Choosing the positive, acknowledging the negative

This week I had two very profound experiences. One was positive and one negative. It made it hard to choose, but the negative can be summed up pretty succinctly. Dementia is a terrible disease that robs people of their personalities and humanity. A once very lovely and charming woman, who was once a patient and then was discharged, was readmitted with a dementia diagnosis and now she is a completely different person. It made me quite sad.

However easy it is to focus on the negative, it is imperative that, in hospice care, you acknowledge, but do not obsess, the bad things in life. It is much more rewarding to look for the positive, but it has to be a choice. This leads me to my next experience, just a few days later. I was called in to do a visit for a patient who was actively dying and had loved music her whole life. When I started walking to her room, I found the family in the dining area talking with the hospice nurse and she introduced me to the family. They were very nice, obviously very loving, and mentioned how much the patient loved music, even the great grandchildren who were present. I invited them to join me for a music therapy session if they wanted and they quickly joined me.

Now, here is where I should point out that music therapy sessions with imminent patients and their families are the most rewarding experiences in my experience, but they can be tricky to get into. I played a few songs that the patient received comfort from in previous sessions and everybody listened intently, but there was no sharing, no community in the room. I decided to try something else. I asked the great grandkids if they wanted to sing a few songs for the patient. Their faces, especially the little boy's, lit right up and they requested "Go Tell it on the Mountain" and "Jesus Loves Me." That resulted in a veritable deluge of reminiscing and laughing. It was really incredible to witness. No body sang with me when I sang, but between songs, the gathering talked about the patient and her influence on a great number of people. The music supported the conversation and the conversation influenced the music. It was a great sharing of love and I was honored to be a part of it.

These little "mountaintop" experiences are what we, as hospice workers, music therapists, and people in general, need to cherish and focus on. The negative is there. It will always be there. But if you look deep enough, the positive will be there too.

Story: In the Hole

I wanted to share a quick story that means a lot to me. It isn't very long or detailed, but was a very uplifting point in my week. It was really a nice way to start the week out for me.

I went to go see a couple this week that have some pretty incredible attributes. The husband is 98 years old and the wife is 102 years old. Some quick math shows that there are 200 years of experience in that one room of their nursing home. Although the wife is unable to communicate, they husband loves to talk and tell stories. Many of those stories, I have heard already from previous visits, but when a person that old is telling you something, you'd better listen! Haha.

I have been providing music therapy sessions for the wife for longer than the husband, as he was not appropriate for hospice services for a while. He would be up and talking and enjoying the session, which mainly consisted of me just playing music to provide positive sensory stimulation and a compassionate presence. There was one session, however, where I found the husband lying in bed and looking about as bad as his wife. Due to the community nature of music, when I provided music therapy for his wife, he received it as well. I sang the old hymns for her that I was told she enjoyed and left.

Flash forward to this week and you'll see the continuation of the story. When I arrived this time, he was very happy to see me. He remembered where I was from and what I was there to do, which, at 98 years old, is quite a feat. He kept telling me about how he remembered me coming to play for him when he was "in the hole." He continued to talk about the time he was "in the hole" between songs for the rest of the session. As I was starting to pack up to leave, he shook my hand and started talking more about that experience when he was "in the hole" and I played music for he and his wife. As he spoke, his eyes lightened and he said, "Your music brought me a little closer to Heaven that day. I thank you for it." It was really a touching moment, especially for an old farmer to admit something like that.

Obviously, that was a great way to start the week. It made me realize [again] that when I'm sharing music, whether in session, in passing, or in concert, that I'm not just sharing it with one person, but anyone who can hear me. The emotions and comfort that a musician puts forth is not meant to be isolated and guarded, but shared with everyone in the room. You may direct your attention to one person, but simply sharing space with someone changes their life a little bit.

Loss and the Holidays

I don't have a very long time to write, as I am at my in-laws with a little down time. I wanted to take a little time to talk about dealing with people dealing with loss around the holidays. For a majority of people, the holidays are seen as a time of family, fun, and celebration but for many people, holiday celebrations are just a reminder of the loved one whom they may have lost. It's important that we give people space, acknowledging their loss, but still not alienating them if they should still want to celebrate. In my experience, people who aren't grieving may have misconceptions of how the bereaved person should cope. Some want the bereaved to "get over it" and join in the fun, while others assume that the bereaved will not want to take part in anything even remotely associated with happiness or joy.

I played at a memorial service for a client who I had only seen once (in which she was unresponsive), so I did not have the opportunity to build up a great relationship with her. Her daughter, however, wanted me to play at the memorial service. When choosing music, she said she wanted celebratory songs and at least one Christmas song. I chose "Away in the Manger" because of the last verse: "Be near me Lord Jesus, I ask thee to stay close by me forever and love me I pray, bless all the dear children in thy tender care and take me to Heaven to live with thee there." I thought it was very bold to want a Christmas song and, as I was playing it, I could feel the tension in the room. It's very hard to reconcile the joy of the holiday season with the grief of loss and it's something that thousands of people struggle with every year.

I guess the point this little story is this: Don't assume that everyone is having a "merry" Christmas. If you know someone who is grieving this holiday season, don't assume you know what's best for them.

I hope everyone reading this has a very blessed Christmas and peaceful New Year!

Early Christmas Gift

I wanted to take this blog post to talk about one of the greatest moments of my life: becoming a father. My wife and I had a baby girl named Maren on December 4th. That day was one of the happiest days of my life, tied, of course, with my wedding. My wife was a champ and gave birth without any pain medications and the result is this beautiful little girl. She was about 2 or 3 hours old when this picture was taken.

Of course, music had a big part in the birth. It was the first time I've ever tried to put together a string of songs together for relaxation that lasted more than an hour. In fact, I wanted to make sure I had enough, so I had 13 hours of songs on my iPod, ready to go at a moment's notice. My wife's preferred music when she needs to relax is acoustic music, so that was a must. It was pretty easy to find a lot of acoustic music, but there was one caveat. Given the fact that she was going to have the baby without the assistance of any pain medication, I knew I wanted her to feel empowered by the music of strong women. That made the playlist a little harder to negotiate. We have several days worth of music on our computer, but there was a limited amount that fit that description. Eventually, I had to relent and use some male musicians as well, but always tried to intersperse them between females, and never more than 2 or 3 in a row.

Aside from choosing the music, I also helped my wife try to relax during contractions, which became increasingly stronger. Much of what I did was take her through short breathing cues and used positive affirmations to encourage her. That, coupled with me timing the contractions, seemed to help a bit. Generally, my talking went like this: "Okay. Take big, deep breaths from your belly and focus just on this one breath. 15 seconds. You're doing great! Just take it one breath at a time! 30 seconds..." and would continue for the rest of the contraction, which would usually be a minute. Obviously, I was not at my absolute best, but I can't help but think that my music therapy experience helped quite a bit.


Overall, the birth was a great experience for my wife and me. Labor was 11 hours with only about 20 minutes of pushing. We were able have an experience that we set out to have. Most importantly, by the end, we had a beautiful daughter!

Story: Unusual Christmas Request/Response

First off, I want to apologize for my little hiatus lately. Suffice it to say that my wife and I have moved and are having a baby in the very near future. Now, I'm going to try to get back on track.

I had an interesting experience yesterday while doing an assessment. For those of you who aren't familiar with a music therapy assessment, this is what music therapists use to assign goals and objectives for their clients. I assess four different needs to find appropriate goals: social, spiritual, physical, and emotional needs. I usually don't know what I'm getting into right away when I start an assessment, which can be a challenge for me as an introvert. I have to meet new people, figure out how to interact with them, and decipher how I can best help them. This can turn out to be an interesting experience, as this particular story indicates.

I met the gentleman on hospice care who I was assessing and he was basically unresponsive. His wife was sitting in the corner of the room, not by the bed, and I could sense that she was understandably very anxious with the situation. She did not seem to know what to do with herself and vented her anxious energy through talking very quickly and at length with me before we started the assessment about the food that people had been bringing her in the hospital for support. At this point, I was a little worried that I wouldn't actually get to play any music for my client because she would take up too much time. However, I was able to corral her thoughts to music. I mentioned that, around the this time of year, some people like hear holiday music, but that I had other styles like country, hymns, jazz, and traditional folk music. She said, "I don't think he's going to make it to Christmas," and began to choke up. I said, "Well, we could bring him a little Christmas now, if you want to." She jokingly inquired, "You have 'Grandma Got Run Over by a Reindeer'? We used to laugh every time that song came on." I did have that song, but have only played it a handful of times for the clients who I know wouldn't be offended by the song. I responded, "I sure do! Want to start out with that one?"

As I started playing it, her mouth began to curl into a little smile, but with very mixed emotions. Her face clearly showed her emotions, but they were very mixed. She seemed to enjoy the song, but then grew sad at the fact that he would not be able to laugh with her when this song came on anymore. She began crying and got up to hold his hand. She sat in the chair near the bed and stroked his hand, cried, and rested her head on the side of the bed. Her grief was evident, but still restrained. At one point, the clients' eyes fluttered a bit as she was talking with him and it filled her with such joy. I told her that the sense of hearing is the last to go and that I'm sure that the client loved to hear her voice. She began talking to him between verses of songs that I would play and it became this beautiful sharing moment between this old couple, these old friends.

Processing the session afterward, I was trying to pinpoint the moment when she began to open up, express her grief, and share with the client. I realized it was during that first verse of "Grandma Got Run Over by a Reindeer." I would never have chosen that one to kick off the assessment and realized that no other song would have granted me access to that response. No other song would have conjured up such an experience for my client's wife. No other song would have started the process of grief and sharing that I had just witnessed. As I thought of the session, I was reminded that music carries its own powers and emotions, and I am simply there to facilitate that process. I think it was a good lesson for me to learn again. I guess music can do a lot without my help and sometimes, I just need to get out of the way and let it do its work.

How I Got Into Hospice Music Therapy

This is a little follow up on my previous post, where I talked about how I got into music therapy. Today, I wanted to write about how I got involved in hospice. In case some people didn't know, music therapy can be used with a wide variety of populations, like hospice, hospitals, educational facilities, nursing facilities, rehabilitation, mental health centers, and even prisons. I think some people may have an idea of who they want to work with when they start studying music therapy. I, however, had absolutely no idea. If you recall, I barely even knew what music therapy was before I decided to major in it.

As my studies progressed, I decided, "Yes! I do want to this!" The next question, then, is "How and with whom do I want to do this?" You see, aside from the various populations to choose from, there are several different music therapy perspectives, methods, and approaches music therapy. How you believe music affects people can help you decide on a population to work with. Alternately, who you want to work with may affect your perspective on how music therapy works.

At first, I began thinking that I wanted to use music to help at-risk adolescents. I remember being a teenager and thinking that, some days, music was the only thing keeping me going. I expressed myself through music and thought that, if I could help teens express themselves positively, then I could help them make progress toward being successful in the world. I thought about this for several years in college, until one of my classes had a music therapist who worked in hospice come to speak. I immediately was drawn to it. I loved the idea of being able to bring some peace and quality of life to people who were dying. My only previous experience with music therapy and dying was during a practicum at the hospital in town. I had no idea what I was doing and I basically watched my supervisor take over and was pretty much in awe of the whole experience.

A few months later, it was time to start looking at internship sites and figuring out what I wanted the next step of my life to look like. I had decided that I would look into hospice settings, partly because I didn't have a hospice-specific practicum, and also because I thought I would really find the work rewarding. Long-story-short, I ended up getting accepted into the internship program at CarePartners Hospice in Asheville, NC and fell in love with the work. I loved working with the clients and their families. I enjoyed the challenge of learning all kinds of music. I especially loved the other people who worked in hospice. You need to be a special kind of person to deal with death on a daily basis and the people you can trust to do the job well are second-to-none the kind of people I want to be around.

Hopsice can be really challenging. An example of that is when a client died during my very first session this week. It can be emotionally exhausting and can leave you feeling almost numb sometimes. But a vast majority of the time, hospice workers are celebrating life, not worrying about death. Death will happen to all of us, so celebrate when you can.

How I Got Into Music Therapy

Through listening to a few great podcasts, like The Music Therapy with Janice Harris and Music Therapy Round Table, I have grown to realize that every music therapist came upon the profession a little differently. I guess I always knew this, but it has come to my attention a little more lately, so I thought I'd follow suit and give my little story.

I've been singing since before I can remember. My dad sang in a men's chorus and the church choir and, being a little boy, I wanted to be just like Dad. I remember singing the liturgy in church and I remember singing "Silent Night" by myself for church when I was about 5. It makes sense, then, that I focused much of my efforts in school on music. I always got good parts in little plays and musical productions, mostly because there were not a lot of other boys that wanted to do them. I don't think I ever made the conscious thought that "I want to make music for my life's work", but I think that, deep down, I always just wanted to make music as a career.

While I was developing as a musician, I also started finding that my friends would come to me when they needed to talk or needed support. I was good at keeping secrets and giving a different perspective on hard situations. People seemed to like that about me. Eventually, even people I didn't really hang out with would tell me their problems. This was around high school and it was about that time that I thought I could make a career helping people. I initially was thinking about counseling or psychology.

During my junior year, when all teachers start saying things like "When you get out of high school..." or "In a real job, you will have to/can't get away with..." and really started trying to get us to think about college or what jobs we wanted. I talked to my mom about wanting to do something with music but also liking the idea of helping people. She is a substitute teacher, so she took a prep hour and looked up various careers, printed out a list, and brought them home. She never said, "You should do this," which is good, because knowing myself at that point, I probably would have done the opposite. Music therapy was listed on the front page of the stack, though, and it immediately caught my attention. I spent some time on the American Music Therapy Association website and knew that's what I wanted to do.

I guess I got lucky, because I didn't really know anything about music therapy before going to school for it. I chose my college based on who had good programs in the Midwest. If music therapy hadn't worked out, my life would be a lot different that it is now. I can do my next post on how I chose which field of music therapy I wanted to work in, but I think this is enough for today.

Have a great weekend!