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.
Saturday, February 25, 2012
Saturday, February 11, 2012
An Impromtpu Memorial
This week's story is one that really caught me by surprise. I came to a facility just in time to see one client before it was time for lunch, so I chose who I wanted to see. I was a little disappointed when I found out that he was getting a bath right before lunch, so I was unable to visit with him. I had another person in the facility, however, so I went to visit her.
This client, who I'll call Susan, is relatively young for hospice care, in her 60's, and easily converses, which is something I don't see all the time. I started the session much the way I usually do, silently reassessing her needs as we catch up. She said she had a headache, which is common for her diagnosis, but is also a sign of stress. I also noticed that she was knitting, which is not out of the ordinary for her, but she seemed to be a little extra shaky. Without a real reason for it, I asked how her family was doing, and that question opened the door to what was really bothering her. "I got a phone call about 10 minutes ago," she told me, "and they told me that my last aunt died of pancreatic cancer last night." She went on to explain, becoming tearful as she spoke, that her family had always been close and that she had lost her parents and all their siblings in the last decade. Susan's aunt had been the last of that generation to die and the funeral was too far for her to travel.
Grief is a reaction to loss, and Susan had lost a lot in the death of her aunt. She lost the last remaining member of her parents' generation. She lost someone she loved very much. She lost a sense of hope, that is her aunt could miraculously overcome her disease, then Susan could overcome her's. I sat there and listened to Susan pour out all these emotions, this intense grief, and wanted to help her. But, what do you say? What can you do? Distraction/redirection wouldn't take away this issue, so I saw no other option than to address it directly. I quietly asked, "Would you like to have a memorial service for her right now, right now? Just the two of us?" She agreed and we started out upon this impromptu memorial. Susan is a very spiritual person, so she started off by praying, and then I played "Amazing Grace" and "As the Deer", two songs that Susan finds very meaningful. I then encouraged her to talk about her aunt, a eulogy of sorts. During all this, she was very tearful and I just sat and listened. I tried to be fully present in her grief and listen quietly. After she wanted to stop talking, I played "On Eagle's Wings" and "You Raise Me Up", which I tied in with her eulogy. After those songs were done, she prayed again. Her headache was getting worse [it was time for her medicine again] and it was time for lunch, but she thanked me profusely for visiting. She said, "I can't believe you came when you did. God really was looking out for me today. I only got the phone call 10 minutes before you came. Thank you so much." With that, we parted ways and I'm sure our minds wandered on to something else, me to my paperwork and Susan to her overwhelming grief. But, for that hour, we were both present, sharing grief and stories, together.
I usually don't have a perfect idea of what will happen in a music therapy session. I usually have to be flexible and quick-thinking. This session, however, completely blindsided me. I had no idea what I was walking into and, if I would have known, I may have done a few things differently. I think, however, that this is one time where the bulk of what I did was what I needed to do for her. I do not claim to be the perfect music therapist, but it feels really good when I get something right and can help someone like that.
This client, who I'll call Susan, is relatively young for hospice care, in her 60's, and easily converses, which is something I don't see all the time. I started the session much the way I usually do, silently reassessing her needs as we catch up. She said she had a headache, which is common for her diagnosis, but is also a sign of stress. I also noticed that she was knitting, which is not out of the ordinary for her, but she seemed to be a little extra shaky. Without a real reason for it, I asked how her family was doing, and that question opened the door to what was really bothering her. "I got a phone call about 10 minutes ago," she told me, "and they told me that my last aunt died of pancreatic cancer last night." She went on to explain, becoming tearful as she spoke, that her family had always been close and that she had lost her parents and all their siblings in the last decade. Susan's aunt had been the last of that generation to die and the funeral was too far for her to travel.
Grief is a reaction to loss, and Susan had lost a lot in the death of her aunt. She lost the last remaining member of her parents' generation. She lost someone she loved very much. She lost a sense of hope, that is her aunt could miraculously overcome her disease, then Susan could overcome her's. I sat there and listened to Susan pour out all these emotions, this intense grief, and wanted to help her. But, what do you say? What can you do? Distraction/redirection wouldn't take away this issue, so I saw no other option than to address it directly. I quietly asked, "Would you like to have a memorial service for her right now, right now? Just the two of us?" She agreed and we started out upon this impromptu memorial. Susan is a very spiritual person, so she started off by praying, and then I played "Amazing Grace" and "As the Deer", two songs that Susan finds very meaningful. I then encouraged her to talk about her aunt, a eulogy of sorts. During all this, she was very tearful and I just sat and listened. I tried to be fully present in her grief and listen quietly. After she wanted to stop talking, I played "On Eagle's Wings" and "You Raise Me Up", which I tied in with her eulogy. After those songs were done, she prayed again. Her headache was getting worse [it was time for her medicine again] and it was time for lunch, but she thanked me profusely for visiting. She said, "I can't believe you came when you did. God really was looking out for me today. I only got the phone call 10 minutes before you came. Thank you so much." With that, we parted ways and I'm sure our minds wandered on to something else, me to my paperwork and Susan to her overwhelming grief. But, for that hour, we were both present, sharing grief and stories, together.
I usually don't have a perfect idea of what will happen in a music therapy session. I usually have to be flexible and quick-thinking. This session, however, completely blindsided me. I had no idea what I was walking into and, if I would have known, I may have done a few things differently. I think, however, that this is one time where the bulk of what I did was what I needed to do for her. I do not claim to be the perfect music therapist, but it feels really good when I get something right and can help someone like that.
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