A Losing Battle?

This week, I met with the daughter of a client of mine to discuss some goals the daughter had for her mother. The hospice nurse had informed me a little of what she wanted to accomplish a little beforehand and I was slightly discouraged. The daughter would like her mother to be able to talk again. On the surface, this seems admirable. The client has a very unusual brain disease [so unusual that I am not going to mention it's name, due to HIPPA regulation] which robbed her of her speech about a year ago. This, understandably upset the daughter, but she found that her mother could sing little songs, like "You are My Sunshine", long after she had lost the ability to talk. The daughter will come in a play music and occasionally get a response from her, such as humming, smiling, or hand movement. I was able to get responses like that in my assessment, so that was normal, as far as I knew.

The daughter, however, has known her mother talking, joking, and singing for much longer than she has known her in this state. She does not like what has been happening to her mother and wants to fix it, which is completely understandable. The chances that the client will talk again, however, are quite slim. In hospice care, we look for decline. Not to sound morbid or as though we like that aspect of our jobs, but if patients improve, then they are inappropriate for hospice care and we are required to discharge them. I would call it a flaw in the system, but that's the system we work in. That being said, I was quite wary and probably did not give the daughter the attention and time she deserved in our meeting. I attempted to listened closely, be supportive, and empathetic, but if I'm being honest with myself, I was quite skeptical. We had a short music therapy session with the client afterward and we got some results, mostly some brief smirks, eye contact, and a little vocalization.

When we were done, I got back in the car and, as is my general practice, I processed the session and realized how unfair I was about our meeting. I realize that I did not give her the time or attention she deserved to express herself. I also realize that the daughter is probably in some denial about her mother's situation, but who can blame her? That's the coping mechanism that is helping her and, if or when her mother's health declines, all I can do is continue to be supportive and let her know that she always tried her best. Trying your best is worth a lot, I was reminded, even if the results will be hard to attain. Therefore, I am going on the record that I am going to try to help her regain her speech, but with a realistic view of her situation. I cannot guarantee that it will be successful, but if this will help the daughter cope or process her mother's situation, then that is the best that I can do. I am not the perfect person, and I never pretend to be, so I hope my mistake can be corrected and my apology accepted.