have all heard stories of other people who "come to" for a brief moment when it seems they never will. It's something completely different, though, when you're there to experience it. Chalk it up to another great reason I love my job!

Friday, June 1, 2012

Am I 100?

I was seeing a patient this week that I have had some fun with. This is not going to be one of those really heart-wrenching tales to read this week. This is just one of those sessions that I like to facilitate.

The patient is 100 years old and has dementia. Unlike a lot of patients under those circumstances, however, she is very cheerful and is able to carry a conversation pretty well. The first time I met her, she said, "How old am I?" I honestly didn't know, so I told her so. She said, "Am I 100?" Again, I replied that I don't know. "Well, I sure feel like it!" was her reply. It was very funny. This last session, she agreed to a music therapy session, but said, "I'm not sure what to do for you, though." I told her that I just wanted to share some music with her, but if she wanted to sing with me even just relax with her eyes closed, that was okay. She only sang one one song, but was able to remember all the lyrics to "Let Me Call You Sweetheart."

A majority of my clients are similar to this. Hospice care is not always about big, world-shattering emotional events. A majority of the time, this is a normal thing. The people we see are just that. People. People can be goofy, serious, angry, happy, sad, and sometimes just sleepy. People are almost always the same people they were before they were on hospice care. A diagnosis or prognosis does not start when the medical tests get back. It starts long before, when they can still be themselves. It continues throughout the rest of their life. In the best case scenario, people can remain themselves until the end. That's what I'm trying to help them do.

Friday, May 25, 2012

A Little Out of my League

This week was really hard in some spots. I had a GPS stolen from my company car, almost killed a few times by people pulling out in front of me, and had a particularly hostile encounter with a client's son. Those weeks happen and I'm admitting that it stressed me out quite a bit. However, I refuse to let that define my week. Here's a story from Tuesday that was a bright spot in my week.

I got a new referral over the weekend and went to go complete the assessment. In case I haven't covered this in a previous post, I'll do a quick review of what I look for in an assessment. I am assessing how I can help a client with my services, so I look for their needs and how I can use my role and their strengths to help them meet that need. I look for social needs [such as isolation or loneliness], emotional distress [anger, depression, anxiety], physical discomfort [pain or agitation], and spiritual concerns [questions of afterlife or suffering]. I can meet these needs through a variety of means on a case-by-case basis.

Okay, back to the story. This woman is in her 60s, which is fairly young, but not unheard of. She is very aware of her situation but is having a difficult time coping. She regularly spoke of wanting to "get better". When I was able to bring up the subject of music, however, her whole demeanor changed. She likes classical music, which is something you don't hear often in northern Iowa. Usually, I get a response of "Lawrence Welk" or "country western" with an occasional "jazz music", all of which I am well stocked. Classical music, though, is something different. We started talking about it and she enjoys not just little guitar etudes, of which I have a few, but she started throwing about composers like Wagner and Vivaldi and operas like La Boheme. Way out of my league as far as playing ability, although I do enjoy listening to them at times. She described the music as having the ability to "make my heart soar" and she loved to sing. She did not study music or perform, but always had a deep seeded love of that style. At the end, she did state that she likes "little swing tunes, too" which gave me something to play for her. She would close her eyes, bob her head around, and smile when I was done and she'd talk about her experiences in music. It was a good session, not in that a lot of emotions were processed, but in a rapport building sense. I feel she really opened up to me, which will be a huge tool in my favor going forward.

With the knowledge I now have of her, I'm planning on trying to provide a CD player and some classical music for her to listen to. To help with her grief, I'm going to try to lead her in some guided imagery, which I'll try to blog about when it happens. That's definitely a topic I'd need another post to do even a hint of justice to. Until then, here's some more reading for you to do. Check out The Mindful Music Therapist to read up on some great music therapy conversations!

Thursday, May 17, 2012

Wind Beneath My Wings

This week, I met with a client I've had for a while and was trying to get her to open up more. I was hoping we could really process her situation, as it is rather hard. She's in her 50s and has a disease process where she understands what is going on, she's completely aware of her situation, but cannot do anything to stop it. She's at the age where she feels that she should be starting to take care of her parents and helping her son get ready for his wedding, but instead her parents and son are now having to take care of her. It's hard for her to stay in bed when she'd rather be outside, or rather, would rather be anywhere but a nursing home.

She enjoys the music she listened to when she was younger, which happens to be 80s popular music. With that in mind, I pulled out Bette Midler's "Wind Beneath My Wings", which you can listen to below.

Before I sang it, I asked her to think about who this song describes for her. After the song was finished, she said, "That's easy. It makes me think of my parents." We began talking about her parents and she was saying how they were such good people and really had tried everything to help her. As she was talking, her expression seemed to show that she was thinking very hard. At one point she stopped and said, "Me being in this situation must be really hard for them, too." I was so glad she made that shift in perspective. Not that she was complaining about herself before, but now it seemed that she was aware that her parents were grieving for her and it helped her to appreciate them that much more. She shared some stories of how they have helped her and then we discussed plans for her to tell them how much they mean to her. 

I don't know if she has or will let them know how much they mean to her, but I know that she really is grateful for them and I just hope they know it.


New blog to check out is : Bliss Music Therapy. She hasn't updated her blog for a while, but what she has posted is good information!