Okay, I am WAY too exhausted today for any extensive narrating, so here is just the basic concept of what happened today. I apologize in advance for the sparse detail.
I met the MT and our new HHA at 10:00am to see a pt at a board and care. This was my second time seeing this particular pt. She is very frail and mostly rests. We sang spiritual songs for her, and she continued to lay there with her eyes closed. However, whenever we would ask her if she would like another song, she opened her eyes, looked at us, and said with a smile, "Oh that's very nice... yes, very nice... thank you!" The MT, HHA, and I stayed for about 20 minutes with pt, singing traditional spirituals to her. Hopefully we were able to improve her quality of life and brighten her day, just as she brightened ours with her cute little smile :)
Our next stop was to see an elderly woman at a nursing facility a couple miles down the road. She was sleeping when we arrived, so we started playing some soft music to comfort her as she rested. She opened her eyes to the music and looked at us, but that was pretty much the extent of her response. The patient was nonverbal lacked any significant emotional response to the music. The MT noticed she was on TPN. Since she is being administered IV nutrients, she is considered to be receiving life-sustaining medical care, which is not part of hospice. Our company is unique in that it accepts a certain percentage of pts with such needs (but are limited to only a % due to funding since we have to pay the expense for that treatment). It's not that our company would stop services just because she's on TPN, but rather, the MT wasn't sure if they company knew, because it is an important factor in the pt's careplan, plus it affects billing.
The third pt was at a nursing facility that staffed THREE MUSIC THERAPISTS! I was introduced to two of the ladies, and hopefully I'll be able to go shadow them someday and observe what they do (it's always nice to meet other MTs!) Our pt there was sleeping, and since she experiences a lot of high anxiety due to her dementia, it is best to let her sleep and not disturb her.
Our fourth pt was also sleeping when we arrived. The MT said she usually opens her eyes when she hears the music, but today she continued to sleep. Even as the MT rubbed the pt's arm and spoke directly to her, the pt still did not awake. She noticed the pt had a small furrow in her brow, possibly indicating that the pt was experiencing some pain... either the pt was just having a bad day, or the pt is declining, as hospice pts do...
Our last visit of the day was to the pt I've visited most frequently. We are d/c-ing or "graduating" her from our services on the 16th, and came to drop off the lyrics I printed our for her, and to just say our good-byes. However, she wasn't in her room, and did not answer her cell phone when the MT tried calling her. We left her notes and I might try and see her tomorrow.
And that's that. Lots of traveling today, and now I'm pooped.
La de da!
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Added significance to pt #2 of the day:
ReplyDeleteShe opened her eyes and looked at us when we were playing/singing to her -- RN just emailed the team saying that the pt's children were sad their mother could not make eye contact with them. Could be that the music was able to stimulate her mind via a different route than speech, allowing her to focus her attention on it. Also could be that her children happen to come at the times when she is disoriented or drowsy. Personally, I believe it was a mix of both.
The important thing is that the pt CAN make eye contact (some what), providing hope to her children that she may be able to make eye contact with them sometime. :)