The time has come for the truth to be exposed about MUSIC THERAPY in AGED CARE!!!
Referencing a bunch of questions and comments that I've heard over the years, let me make a few things clear....
"Oh, you've come to do a singalong! How lovely"
Out my mouth = "Yes, I've come for music therapy" (with a sweet smile).
In my mind = Actually I've come to work intensely and therapeutically with 30 individual residents in the space of one hour. I've come to observe their reactions, their interactions, their responses, their facial and bodily affect, the way they move, the way they express themselves verbally and non-verbally, to notice whether they instigate these responses or require facilitation, to assess their particular mood for that particular day in order to decide whether I aught adapt whatever session I had planned to better suit their needs. While I'm doing all of these things for a whole bunch of people all at the same time I'm going to smile and sing and make them FEEL like they are part of an old-time singalong or a chit chat or a trip down memory lane whilst all the while I am secretly addressing their therapeutic needs through musical interventions. So yeah - I guess you could say it's one complicated singalong! (Oh, apart from the times when we don't sing at all - like when we're dancing, exercising, song writing, relaxing, doing quizzes, going outside, going online etc. etc...)
"So, did you have to do some sort of training or a special course to be able to do this?"
Um - actually, YES, yes I did! Personally I did 6 years of Uni which included moving interstate, "hundreds" of hours of clinical placements, "hundreds" of hours of a Masters thesis, "hundreds" of hours of emotion and anxiety and insecurity. Music Therapy is an allied health profession and EVERY music therapist has to study for at least 4 years (in Australia anyway) and graduate to be able to register with the Australian Music Therapy Association. It's really not for the faint hearted!
"I'd rather you not play those war time songs because some of our residents might get emotional."
I had a facility manager ask me to "perhaps not sing songs that trigger memories from the war time" because a volunteer had seen a resident cry when we sang a war time tune. She also asked me not to sing about dogs as a resident who loved dogs had recently passed and she didn't want to risk upsetting anyone. I realised at this point that perhaps the facility manager didn't quite understand the concept of music 'therapy'! I asked if I could have some time to discuss the program with her and the volunteer and any other staff who were interested, but alas she did not have the time. I wanted to tell her that in fact it's not such a bad thing at all for a resident to shed a tear - especially to shed a tear in a group environment while others are there to support them emotionally, to heighten their sense of belonging amongst a bunch of their fellow residents, to have the opportunity to reminisce with others who often can honestly relate and show true empathy. The act of being supported therapeutically in such a setting is often enough to resolve that emotional blockage and improve their quality of life. To shed a great is often a FANTASTIC outcome!
Unfortunately the facility manager, who never had the time to listen to any of my explanations, eventually gave music therapy the boot :(
"Would you like me to go and get the song books for you?"
Thanks for the offer but I like the idea of 'exercising the mind'. Singing from memory is a great way to demonstrate recall of long term memory and is also SUPER EMPOWERING because, generally speaking, we never seem to lose lyrics permanently. We may need a reminder or we may need to hear the melody but it's a very rare occurrence to come across someone who has actually forgotten the lyrics to the 'golden oldies'.
While I'm on the topic of 'song books', imagine what it's going to be like when Gen Y are in aged care! To suit everyone's needs there'll have to be a hip-hop song book, a pop song book, a country song book... thank Goodness I'm working with people who only had the one station on the wireless - makes my audience much easier to please!
"I don't think we need any documentation, we'll take an attendance list and that should be enough - how about you just spend your time doing the music."
Sorry lady but it's MY professional credibility on the line here!! I must admit that in the early days I sometimes relented with this one (who wants to do paperwork anyway?) These days however it's a no brainer. Documentation is a must - Imagine if a physio therapist did weekly consults and didn't document what was happening with their clients!?!? Absolute outrage! Well it's EXACTLY the same with a Music Therapist. Imagine if the accreditors came to visit, saw music therapy listed on the calendar and found not a lick of paperwork in regards to what it was that we were doing!? Imagine if Vera was played country music during her palliative journey when she absolutely DESPISED country music but there was no MT assessment in her file so no one knew! Imagine if Basil's chair was placed 5 metres away from the music therapist, when an MT assessment would have CLEARLY shown that he was deaf in one ear and needed to be sat directly to the left of the therapist! Imagine if Esme's daughter asked you what you were trying to achieve through Esme's involvement in MT but and you had no Care-plan to show her! Imagine how unprofessional that would look! Imagine if Clyde's radio kept being turned on every morning but an MT evaluation would have shown that in fact, the radio has shown to make Clyde appear anxious and he should only have specifically selected music played to him. Eeeek - just the thought of it all makes me shudder!!
"Yeah we really want a music therapy program at our nursing home - we thought maybe you could run a choir?"
Haha, *chuckle*, the old choir suggestion hey... Yes, I totally love a good choir and don't deny their amazing therapeutic outcomes... and yes, many residents often have a long, positive history with choirs.... CHOIRS OF THE 1940's THAT IS! A time when the choir was an exclusive singing group, where you didn't sit with your friend you sat in your specific vocal group, there was absolutely no place for chatter, there was a large focus on hymns and there was a very definitive 'leader'. The choir of this day was a very serious event with a reputation to uphold. Go on, you try to eradicate these ingrained choir ethics from the mind's of the oldies... ha!
"Shall I go and get the box of instruments so the residents have something to shake?"
Hmmm, a tricky one and I often say "thanks, that'd be great" even though I usually feel uneasy about it. It's a very fine line between 'age appropriate and practical', 'patronising and creative', and I usually feel that handing out a bunch of shakers is a little bit too 'kindergarden' for aged care. Of course every resident is unique, shakers do have their place and some people will show endless joy from shaking their shakers...
But that time I took ten djembes to the nursing home with me was amazing! A new EXCITING instrument, a stimulating conversation about it's cultural background, able to be played by everyone as they sat at chair height and don't need to be held, a variety of sounds to be made and techniques to create them.
My advice to nursing homes on stocking up their activities cupboards with instruments??? Keep the box of shakers but add a bunch of exciting 'grown ups' instruments :)
"Come on, that's enough chat everyone - lets get back to the music"
This comment usually comes from the residents themselves but I'm always quick to reassure them that chatting is just fine with me! It's a great opportunity to demonstrate recall of long and short term memories, develop stronger social networks, support each other emotionally, express themselves verbally and develop a sense of control over their sessions. In fact the music part is really nothing more that a 'tool' that I use to actually encourage interactive discussions. Sometimes we will sing or listen to one song and then Woosh - the session takes a tangent. All of a sudden we are talking about motor vehicles, then we are talking about the olden days, then we are talking about residents families, then we are sharing happy memories of our childhoods - before we know it an hour has gone by and everyone is blissfully sharing their lives with each other. Music has played a very small but very vital part in this session and all the goals I was aiming for were achieved :)
"No there's probably no point working with him at this hour - he gets too anxious in the afternoons"
Afternoon anxiety + music therapy = a match made in heaven!!!!! Seriously! If you can organise a music therapist to be at your nursing home around 3pm(ish) you are onto a winner. Putting on a CD just doesn't cut it in this scenario, but having a music therapist sitting next to an anxious resident, making eye contact and singing soothingly with them really does make a difference. It can make a wandering resident stay still, a non-verbal resident sing along, an aggressive resident keep their hands to themselves and a distressed resident forget their worries.
"I don't think we really need music therapy here - we have a local group come and do a concert for us every couple of weeks".
Well hopefully after this post goes viral throughout the ever growing world of aged care networks this comment will never be made again!!!
Music therapy truly is SO MUCH MORE than a concert, a distraction or a singalong.
GET AMONGST IT!!!
Please don't hesitate to contact me at ohmymusicalgoodness@gmail.com if you have ANY questions about music therapy in aged care!!!
You could also contact the Australian Music Therapy Association on http://www.austmta.org.au/
