On My Own...

I left the house around 8:45am this morning to meet the MT at the care facility where I had met our company president and founder. Of course, the first thing I did was get on the highway going westbound instead of eastbound, so already I was set about 10 or 15 minutes behind thanks to all the traffic. When I finally got there, the MT was already waiting inside. I felt bad for being late and really wish I hadn’t gotten on the wrong highway at first. The MT and I went to check on all our pts and see where they were. Two were sleeping, one was sitting with the group on the reminiscence wing, the other was about to be bathed by one of our HHAs, and our gentleman pt was with the group on another “unit.” The MT and I split up, she taking our gentleman pt, and me on the reminiscence wing. Since there was only one of our pts there in the gathering space (other than the one leaving to go get her bath,) I decided to take her over to the piano instead of me playing guitar for the whole group. I’m still shy about playing, so I’d much rather play an instrument I’m more comfortable with and to only one pt instead of playing guitar and singing to a whole group. I wish so badly that my pts knew pop songs from the past decade… those are the songs I know! I’m lost when it comes to music from the 20’s and 30’s… the MT wheeled our pt over to the piano, and I sat down on the bench with our company’s binder full of songs before me. I spoke to the pt, but she didn’t respond. She didn’t look confused either… it was as if I wasn’t saying anything. I began to play “Let Me Call You Sweetheart” and tried to make eye contact with her as much as I could, and not look at the keys. She wasn’t engaged in the music at all. Then, the staff from the facility wheeled over another one of their pts to sit and listen to the music. I continued to play and sing, but still no response. The other pt at least smiled at me! I played song after song, flipping through the “Traditional” section of the songbook. About 10 minutes later, the staff wheeled over our cute little Japanese pt who was supposed to have been getting a bath. She was slumped down in her chair with her arms firmly crossed and her eyes closed tight. I greeted her with a warm smile, receiving no greater a response than from our other pt.

So there I sat, flipping through the songbook, singing songs for two pts who were mentally in another place, and a third pt who would’ve smiled if I played Schoenberg or Metallica.
I was concerned that our little pt with the crossed arms. Last time I saw her she was so happy to hear the music and smiled so sweetly. I went over to her and sang unaccompanied by her side. I gently touched her arm, but she only tightened her grasp around herself. She squeezed her eyes tighter than they already were. I thought maybe my singing was that awful that I made her squeeze her eyes shut and pull away from me, but she was in that sort of mood when we first arrived, so I’m hoping it wasn’t my singing… However, if it wasn’t my singing, then it probably means she was upset or in pain, which is even worse than her hating my singing.

I returned to the piano and flipped through the songbook some more. As I flipped past the last page of the “Traditional” section, I panicked. I had entered the children’s section of the book! I don’t know what else to sing! That’s when I found “It’s A Small World.” I thought this was perfect since Disneyland is only a hop, skip, and a jump away. I opted out of playing anymore piano, and just turned around and sang directly to the pts. I asked them if they had ever been to Disneyland. No answer. The dear pt who was continuously smiling was wearing a Winnie the Pooh sweatshirt, so I asked if she had ever been there. I told her that Winnie the Pooh was there, and Tigger too; as well as Mickey Mouse, Minnie Mouse, Cinderella… our silent pt looked at me as if I was naming famous Norwegian scientists, or other names she’s never heard of… and my other pt was just as closed off as before.

“…it’s a small, small world!” I said to the pts, “Isn’t it a small world? It’s amazing how you can find similarities with almost anybody. See, you two both decided to wear pink today!” No response. I gave up. I thanked them for letting me play music for them today, and said individual good-byes to our two pts. I told our little Japanese pt that I hope she gets lots of rest today. Then I left (even though I felt like I was escaping!)

When I found the MT, she was just finishing with her pt as well, so good timing on that front! We went to the office upstairs, charted on our pts, and went on our way. I thought it would be easier playing for the pts with dementia, as they are probably less quick to judge, but boy was it hard! I felt so foolish! I want to say I made a positive impact on their day, but I don’t know if I really did… with no feedback at all from the pts, how do you know if you made a difference?...

Since we’ve had a lot of new admits in the past couple of days, I went off on my own (eek!) to see a pt we’ve had for awhile, who is now actively dying, while the MT went to see our new admits. So back to the SNF we were at yesterday I went. I honestly was not nervous at all to go see my first pt by myself. She was pretty unresponsive the last time I saw her, and I figured she’d be in a deep sleep, so all I would have to do is play some soft music on the guitar for her to help her be at peace, and to know that someone was there for her and to comfort her. Well, to my surprise, the pt’s family was there gathered around her. “Oh, you’re going to play music? How nice!” the pt’s daughter said. “Now do you do this as volunteer work?” “No,” I said. “This is my job… or at least will be. I’m a music therapist. It requires schooling and a degree.” She looked lost for words for a moment. “Oh, how nice,” she said with kind sarcasm. The pt’s son found me a chair and placed it by the pt’s bed. I sat down with my guitar as her family anxiously stared at me, full of pleasant curiosity. All I could think about was choosing songs the family would approve of and calming the pt, while still defending my profession and proving that no, this isn’t just some volunteer gig! I finger-picked some through some chords till I found a key that would be good for “Amazing Grace,” my new go-to song. I could hear the family behind me keep saying, “Oh isn’t this so nice?” And of course, more family members arrived, as if I wasn’t nervous enough already. I haven’t been playing guitar much lately, so the strings felt like they were resting on my bones. So much for these callouses that do a whole lot of NOTHING! After some “Peace Like A River,” I threw in some “Kum Ba Yah” and privately dedicated it to my dear Uncle Tommy since it’s his favorite music therapy song.

After about five more minutes of playing, I got out the songbook and gave it to the family. I said they could pick out a song that they think she would like. The son asked if I knew any Italian songs (if you knew the pts last name, you’d know they were obviously Italian.) I told him that other than that song they always play at the Olive Garden, my Italian repertoire is rather limited. He laughed and said it was okay. (Note to self: learn some Italian songs!) The daughter said she liked Christmas songs, and suggested “Silent Night.” Thank you! A request for a song that’s easy, and that I know all the words and chords for!

After a couple Christmas tunes and another run through “Amazing Grace” upon request of the daughter, I gathered my things and went on my way. Before I left, I told the family that if they needed anything to not hesitate to call us, and that we’re here not just for the pt, but for them as well. They graciously thanked me, and I graciously left, glad for it to be over.

I don’t want to come off like I don’t enjoy music therapy. It’s not that at all. It’s just nerve-wracking starting out, and I’m not very confident in my skills as of yet. I actually didn’t think I’d be seeing pts by myself till the 3rd or 4th month, so the fact that I agreed to going alone surprised even me! But anyway, just please know that when I say I was glad to leave a pt, I’m just relieved to not be under pressure anymore. I really do enjoy playing for the pts and interacting with them, and I can’t wait for the day that I feel confident in what I do and the pressure and nervousness goes away.

So, now to an in-service and IDG meeting, the fun part about this job :-P