A few of the many amazing stories I have found myself in these past 6 weeks of my internship:
Dang my Rowdy Soul
My second week we visited a newly admitted patient in her home. Her quality of life was very low and she was unresponsive to us and our music therapy, but we knew the husband would benefit, which is perfectly appropriate in hospice. After we explained what music therapy was, the husband told us what his wife likes, and also mentioned a song that he was interested in hearing, called “Dang my Rowdy Soul”. He explained how he used to listen to this song on his grandparents’ Victrola but hadn’t heard it after they died. I took it upon myself to find the song, which I did thanks to Youtube, and I wrote it down and learned it.
The next time we visited, I played the song for the husband. He confirmed it was the right song and was a little flabbergasted that I had found it just for him. I asked him when he heard it last and he said 1951, right before he left for Korea. He was very appreciative of our visit and our music.
His wife died the next day. It may seem odd to hear, but sometimes death is a good thing, especially considering her quality of life was so poor and it was very hard on the husband. But what struck me was that we wouldn’t be going back to visit. If I hadn’t learned and sung the song for him on that second visit, he may never have heard it again.
The Old Rugged Cross
We went to do an assessment (first time visit) of a current patient with dementia. My supervisor was familiar with the patient and warned me that she may be agitated. We arrived to her room in the nursing home and looked in. The patient was small, and curled up in her bed. She was in the fetal position and laying sideways. She appeared to be sleeping. My supervisor knelt down next to her, touched her hand over the blanket, and spoke her name. Her immediate response was a jerky motion and “what do you want?” but didn’t open her eyes. When we said we were here to share music with her, she said “alright.” Knowing she was spiritual, we began singing hymns. The patient began singing along but never opened her eyes. After a period of singing, we said good-bye and that we would be back soon. The patient thanked us for coming and was very appreciative. She was pleasantly resting when we left.
Upon writing our note in the patient’s chart, we found several other notes stating that the patient was agitated, mean, and uncooperative, calling people names and telling them to leave her alone. My supervisor and I looked at each other in bewilderment. How interesting we didn’t get that response at all…
Precious and Few
On a Friday afternoon, the last patient of the week, we did an assessment of a gentleman who had been discharged from Hospice and recently re-admitted. Only in his 60s, he was rapidly declining due to Alzheimer’s disease. His wife was present and was coping well with her husband’s condition. Since my supervisor had done music therapy with this patient before he was initially discharged, she knew some of his preferred music, and also that he used to dance. Usually only able to hold attention for five seconds on one thing, the patient kept dancing with help from his wife while my supervisor played a blues progression on the guitar. When the music stopped, my supervisor talked to the wife about her husband’s care, while the husband wandered around the room, not really focusing on anything.
Knowing the song “Precious and Few” was a significant song for the couple, my supervisor pulled it up on her iPad and played the recording while the wife took her husbands hands and moved them in a circular motion while dancing. He complied and moved along with his wife.
As I was watching, I noticed the patient was moving, but not exhibiting any kind of affect (emotional response) and not acknowledging his wife. Then, for a brief moment, the husband put his left arm around his wife’s waist and pulled her in close, resting his chin on her shoulder. She laughed and “awww”ed and said, “See, you’re still in there somewhere.” But before she finished her sentence, he went back to his previous behavior. The moment brought tears to my eyes.
I spent most of last week in orientation, so I was in the office and not out on visits. There’s a particular song I’ve introduced to my supervisor, called “Going Home.” It’s poignant and very appropriate for those last days and moments of a patient’s life. Just as my training was getting underway one morning, my supervisor texted me and asked me to call her so I could sing her the melody of the song, as she was about to visit a patient who was impending (very close to death) and she wasn’t completely comfortable with the song yet. I left her a voicemail of me singing the song and she also was aided by a Youtube clip.
She texted me later that the song was perfect for the moment and the family members were able to grieve openly with each other. My supervisor left the patient relaxed, though still showing signs of impending death, and the family, close together.
The patient died that afternoon.
Oh, how much have I seen the effects of music therapy in hospice care. It’s the soft cushion of care and support upon which our patients and families rest and breathe.