Older Adult Panel (10/28) Closed Caption Text

October 29, 2021 | By More
11:31:51 I am going to record this meeting for those of folks who are interested in learning from the content and not able to come today so I'm going to just take a moment and press record.
11:32:03 You should see something pop up in your.
11:32:08 You should see something pop up.
11:32:11 Just asking you to accept that it is being recorded and that you consent for it to be recorded if you stay in the meeting.
11:32:19 I am so thrilled to be having this discussion today. I want to start with a little disclaimer about our language saying that this is about music therapy with older adults.
11:32:32 I know that the national clinical practice committee is trying to help us as a field move toward more Person Centered language and do away with population focused language in how we talk about our music therapy practice.
11:32:47 But I think that it is very difficult to articulate the specific and unique clinical wisdom that comes with working with any group of people and and also older adults as a whole.
11:33:03 If we remove that language from our discussion.
11:33:07 Older adults as a group face their own challenges and oppressions within our society. And I think that, to not refer to them as older adults or races, a lot of those challenges and oppressions that we need to be aware of this music therapist clinicians.
11:33:22 So, we will be referring to the group that we work with as older adults. Today, I'm very pleased to present our panel of expert clinicians in music therapy with older adults.
11:33:36 We have their named panelists at the top of at their screens, but we have Melinda Bernhard Olivier colon, Holly Cymru Pauline Broberg Lewin Abby dark Angeles, and we will have Nancy server joining us she is driving at the moment but she will sign on when
11:33:57 she can.
11:33:58 And I'd like to just ask each of our panelists to briefly introduce themselves, where they are in the region, and their background and clinical practice situation as it is, at the moment, so I'm Melinda Do you mind if I start with you.
11:34:14 Yeah, that's fine.
11:34:17 Good morning all. Hold on one second. Hold on one second, I didn't actually record it no i did record it. Okay, sorry.
11:34:24 Go ahead.
11:34:26 Hi.
11:34:27 Hello from Greenwich like New York which is about an hour north of New York City, and I've been in the field for about 30 years, and working with this population for over 30 years, and currently I am offering free virtual music therapy groups for people
11:34:49 living with dementia, with their care partners as well as a free support music therapy support group for the care partners alone.
11:35:03 That's basically it.
11:35:05 Thank you so much Melinda.
11:35:08 And I'm going to call on Olivia next if you don't mind, please.
11:35:12 I.
11:35:21 So my name is Olivia Khan Hello everyone, I am the Assistant Director of therapeutic arts and enrichment programs at a nursing home here in Bronx, New York, and I've been working with this population for 11 years been working with older adults on enriched
11:35:33 living skilled nursing and memory care neighborhoods, we call them neighborhoods, and a lot of my work is focused on group work with older adults and consisting of intergenerational groups, and really learning how to bring all the residents together.
11:35:54 No matter what neighborhood there on finding a way to use the music to bring everyone together.
11:36:02 And, and connect with one another.
11:36:06 Thanks so much, Olivia.
11:36:09 Holly Do you mind going list.
11:36:11 Sure.
11:36:13 I am a music therapist in a psychiatric hospital in Roanoke, Virginia, could have a state hospital.
11:36:21 And so we serve adults of all ages but I work on a geriatric treatment team here. So, talking about labels. But anyway, that's that's what that's what they call it.
11:36:34 And so the challenge that I face here is that prior to work starting working here two years ago, I was a lot like Olivia actually I worked in a nursing home with neighborhood concept, and we worked really hard on having each neighborhood develop their
11:36:47 own culture, and then also how could those neighborhoods come together and music therapy was a great tool for that, especially on our memory care neighborhoods, but really in all of the neighborhoods because music is such a great way to bridge, all of
11:37:02 those gaps, so I've experienced kind of in the ultimate Person Centered model, and then the least Person Centered model possible. And I think it's really important to, you know, use music and both of those.
11:37:17 Thank you, Holly what great perspective.
11:37:20 Pauline would you go Next please.
11:37:23 Sure. My name is Pauline Grover Cleveland, I'm situated in Berwyn Pennsylvania. I work in a local hospice we serve five counties to have about 150 patients, impossible to see on my own, so I had interns.
11:37:40 I went to Mr colada live right near miq lot and most of my students are from there, that we have affiliations with interns at six different schools, all the way from Boston down to Florida.
11:37:49 I work with people that are dying that the government has genes are going to die within six months. And I love, and love what I do.
11:38:00 Thank you Pauline we'll look forward to delve more into that as we talk. And finally, happy, would you mind and Abigail dark Angeles.
11:38:08 I am in Winchester, Virginia.
11:38:11 I have been working with this population for about nine years, maybe a little over.
11:38:19 I actually moved to this area to start the music therapy program at the community that I work in now which is a continuous care retirement community.
11:38:27 So we have independent living assisted living traditional skilled nursing and then a memory care neighborhood as well. And we very are very much that person directed model as well.
11:38:38 So we have students and students that come here as well as interns national roster internship and just kind of the whole scope we have roughly 400 residents and just one of me, but I'm able to work with residents on the entire continuum of care so a lot
11:38:56 of group work as well as individual work from, you know, wellness to rehabilitation to end of life so really kind of the whole scope of older adult work
11:39:08 metastatic thanks so much Abby.
11:39:12 So for everyone just to know I have a few questions that I'm going to ask all of the panelists together to discuss. And then we had a few other questions that came in, in the Google form that I had everyone fill out for the, for the meeting information,
11:39:28 so we will get to those.
11:39:30 If you have questions that come up, as we discussed please feel free to put them in the chat. I would just ask that we don't have ongoing conversations in the chat just so that we can focus on the discussion that's happening live, but do feel free to
11:39:45 use the chat to pop in your questions and comments and responses as you are moved to do so.
11:39:54 So, I'd love to start just by asking and we don't have to go in order or anything I've just for asking our panelists, if you would discuss what you find most exciting about your clinical work with older adults.
11:40:11 And I'll start.
11:40:12 I'll start. I think the really the most exciting thing is that no matter what kind of facility you work in or kind of setting as music therapists, we really get to see our clients at their best.
11:40:23 And so in this population, even, even if it's not hospice, you know so many people only see decline. And so to be able to chart measurable gains, or even maintenance is really great and then to be able to report that to other care providers, or family
11:40:42 members or whatever to be able to say, look, this is, this is what they can do and even to the patient or the client themselves you know to be able to build them up and say look at all of these ways that you do matter, and that you are able to contribute.
11:41:01 Oh, go ahead and answer Next, I kind of have two things that I find most exciting about this work, one I think because working in the CRC model.
11:41:09 I have really long term relationships with residents that live here so they might enter an independent living and I'll work with them all the way through.
11:41:18 And the thing that really strikes you about it that's different from other populations that have worked with, is that the relationship is really appropriately reciprocal.
11:41:26 So, you know, they get to share just as much as I get to share and we're both kind of really invested in that relationship so that's something I really appreciate about this work.
11:41:35 And the second is just the large scope of practice opportunities that are here again from you know the wellness to the rehab to end of life. So, it leaves a lot of variety and, you know, I think even more opportunity for kind of creativity.
11:41:54 One of the things I like most about hospice work is just that you never know when Hospice is going to call. So the thing we try to offer up most of our patients is transition music therapy that music that final song that family gathering at bedside, and
11:42:08 you just never know when that's going to be so there's always this feeling of being on call. There's always this feeling of the preciousness of the moment.
11:42:16 And that makes I think hospice work really exciting.
11:42:23 I I'd like to say that every I resonate with everything that all of you said already.
11:42:30 In addition, as someone in private practice for quite a few years. I love creating brand new programs. And, and there's so much opportunity to do that and hopefully we'll get more into that later.
11:42:44 If any of you are interested in how to create programs.
11:42:49 And so, also I love meeting the people and hearing their stories, they're so fascinating. There's so much to learn from them. And, yeah, I love this population.
11:43:02 Yeah, I also have to say that everything really resonates with me that everyone is saying.
11:43:08 And, and also, you know, just having the opportunity to witness their wisdom and their life experiences.
11:43:17 And, and also to just to see how we are always evolving as humans until our last moments in life.
11:43:28 Wow, that is, a lot of really profound things not only about the work with older adults but also about life itself as I'm hearing all of you speak about the, the, always growing and evolving and the preciousness of the moment.
11:43:45 And then the opportunities for growth for ourselves as well as clinicians as entrepreneurs and program building and and and also like just, just in our daily lives, as we find that this rich this work enriches ourselves.
11:44:01 so I appreciate all of that. Thank you.
11:44:18 I can do him, sir.
11:44:20 you want. Do you want to start Olivia.
11:44:23 Oh sure, yeah.
11:44:25 It's kind of just right at the tip of my tongue but the things that come right out or trauma and grief.
11:44:32 I, you know, as a young music therapist starting out I was like I got the music and I know the song repertoire and I know you know the abilities physical and cognitive abilities to work with, but I really didn't.
11:44:48 I really didn't realize how much trauma and grief on process trauma from years of, you know, life events big life events and grief that isn't just somebody dying but all of these losses that you experienced as an older adult that comes that comes all
11:45:09 of these many layers that come into your groups or your sessions.
11:45:31 And also a supervision has been the biggest part of this work for me is really hearing how other people are experiencing the same things and how we can take care of ourselves and learning when to have a shield for some of those moments so we don't just
11:45:47 suck it all up as empathic humans.
11:45:52 And, and that balance between, you know, the boundaries that are protective of us and then helping you know the people we're working with create those boundaries for themselves and grow and learn and heal from some of that.
11:46:10 Wow that's that's really profound I hear you on the many many losses.
11:46:16 And the difficulty of navigating all of those for yourself and with your co workers.
11:46:21 Abby I think you wanted to go next. Is that right yeah yeah I have kind of several things kind of different perspectives, one is challenge that I've had that I think is not just population specific but music therapy specific is a sort of ongoing dialogue
11:46:38 on understanding other disciplines that might use music.
11:46:43 So, in particular I'm thinking of a co worker that I had that prior to coming here was a professional musician so they used a lot of music in their work.
11:46:54 And so, you know, just having that conversation of, well, I use music in this way, do you have, you know, a scope of practice that guides how you use music Could you share that with me, even how can we work together.
11:47:08 So that is something that's come up here you know several times just knowing that we haven't activities department and so I'm really lucky in that I don't have to do singalongs you know they can do sing along so just kind of discussing how we will, you
11:47:22 know, delegate the use of music right because I think sometimes we think as music therapists we own that right to music. Right. That's something that other people can use.
11:47:33 So there's that. And kind of going along with that is the notion that music therapy is a therapy and not just an activity, so that need for like ongoing advocacy.
11:47:45 And I think when I first started here.
11:47:47 And maybe this just speaks to our training, but we talked so much about advocating that I kind of came at it like aggressive, like this is what music therapy is this is, you know, how it's going to be done, and realizing that actually it comes to understanding
11:48:03 comes from a place of seeing is believing and just kind of having more of a listening approach to advocacy and finding out just where there's opportunities for education.
11:48:15 And like a gentler way.
11:48:17 So, for example, making sure that the appropriate residents come to my various groups. It's like having a description of the group and maybe giving the nurses a list of residents who need to come.
11:48:29 So then it's there and it's posted and that's kind of how it's done. So, those are kind of some of the challenges that I've had here and then just from a resident perspective kind of the the ongoing challenge that I have is dealing with.
11:48:44 To me the most difficult.
11:48:47 Residents will work with is a resident who recognizes that their cognition is impaired. And so they're not so far into their cognitive impairment that they just can't even recognize it and so that goes back to that trauma and grief and so, so I think
11:49:03 for me, that's kind of the most difficult is how do you support someone in, you know, handling this sort of new normal that's again get a transition down the road and all the losses that go with that.
11:49:15 So I think those are kind of the challenges for me.
11:49:18 Yeah, I.
11:49:19 Oh, go ahead Pauline.
11:49:23 I'm just thinking about the challenges and there's some very much there's a lot of logistical challenges. There's nurses that don't get it and you don't see their patients as often as hospice.
11:49:32 There's the driving endless hours to go and see somebody and they die before you get there, that's really challenging.
11:49:38 There's also cold, it was very challenging, we were, you know, people non grata for two months and then all of a sudden is essential workers who were the only people allowed in, and where they're singing songs from a distressed daughter to her dying mother
11:49:52 and being this go between and we're watching people die slowly gasping for breath, the humility of being of singing outside of people's windows of doing things in the courtyard in the middle of winter.
11:50:04 I find those very challenging.
11:50:07 Those were very challenging things but it's really funny that even though those things are really challenging and they're all pretty huge.
11:50:15 Through it all, you know when you when you're with people and they're so vulnerable and they're dying, and they're really distressed and they've just come from Texas and they haven't talked to them other than five years, and you are the one who can say,
11:50:25 And you are the one who can say, I want you to go to bed side right now, you're going to stroke mom, and we're going to sing her favorite song that that that that ability to have to be able to bring comfort to people when they are the most vulnerable.
11:50:39 I think is such a gift. And it I never come home and say oh my god I had a terrible day, I'm like wow today was, I really made a difference. And that's that's that's how I cope with all the challenges and forget the driving forget all the code but we're
11:50:55 not there anymore Like we used to be just pluck a for what it is.
11:51:03 I wanted to play off of. I wanted to say something to go with what Abigail said but now I want to say something to go with what you said Pauline. I think that early on a real challenge for me was feeling bold enough to, to be that person that you were
11:51:18 just describing that that go between between the families, I was working in a nursing home but as you know Pauline it's so hard sometimes for the actual hospice therapist to get there.
11:51:28 So there would be times that there would be a end of life situation right here right now they need your support.
11:51:35 And those those times meant a lot. And I can remember very clearly exactly who the person was and who the family was the first time that I said, Why don't you sing along with me, she hears you.
11:51:46 And, you know, the stepping outside of the room later and the sun's telling me how much that meant to them so I think seeing ourselves as professionals and knowing that we do have, we do have those clinical skills and we need to be bold and and go where
11:52:02 the family needs us to go was early on a real challenge, but I also wanted to talk about what you were saying Abigail about like defining music therapy and the, especially in person centered care right defining where does music therapy fall in all of
11:52:18 this because of course we see this as, see, see this as a whole person. and all of these disciplines are so important.
11:52:27 How can I work with the CNA to be providing the best care what kind of communication. Do I need to have with the CNA so that this person can show up to a group or an individual session with, you know, Maslow's Hierarchy met at the appropriate time.
11:52:46 Right.
11:52:46 So I was just gonna say that was a challenge that I navigated and I just like you came in as such a strong advocate because that's what we were told to do right.
11:52:55 Don't let anyone call you the music lady, but then you think about it, actually had an intern Tell me once that every time he goes into a room he says, I am music to this person.
11:53:05 I know that I am the vehicle, bringing music to them the best way possible. So if someone calls me a music lady that's not so bad because I am the lady who is the music for the person when they need it.
11:53:17 That was a way that it reframed for me. And just like you said, you really just end up realizing that letting your work speak for your sport itself is the best way to advocate.
11:53:29 It's interesting that you talk about being musically the from private practice point of view if I go into a facility and say I I'd like to start a program here, and they're like well we don't have any, any money in the budget.
11:53:43 We haven't we have money in the budget for entertainment.
11:53:48 And I'm like, you know what, put me in the entertainment thing, I don't care, get the money wherever you want.
11:53:55 So just call me that call me whatever you want and I'm just going to do the best I can.
11:54:01 But there's that but there's also, there's for me, why I became went into private practice is that so much politics.
11:54:11 I just always wanted to focus on the client, and apparently that wasn't really what they really wanted me to do when I was working in facility.
11:54:21 They really wanted me to, you know, work that I remember one time basically getting in trouble because someone.
11:54:32 I don't know there were just a number of things that that I really wanted to help the client and and my boss said to me, Listen, you can't you can't do that.
11:54:46 This guy does all kinds of favors for us, you gotta you know it was someone who worked there, he does favors us you can ask him to do this. And I was like, yeah, eventually she wanted to fire me and she did, and actually it was the greatest blessing.
11:54:58 And I started my own thing and and and and also just to tell people out there I ended up going to another facility I applied for it right after that job I applied for a full time position, and it was actually like an activity director thing but I really
11:55:14 wanted to focus on music therapy. So I said, I really don't want to do Bingo. So because of that I didn't get the full time job but as I'm in the interview.
11:55:24 The gentleman who was interviewing me said so why you really not at that other job, like I didn't want to tell them that you know she didn't want me there anymore.
11:55:34 And I guess I got a tear in my eye. And I thought, okay, I blew this interview, it's over.
11:55:41 And he said to me, he said he said you want a tissue and I was like oh man he sees my eyes about the tier and.
11:55:50 And I said, I guess I blew this, and he said no, actually you made, you've made you see more human to me, and I would want you to come on board.
11:55:58 So and I did not get the full time job but once they open it figured out a way to get in music therapy part time job in there, he hired me immediately.
11:56:07 So sometimes you just got to match up with the right person.
11:56:11 And another thing I wanted to talk about which could happen in any population that happened to me and this was another reason why my work changed a lot throughout my career is I ended up with repetitive strain injury from playing the guitar like since
11:56:26 was 10 years old playing and playing and playing in group after group after group after group and and my mom what I want to tell everybody is that going through the field is, is you're like an athlete.
11:56:40 I don't know if they ever told you that in music therapy school but we as musicians we are as like athletes and we have to stretch and we have to keep our body in good shape.
11:56:51 Otherwise, at one point during my career I was not able to lift a fork. It was terrible and I thought my whole career was over, and I found other ways around it, I started playing the drum more I started playing keyboard more better ergonomic instrument,
11:57:05 then guitar. So that's just a really important thing to keep in mind.
11:57:11 Just a quick anecdote to go off what you said Melinda.
11:57:14 You know how it is when you meet somebody and you, they say what do you do when you say I'm a music therapist. Well I had that happen. And it was, this was a long time ago and like a Blues Club, and we were meeting the band and the man was named biscuit
11:57:28 Miller, and I told this guy Miller I was a music therapist and he said that's great therapy for musicians. Let me pull up a chair is that like, you know, for my store hand and for my sore shoulder and.
11:57:40 And it was funny but it also really got me thinking about exactly what you just said how much we have to take care of ourselves as therapists too so completely unrelated but I just wanted you know it's it's it's like it's it's it's like we're in the closet
11:57:54 about what really happens to us. You know, it's like, oh, we can keep playing we can keep going on, but it's hard. It's hard. You really have to stay on top of that
11:58:09 are so many directions, I want to take this discussion because you've all brought up such wonderful points.
11:58:15 But I do know that some of the people who expressed interest in this talk, were newer music therapists or people who are seeking internships and at the very beginning of their careers and so I guess I want to just go off of that last point, how do you
11:58:30 take care of yourself as a musician in this work, and I mean probably really goes to any clinical work but it's certainly relevant here as well.
11:58:41 I'll go, I'll go first. So I think the most important thing in hospice, at least, and what I try to teach my interns is really the importance of seeing the beauty in the moment.
11:58:53 If you can see the beauty in the moment, all day long.
11:58:56 And you can you can you can learn how to do that, you can come to that point. Be like being as precious as it is in the field of hospice.
11:59:05 Then you come home and you feel great.
11:59:08 And this whole idea of well, two weeks from now I'm going to take a trip to sell and sell and then I'll drink that line and then I'll have.
11:59:18 I'm going to feel great then. I think that's unsustainable on many levels. And I think that that just rituals also can be very helpful. I opened my school, I sit in my stool.
11:59:29 I really focus on everything, I put on that strap just like a chaplain whereas one of those things. And then I feel really grounded and like I'm doing, like doing what I was born to do rituals, seeking the moment, those are things that I find really sustaining,
11:59:47 shall we say,
11:59:52 Yeah, I have to I was, I was also thinking about rituals myself of.
11:59:58 What's your ritual before you come into work.
12:00:02 How do you get ready. How do you prepare yourself for your day. How do you shield up if needed if you're going into a resident or a patient or clients room, and you know they're they're a little bit of a challenging case for you so how do you put your
12:00:20 armor and shield on so that you can, you know, be prepared.
12:00:26 And also end of the day rituals or middle of the day rituals, you know, things like how really taking your lunch, like taking lunch is an important thing, making sure you're drinking hydrated nourishing yourself.
12:00:41 All the things that we can get so busy with doing because we are.
12:00:46 I mean we're here, we're with our, our clients we are, we're in their homes for me. I'm in their homes, you know, finding those spaces for yourself where you're not like right in our living room or bedroom kind of space where you're, you know, going to
12:01:03 take the time for yourself that you need. After challenging sessions taking a moment just to read center and then at the end of the day if needed as well.
12:01:17 Yeah, I would say.
12:01:20 Similar along those lines like purposely taking a breath before to before you go into someone's apartment or if you've had a challenging session you know taking a few breaths before you go to your next thing, and kind of with that, this idea of boundaries
12:01:34 right like so.
12:01:37 Personal life versus work life and what do I need, like, Can I structure my schedule in a certain way so that I don't have all difficult residents in one day or, you know, all groups if I know that I need that Brady so you know hopefully we have a little
12:01:53 bit of say over schedule with that but also, I think, for me personally I used to be especially because I started the program here I used to be a workaholic, I would stay late, I would come in on the weekends, you know, and I just realized I'm no good
12:02:09 to anyone else if I can't, you know sustain any kind of, you know, health, emotional or physical so for me really learning that boundary of okay it's five o'clock, like this can wait till tomorrow, taking my lunch, like you said, that kind of thing.
12:02:26 Sure, sure. And I'm so sorry I just wanted to bring on Nancy, because she's arrived and and have her introduce herself as well and so that we can have her voice in this discussion also Nancy, would you mind unmuted yourself and introducing yourself just
12:02:45 where you are in the region, and a little bit about your clinical work.
12:02:56 She may have stepped away, I will check with her and then bring her back in as she's available.
12:03:03 But yes, all of those things seem are very, very, very important. And I also wanted to just put in a little bit of from calling in from my other hat as a classically trained musician, repetitive strain injuries are real and, you know, and a real risk
12:03:22 in music therapy and I think that what all of you are saying about taking a moment for yourself. I like to encourage everyone here to bring that sense of mindfulness to how you physically player instrument.
12:03:37 I had a teacher at conservatory who told me, I'll be honest with yourself when you're practicing. Does it look, does it sound good, but also does it feel good, you know, and if you are noticing that you have just outlandish you know it sounds great but
12:03:53 you have outlandish amounts of tension in your wrist, then you got to change something you know you need to figure out how to apply the, the force of your body in a different way or from a larger muscle group or something like that we are athletes, and
12:04:09 we're we're small muscle athletes, but we're still athletes and therefore susceptible to injury, so I just wanted to call that piece back in as well, and.
12:04:19 And so yeah if. Oh, go ahead please Linda, as an older adult at age 60 I started taking ballet Barre class, and I found that to be like the greatest thing for my body.
12:04:32 And with the pandemic I wasn't able to do that but now actually I just started again yesterday. And I'm taking it. I'm taking the classroom and 80 year old 18 year old.
12:04:43 That's awesome. I did about it. Yeah.
12:04:47 I'm just to play off of what you just said Clarissa I I catch students doing this a lot and I talked to them a lot about how it's not called working music.
12:04:55 It's called playing music, and we do get to use it for our work but it remains play, no matter what, if music is play. And so, maybe you all have experienced this but your, your residence your clients, they can tell when you're not in the music or when
12:05:14 you're not owning the music or when you've gone somewhere else or you don't.
12:05:19 Yeah, you don't have to like the song but you have to you have to be owning the music that you're making in the moment and they can really tell.
12:05:26 And so, if I've had times where that doesn't feel authentic to me.
12:05:31 You know I have to figure out how to, how to, how to make that work. Another thing I was going to talk about with the repetitive muscle injuries, is that early on in my career, my workplace bought a guitar for me.
12:05:46 And I had all this wrist pain, and it took a while for me to say, I have a lot of risk pain with his guitar the action is too high and they said, Oh well, take it to the shop and get them to lower the action you know I was, I was scared to say that like
12:05:59 you already spent this money on this guitar for me. How can I possibly ask for more.
12:06:04 Don't be afraid to, don't be afraid to ask for what you need. And then one other thing, maybe from both the physical but also the psychological side of keeping yourself well is that my primary instrument is piano, and you know that we all use guitar a
12:06:18 lot in work but piano is where my love is. And so I started instituting as many more opportunities as I could to use the piano and looking at that, after being in practice for a few years was a great way to shake everything up and rethink how am I doing
12:06:38 this and what what great new clinical ideas came out of that was really was really cool so look into, you know, look so far beyond sitting with you and a client and a guitar in between your, there's so much more that you can do.
12:06:56 I wanted to add.
12:06:59 And just thinking of our instruments, but for vocalists and our bodies as instruments and working with older adults, a lot of times we are singing in lower registers, when changing our keys and stuff and so just making sure that you are still utilizing
12:07:16 your range so for me as a soprano, making sure that I'm still working up there with some of my, my, higher ranges so that i'm not i'm really keeping my vocal cords, flexible, so that I, when I am working with residents who can use those higher ranges
12:07:37 that I haven't completely, just let that aspect of my voice go.
12:07:44 Yeah, I was going to add two more things kind of along those lines is one is really thinking about the environment in which you're providing the music therapy so I spent a lot of time thinking about this when I first came because I would start doing individual
12:07:58 sessions I'd go into someone's apartment and realize there's only a chair with arms in there for me to sit in So then I'm playing guitar and in a comfortable way or doing groups right we might bend a certain way to get someone's eye level or how big is
12:08:12 the space. And, you know, if you talk to an occupational therapist or have someone that kind of checks out you know the height of your keyboard and your chair and are you doing things ergonomically correct, I don't think we really are taught to think
12:08:25 about that as music therapist, but that's absolutely something we need to think about because that's what we're doing all day long repetitively so I had to really think about, you know, making a cartoon that fit my needs that had a stool so I could bring
12:08:38 us still with me and all that kind of thing.
12:08:41 And going along with that to you mentioned voice I'm just thinking of coded.
12:08:46 I don't know about anyone else but I'm not a vocalist by by trade or anything so singing with masks I found that my jaw was really hurting, and I'd never experienced that before and of course I'm singing louder so they could here.
12:08:59 So I really had to think of okay what can I do to help myself to sustain this so using like personal amplifying device.
12:09:07 I'm just thinking about again the space that I could set people up into really help myself in that way.
12:09:15 Maybe even singing less.
12:09:18 Yep. I use movement a lot.
12:09:22 And there's so much communication that can happen with move and expression with movement, and especially if you don't want to use your voice.
12:09:32 And it's ergonomically good for you to so
12:09:37 these are all really important ways to care for each other and I'm sorry Pauline I cut you off. Go ahead. No worries at all.
12:09:43 I think schools are so important, because I always get my interns in school because they don't like some of the tools that they come with their as bulky as the students in the room.
12:09:52 So this is a little camping tripod things that just barely put you on and they have we have tall ones for higher beds and short ones for lower beds everybody gets to schools and other thing I think is important for interns because they do go through suddenly
12:10:05 they have to learn at 5000 songs for people that are, that are in hospice, and they often get trouble with their fingers with their arms with their bag, all that kind of stuff.
12:10:16 And especially with their voices as well and so I say, take a break from guitar. I want you to go and make a playlist of 10 oldies tonight, just with backtracks and you're going to play those on your phone, and you're going to make sure you can put them
12:10:28 in automatic slow down or whatever amazing slow down, put them in their brains that you like it's so important. We don't want to go from your back to your voice so you don't have to use, you don't have to play an instrument and this is also really important
12:10:38 in terms of stress students arrived, and they're like, Oh my gosh, I only know one him. What am I going to do and they're, they're terrified and that that's not good for the soul either.
12:10:48 And so having these backtrack says backups in five or six different genres just five or 10 songs. Really makes all the difference in terms of meeting those challenges of those first few months of living up physically to the demands of the job.
12:11:04 I think that's an amazing use of technology to help support, you know, sustainability in our work as music therapists I'm so glad that you brought that up, and also about repertoire, we got a couple of questions about, about how to keep repertoire current
12:11:23 and also how it seems as though there's some confusion as to what repertoire is relevant for our, our older adults because a lot of people seem to be saying that, you know, okay.
12:11:49 Why do you think this is happening and what can be done to bring music therapy into this century, and I want to put it, this is exactly how the question was written so it could be that the music of the 1920s is relevant from their childhood memories and
12:12:03 things like that. But what do you all think about our repertoire in working with older adults.
12:12:10 Well first of all, sorry, Go ahead.
12:12:15 First of all, not everyone grew up with the Beatles, like, like just to take care of that to begin with, um, I did, but not everybody did.
12:12:27 Um, so there's that I also think that it depends when, like when I was in school, actually at the beginning of my career. There was a certain repertoire and a lot of it was the 1920s, a lot of it was also songs that since Black Lives Matter happen, I,
12:12:44 they're out of my repertoire now and I had to be really, really careful about something that I've played like 30 years. It's over. Goodbye Oh Susanna not happening anymore, you know, and to be careful with jingle bells and that kind of thing.
12:13:01 I think you need to know everyone who's in your group, and who you dealing with, and and find out from them, what's going on I, I met a woman. Recently, it was a little bit older than me, and she told me now in general, we're taught Well usually around
12:13:20 adolescence is the music that you remember as you get older. And in general, that's true but this woman who I met who was a drop older than me, told me that she had a horrible adolescence, and she wants nothing to do with any of that music, and she likes
12:13:36 heavy metal.
12:13:38 Now this happened to me a couple of times in my career, so it's not the norm. But you really have to know who you working with patient centered.
12:13:50 Anyway, that's along the lines of what I was gonna say is it sounds like maybe why this might be happening I'm not sure that this is you know happening or health is happening but yeah maybe people aren't using utilizing individualized assessment to find
12:14:05 people's musical preferences.
12:14:08 And I think yeah just reiterating that sort of golden rule if you will of, you know, if you get a referral and someone can't tell you what kind of music they like going 15 to 20 years pass their birth year you know, and figuring that out and starting
12:14:24 from there and I think just to point out like my work at a cc RC I work with age of 65 to 103. So you're talking about a huge range. So you might be talking about the Beatles but then you're talking about something far older than that to for the hundred
12:14:39 and three year old. And I think also to just remember that we're looking at the residents preferences, but we're also looking at what music was a part of their overall life, so maybe it's appropriate to use a song from 1920s with a resident who the 20s
12:14:57 is not their young adulthood because maybe their parents saying that that song, so it resonates with them in that way. So I think it speaks more to just learning again like you said that the resident directed what is when music is part of their life.
12:15:11 And what music is their preference right culturally or whatever. I just I just want to jump in because Maria Ji said dumb question Why do you have to be careful singing Jingle Bells Did I miss something in its history, and apparently one of the verses
12:15:27 later on, is something that that uses language, that's negative toward toward African Americans so I don't I do, I do do Jingle Bells I still do it, but I I just do one verse.
12:15:44 And that's what it was.
12:15:47 Um, yeah, just to jump in with what everybody's saying about individualized assessment that is so important, don't discount the music of people's parents because that is important.
12:15:58 And also, you know, folk songs and again I understand that folk songs we have to be very careful. At this point, but they mean something to everybody and can be a great equalizer and what what is that person's folk music is something I like to figure
12:16:11 out.
12:16:13 I've had interns do projects with clients where they create their like music tree. And so the trunk of the tree. And then the branches might be like their parents music and like this.
12:16:26 The first concert I went to so like the music from that time and then you know the songs that played at these important times in my life and things like that, really delving into that can be therapy in itself, for, for somebody.
12:16:39 And then also, can we think beyond pre existing songs.
12:16:45 And, you know, honor music preference by playing music that is in a style. That means something to them, but I'm using it to address whatever their political goals actually are in the moment it doesn't have to be a song, it's, it's music.
12:17:03 And then sometimes that individuals have individualized assessment is so hard like we have a patient here who is really unable to communicate in a very meaningful way and has no family to speak for him, but he has tattoos that look a certain way and I
12:17:16 made a pretty solid guest about his music preference based on that, that he responds to really positively. So I don't know if that's bad if I was stereotyping or whatever but I was using the tools that I had to, to learn about the person, and help him
12:17:34 have gains.
12:17:36 The way. absolutely. I mean, and that all sounds like you are all advocating a very individualized approach to assessing what somebody whose music preferences might be.
12:17:46 And I have a comment in the chat from Alicia, who says yes I see that a lot of family reports a preference for someone with moderate advanced dementia, but the individual response best to music from 20 years before they were born.
12:17:59 And I'm seeing some agreement on the panel there as well. Absolutely, or even I was gonna say, to music that they might have taught their children. Yeah, so I had an example of
12:18:13 a resident was actively dying and the family was at bedside.
12:18:18 And I knew that it was, if you look at the numbers it's not age appropriate the song but I knew that it was a special song that he had sung with his children so as he's actively dying the whole family's bedside singing skin rinky dinky day, you know,
12:18:32 so just to know, that kind of stuff too.
12:18:38 So I wanted to piggyback off of that so I think it's really important people say well there are 100 years old so you got to go back 100 years but you don't you got to go back 120 130 depending on how old their parents were when they had them because lullabies
12:18:52 and things like that that they are the things that they remember we talked a lot in hospice about the onion effect so that people might know songs from the 70s or 80s, but as they decline that line physically that onion peels away and you've only got
12:19:07 the central you're going back to things like Mary had a little lamb. In my country because of the things that are really innate to when they were very very young.
12:19:17 Also I think that it's really important to delineate between what a song is published, and when it was popular people look at things when things were published and it's totally off because it wasn't popular until Frank Sinatra saying in 1960 and people
12:19:29 are like, Wait a second. That's so weird that songs from the 1920s interns do, is they make playlists for just that when we're songs popular, what's your 1900 playlist what's your 1910 playlist.
12:19:42 Again, when people are transitioning what we do when we don't know anything and there's not even a chat to to go by, then what we do is, we often do what we call you know that musical life review, one song for every 10 years of life, or will do what I
12:19:56 call an in honor obsession. We do one song in honor of of parents, another song and honor of grace and other song in honor of all the wonderful times we've had on our life and honor of love on, go on and on.
12:20:09 And so students right up to the individual playlist for each of these categories of honoring, and if they've served in the Army whatever you mean us keep going on and on.
12:20:18 And so these are really great ways to think really individually about music, often when people go into hospice they've been in their house but they're moved somewhere else to get that that critical care that they need in the final weeks of their life.
12:20:31 And it's it's guessing what's best but if you have in your pocket in your tool bag that playlist of one song for every Jew Sonia and if you have in your pocket that playlist of your in honor of songs, then you're really you're armed and that's that's
12:20:47 that's.
12:20:50 And I also. Oh, sorry.
12:20:53 I was just gonna say that I just put a reference to an article in the chat that I find really useful in what you're talking about. It's music therapists perceptions of top 10 songs by decade, it was in perspectives in 2014 So anyway, just a reference
12:21:14 point for anyone who's interested because I found it very helpful, but I just wanted to also add modern music, and I was just thinking about our LGBT and allies group, and there's not a lot of songs that really connect to that population.
12:21:25 So, creating a playlist and then, you know, offering songs to the residents to see what connects with them is this work with us I mean you know if they don't like something it's always an opportunity to say like Hey What don't we like about this but one
12:21:38 that really connected at one time was.
12:21:41 This is me from the greatest showman, and on so many levels and they were really able to both those residents who identify as LGBT or and the Allies could really come together and connect with the song lyrics from some of these, these modern songs.
12:22:00 Absolutely. And I just saw Nancy joined us Hi, thank you so much for being here. I know you're in the middle of a busy clinical day. No, it's you know I couldn't unmute and that's the first time that's happened to me when I joined a zoom from the car,
12:22:23 because I was driving. We love the unmute so I was like I can't talk to you.
12:22:23 Just tell us. Yeah, just tell us a little bit about yourself and you know, I want you to jump right into the conversation but let us know who you are and your clinical work right now.
12:22:32 And, and I do have some comments.
12:22:36 First of all, it's so great to be with all these lovely people that I've been listening to that have the same experiences.
12:22:44 I do feel like I'm at home.
12:22:49 So I became a music therapist in 2010 and I have my own private practice, working with, with seniors, mostly with memory care and assisted living and skilled.
12:23:02 I also was hired part time when I first started at Camilla Hall nursing home, and we add have built, we just hired our second music therapist, other than me.
12:23:17 So I've supervised tons and tons of students and so grateful from template and Immacolata
12:23:25 and really created that that music therapy department.
12:23:32 Under the recreation therapy department so it's been it's been great, and
12:23:40 a couple of things that that I have run into that, that I was as I was listening that were a little different.
12:23:48 I do, I go to many many many facilities and, and gratefully, a lot of them are back after coven because obviously that all went away.
12:23:59 Most of it went away.
12:24:01 Last year, and sometimes I stroll. Many times I just stroll on a floor.
12:24:10 So I've never really sure what the situation is going to be in. And while I don't do hospice work.
12:24:21 I studied hospice work but it's not something that I do all the time. I still run into people who are dying and and sit with people as they are dying.
12:24:34 And when I'm strolling I've, I've had situations where I walk into a room and I didn't realize that was happening until I get there.
12:24:43 So one of the things I help my students with.
12:24:51 And I'm very lucky that that I'm able to do this, is being able to run into that situation without morning family might be there.
12:25:05 And having to go into that space with them, so that I can sing, music, that they asked me or that they know their mom or dad like, or if it's someone that I've been spending a lot of time with.
12:25:19 I know what they like, even if they don't,
12:25:23 and sometimes being alone with that person and you can, you know, and Pauline and I have met before.
12:25:33 You can certainly see the relaxation on the person's face even if they're not communicative.
12:25:41 In addition to being able to go out of that room and the next person you see wants to sing You Are My Sunshine immediately, or so every I'm throwing a song out, but you have to be able to emotionally take that breath.
12:25:56 Quickly, and move into that different space.
12:26:01 And the sorrow I might be feeling because it's someone I've been with has to wait.
12:26:08 And it really is not an easy thing to do, but there are ways to,
12:26:15 to make that happen so that you know you know you're going to honor them later. You just honored them anyway.
12:26:22 And you have to be able to flow in and out of different situations in a stroll that you don't know who's who's next, necessarily.
12:26:32 So I did, I did want to speak to that and I.
12:26:37 The other things the rituals the PTINVT for my shoulder. You know this past year so yes.
12:26:46 Keep that core strong.
12:26:57 Get your exercise and put down the instrument if you need to get them doing something else with you
12:26:58 and music wise I go in and now I do everything, so many different groups so it's anywhere from Frank Sinatra era to.
12:27:06 I've been working on the railroad all over the spectrum and, you know, sometimes it's it's a nice mix sometimes it's the same stuff all the time because that's what they saying and that's what's making the brain go and and get working.
12:27:24 So, Sean. Thank you.
12:27:26 Sure, thank you so much for, for sharing all of those.
12:27:29 All of those experiences and your wisdom around, around that and that does sound so it you know I've been there too and in sort of a different context, I'm a pediatric music therapist by training and so I've done individual sessions have also done the
12:27:44 school, sometimes and and and the quick transitions emotional transitions that need to happen are so important that that you're able to do that but also so important that you don't that you don't delay your grief forever.
12:28:01 Because that is that's that's a very real piece of this work as well.
12:28:06 Again, there's so many directions, I'd love to take this conversation, but I want to acknowledge that I have a question in the chat from Paula, and she asks What are your opinions about introducing new music that can be learned.
12:28:19 For example, a simple chorus to repeat.
12:28:24 Oh, sorry.
12:28:26 I was just gonna. I was just gonna say that, um, I don't, I typically work with themes.
12:28:33 So I don't really like to have a preconceived notion about music if it's simple or not because I don't want to have a judgment of what I'm bringing to my older adults I want them to experience it.
12:28:46 However, so getting ideas from themes from the groups of what what theme would be like to work with. Is this like a protest song and then bringing them options so that they can feel empowered to choose from there.
12:28:57 And then deciding if you know looking at the lyrics reading through the lyrics listening just to the music, then hearing it I like to play our recorded then playing at ourselves how do we feel it in our bodies.
12:29:14 that connects with them or not. Yeah, I just want to say about the idea of simple that as music therapists you know we use varying levels of musical complexity.
12:29:24 For very real clinical reasons there are times when we want the most simplicity possible there's times when we just want rhythm, or when we maybe just want melody with, with the absence of rhythm or or whatever so thinking about simplicity and that kind
12:29:38 of a form might might might make some sense, but I just wanted to share that music is such an amazing way to help to demonstrate that anybody can learn.
12:29:53 I used to direct a choir in the nursing home where I worked, and they were doing a concert all about animals and they were using the song place in the choir.
12:30:05 As part of it all God's creatures got a place in the choir.
12:30:08 And most of them did not know it when we started but we used it anyway. And we practiced it at the beginning and end of every rehearsal once a week, and I knew I had, I knew that we had really achieved something when I saw one of the ladies in the fire
12:30:21 who didn't know my name or her own name humming that song, and I knew like, Yes, we did it, and there's so much benefit there, think about all the neural plasticity that you're harnessing, and all of the ways that you're helping them maintain for as long
12:30:34 as possible so I absolutely advocate teaching new things, as long as you have a framework for it to be successful.
12:30:42 Yeah, I was going to comment on that too to political opportunities I can see for using, you know more new music. One is in our assistive living neighborhoods, we have kind of a music appreciation group.
12:30:56 And so I really let them be, you know, what do you want to learn about next week and I'll put together a whole program and they in that group they actually request, like we were doing love song so then they said well what are some popular love songs today
12:31:10 so then we looked at, you know, performances and recordings of Love Songs of today, or we did a whole program on jazz, you know, from the beginning to now and they said well what's jazz like now, so I think it's appropriate in that situation, and speaking
12:31:26 Holly to your choir, I can think of doing groups on our memory or neighborhood where I'm actually. So I'm a trained and empty as well so using the technique of MTV, where you're teaching them new information via song and asking them later can they recall
12:31:45 that so it's absolutely perfect because you're working on their memory.
12:31:47 So similar to your choir experience so.
12:31:51 And you wouldn't be able to work on their memory in that way using a song that they already knew so you'd have to use music that they didn't know. So, with me music.
12:31:59 Yeah. and so at Mt is neurologic music therapy correct. Okay, yes. Yeah.
12:32:07 I think that it does work I've with the people I work with the people living with dementia.
12:32:14 And I wouldn't do it.
12:32:17 I wouldn't do every song that way but every once in a while I might introduce it maybe something might come from the group that someone might say something over and over again, and or a story or the story they keep repeating and I would you know take
12:32:30 very few words from that and make it into a song.
12:32:39 There's a lot of different ways to use it and even my Hello song It's Hello Hello Hello. I mean, they never knew the song before but you're gonna walk out and when you walk in Hello Hello, they remember it so people with memory impairment can learn new
12:32:53 things.
12:32:55 Yes.
12:32:58 We had a question. A really just a somewhat, one of the participants wanted to learn from all of you were some suggestions on how to help older adults have very cognitive ability to succeed and feel successful in group settings I know we've already talked
12:33:15 about some of those things but I just wanted to mind the group's wisdom for for other ideas about how to approach that.
12:33:25 Yeah, go ahead.
12:33:29 Please we do besides surgery patients because of the business piece. We offer singalongs and it's also a way to keep your eye on everything that's going on in that facility students coming up.
12:33:39 And there's a bunch of things that you can do to make those singalongs inclusive.
12:33:43 We talked about one song for every 10 years of life. They're going to know one song. Another thing you can really do to make things easier for people is to really accentuate along those neurological music therapy lines accentuate the beat.
12:33:56 After a while everybody in the group has been trained to find also the pitch that people sing at it's generally lower than I do, as Olivia mentioned you know you know it's going to be lower, and you kind of go there, but between lowering the pitch, having
12:34:11 really easy songs where the refrain is repeated over and over again, they'll let you do like yesterday the monster night Oh it was walking down the street right you do all that.
12:34:23 They do dumb ass. And it's really simple and it's repetitive, and it's the, and they know that refrain is coming. That makes everybody feel included. You don't have to know the first nobody's going to sing the first because it's too difficult for everybody
12:34:33 to remember number court verse number five of the monster mash and so everybody is reduced to be reduced lifted however you want to call the same place which is that referring.
12:34:45 One of my favorite things to do.
12:34:49 It is the pentatonic scale.
12:34:53 If you have one of these. If you have this little glockenspiel here this is for the key of C i took out the F and the B, and they can't make a mistake as long as you're playing in the key of C accompanying them.
12:35:05 And it's, it's one of my favorite things that I do the pentatonic scale.
12:35:10 There are no wrong notes on the siloed phone.
12:35:15 Oh that's lovely.
12:35:18 I was going to echo what you said about rhythm, rhythm is the organizer and Energizer we all know that and we can all come back to that. And so, setting up some kind of an intervention where I know that the people in the group who are more are going to
12:35:32 be more independent can either act as leaders, or also.
12:35:39 Yeah, can act as leaders or can maintain while maybe I'm over sitting next to this person providing some more hand over hand assistance or knowing that this person is participating in a receptive way, which is also really really beneficial.
12:35:53 So, you know, I feel like I've already said this but again just making sure that we're harnessing the power that music has to bridge, all of these gaps,
12:36:06 probably take people. I think I didn't take people on an experience.
12:36:11 So, and I do so many different groups and they have different desires musically by.
12:36:31 Obviously incorporating songs or subjects that may come up and we'll go that direction, immediately. If someone knows a song and I don't, then they sing it for the group.
12:36:44 And then we all sing it and we all learn it.
12:36:48 And I found that they, they almost recognize me also because of the fact that I start this. Oh, and they, they know every word, and it's just cognitively.
12:37:05 I think it's so healthy for them, and they feel empowered because they do know the words. So, and that music has its ebbing and flowing and you know I mean I'm doing a lot of john Denver and I'm doing a lot of Peter, Paul and Mary right now and even a
12:37:23 little Joni Mitchell so.
12:37:25 So as a, as a music therapist, I'm now learning a lot of different songs because the different groups are so very used to be that it was pretty much the same music the same age groups, especially in the memory care but now that is unfortunately not the
12:37:45 case. So I'm trying to get everybody, and the courses I absolutely do them over and over, you know, they, you can sing a song so many times they don't care because they're having too much fun and they know the words.
12:38:00 So, anyway, it sounds as though a lot of what I'm hearing is that in order to best work with older adults very cognitive ability you start from an assumption of strength, and then they join you Where, where they will.
12:38:16 Is that does that sort of resonate with what I'm hearing.
12:38:22 And, and what they're.
12:38:26 A lot of times you can even start with what singers Do you like.
12:38:32 And if they can't think of the name which is a happens an awful lot you just start saying the names and they're like, I'm, you know, Frank Sinatra, oh my gosh Tony bed so you know immediate, you know, that's there.
12:38:49 And, yeah, just, and sometimes it's trying to get to know them really quickly, because I don't I'm not always with the same people. And when I am that's a whole different experience because I know what triggers their requests
12:39:06 that they can come up with themselves but if I don't I, I'm getting to know them as we're, as we start as we get to work.
12:39:16 One of the things that I was thinking of is our work here is a lot of open groups you don't have closed groups so I don't know who's coming in for my group so I already have to work with the assumption of I don't know who's here but where are the areas
12:39:30 that I can create some kind of familiar structure was kind of what you were talking about.
12:39:51 of, you know, we were talking about rituals for ourselves or whatever rituals for your groups. How are you starting your group, whether it's with the Hello song or whether it's with like a breathing or a movement exercise or some vocal warm ups together
12:39:41 just to get the sound moving.
12:39:50 That's something we can all kind of participate in it's really lovely to do something where we have a movement to music, and then we're mirroring each other and we're sharing and sending it around the group together.
12:40:03 Those are some, some ways to just kind of add some other tools.
12:40:10 Yeah, and even look at regarding that even look at the smallest movement that's going on. If it's like even someone just tapping their finger like that, so powerful.
12:40:22 Yeah.
12:40:23 Just and then make it bigger, make it smaller, you know, just do it with your arms, that kind of
12:40:33 So when people are getting really close to die you know they have you're transitioning and then you have agitated terminal agitation often followed by actively dying.
12:40:41 And people are they look really flat there's almost nothing going on, towards the end mouth is open. Breathing is pretty heavy, and then comes the music therapist and the good music therapist who gently rocks the bed and rhythm with the patients breathing
12:40:55 and place and rhythm with the patients breathing.
12:40:59 And lo and behold, it's kind of as if some baby wakes up I don't know what it is but you start seeing teeny tiny things, they'll see more relaxation during the refrain of this.
12:41:11 Oh yeah, here it is and then you'll kind of see a tightening when it goes back to the first.
12:41:15 It's just amazing what you sometimes can see or sometimes at the end of the song people will take a deep breath at the end and it just gives you goosebumps so you're just like up Did you see that there we go there with us, it's truly something to watch
12:41:30 for.
12:41:31 I feel like you've said this, you alluded to this before Pauline and you to Nancy but this like honor that we have, of being a witness to to our clients.
12:41:43 And I've seen that in that moment, you know, you saw that and really what difference does it make, but it does make a difference that they were seen, and that their humanity and their individuality was was recognized I think that's so so vital that we
12:42:01 are containers for that. I just wanted to throw that in there.
12:42:09 Chris over always says her mantra is people want to be seen.
12:42:15 And, and they want to know do you see me.
12:42:19 Do you hear me.
12:42:21 And with memory.
12:42:25 Unfortunately, in skill to, they're not treated as if they're seeing they're not seeing it you know they're doing things, and if you really pay attention, there's a reason.
12:42:37 You know, maybe they were a doctor before maybe they were a teacher, before.
12:42:44 And you have to flow with that I had a gal start asking questions of the group, how we were to bring up.
12:42:54 Well, tell me about that and did you used to know and she said, I think it's nice if we all understand each other, and I was like okay so we kind of flowed with that you know in it and she felt so good I said oh are you a teacher and so she started talking
12:43:09 about herself.
12:43:11 Just the lightness, that you walk into a group and everybody like this, and you start.
12:43:18 And then they see something's going on and they're kind of paying attention and then they'll start singing with their eyes closed and then they'll, you know, get live, it's, it's the best job in the world, and the best job in the world, exhausting.
12:43:34 But the best judgment in the world.
12:43:38 I've been talking with several groups recently, of people who are living with dementia who are actually speaking for themselves. In all the years I worked in this, in these facilities, no one really said anything to me.
12:43:54 And these people like they're taking the power back and they have their own group of people who they speak for themselves in the most important thing that I'm getting for it from it, is that everyone needs to be respected and and living for what their
12:44:10 purposes so if that woman was formerly a teacher. Maybe she could use that skill to teach the group there was one woman, it was it was in an art group and it was on a zoom thing.
12:44:20 And she's dementia is progressing a bit, but she, she was able to tap into her teaching skills from when she was an art teacher, and we had the greatest art lesson from her.
12:44:32 So that's something really to keep in mind really remember what their purpose is, so they can still have their purpose and and have it come out through the music group.
12:44:46 I just I
12:44:48 just want to hold on to it because before I was a music therapist. My mom had dementia so that's why I'm in this world.
12:44:56 And I went to the place where she was living, and we did a sing along.
12:45:04 For Christmas and a woman who played the piano for the sing along, was pretty far into her dementia.
12:45:14 And so I remember standing there with her and she goes, Oh, please, if I'm going too slow or something you just you know I can stop. And I said you are rocking this, you are rocking this, it just, it blew me away that she couldn't speak very well and
12:45:29 she was really not.
12:45:30 But when she sat in front of that Music Man.
12:45:34 She had it and every one of those people knew all of those songs.
12:45:39 So, sorry.
12:45:43 Thanks.
12:45:46 Pauline Pauline was gonna say something.
12:45:49 No, I just was thinking about you know and then final stage and people are listening to songs and stuff and just how absolutely meaningful it is and you know I think we've all spoken to that a little bit.
12:45:59 And, you know, there's so there's, there's so many things that you've learned in time that you want to kind of shoot yourself in the foot for for not having known when you were younger but when you were just starting out, but even if you just learn as
12:46:10 as you go along and that's another really wonderful thing. And that idea that people want to be witnessed I think compliments nicely with the idea that the family also wants to acknowledge often that that life was a life worth living.
12:46:45 in the songs in between the songs, families to make statements of affirmation mom lived a good life he lived a long life You were always there for us assurance, you're never going to feel pain, we're going to be really watching you Mama, we're not going
12:46:38 to let you feel any pain as things go forward and reminiscence I remember when mom this, and that's something that you do not for the patient but for the people they don't know what to do.
12:46:50 They've just arrived from Florida, and they're like oh my god I don't know what to say, like, just talk keep talking keep talking and just keep keep it going all those positive things you remember, and statements of love, I love you.
12:47:03 I'm going to take you with me. If I have children, this is what I'm going to tell them about those really gushy things.
12:47:09 And that's wonderful. I think that neurological music therapy that you married mentioned Abigail is very important to have that basis to really know what you're doing with beat and breathing and rocking beds and all that kind of thing.
12:47:21 Um, but I think it's, it's also very important to do death doula training to be able to take songs and use them as stepping stones for those really difficult conversations, for arranging visuals which direction Mr Jones, do you want to be facing in your
12:47:37 final days, who do you want to be there. Do you want them to cry Do you want them to tell you what they remember about you.
12:47:43 Don't leave me some people really just don't want to hear that.
12:47:46 What do you want to hear and having those conversations and you guys teach interns that even with a sudden sound like you are my sunshine, you can still use that as a stepping stone for having those difficult conversations.
12:47:59 So, Mr. Jones.
12:48:01 That's telling you, our reception, I see you smiling, you know, what are your ideas about the perfect the sunshine going out what are your ideas on that, and they'll start to talk to you about that any song you can use to have those conversations.
12:48:14 You got it. Get that get get that flow off the tongue, as it were, and not be scared of it in the beginning students are like, Oh, so Mr Jones, all those who hurt.
12:48:24 I mean they just don't know what to do.
12:48:26 And then use the song to ask those two questions. Absolutely. And that brings me to a question that we received.
12:48:35 And this I'm kind of thinking about students. Someone had a question about how do you prepare a best interview for an internship in elderly care facilities.
12:48:46 And so all of you I, I'm assuming, and it sounds like I've taken students and interns and everything so what would you most like to see in an incoming intern.
12:48:55 I think the main thing.
12:49:09 Sorry.
12:48:59 The main thing I always look for, I don't take insurance. Currently, the main thing that I always looked for when I had interns, was that they genuinely loved the population and did want to be with them.
12:49:11 You didn't want to be anybody's last choice.
12:49:14 Older adults don't deserve that.
12:49:16 They, they need to be your first choice and you cannot teach that.
12:49:21 So that was what I was always looking for was that genuine love, and that was that long into appreciate that long and to learn and to be that container.
12:49:31 I had a student come in with pretty bad music skills, who demonstrated just that genuine love and was one of my best interns that I ever had, you know, because she was able to, she was able to make the strides that you needed to.
12:49:46 Yeah, that's what I was going to say as well. We offer free housing with our internship so I get a lot of people who apply that maybe just want to live here locally.
12:49:56 And so it's that's really important to be to know that someone actually wants to work with older adults and they're not just looking for housing.
12:50:03 So there's that. But I also think to be prepared. I would hope people are doing this but to know you to familiarize yourself with the culture of the community that you're applying to.
12:50:15 So their mission statement their philosophy, what type of community is it I think maybe a lot of students think older adults and they just think Nursing Home, and That must be it.
12:50:25 But the living possibilities for older adults, and the models of which to, you know, facilitate those services are so vast now so I think really knowing that philosophy and the mission and what type of unity, it is.
12:50:40 And knowing how music therapy functions there but also how it fits in with that model and that philosophy.
12:50:48 I think that's really appropriate.
12:50:53 And as far as the music and the actual like audition portion of it is just, I tell this to my students also like to familiarize yourself with the music start making playlists from the decades and just listening to it so that you can film really arise
12:51:06 yourself not just the song but the style of music so that's kind of what I would suggest but I'm, I'm right there with you, Holly first and foremost you gotta, you gotta love my residents and want to work with them, because it's not just a job.
12:51:20 You know it's a passion so.
12:51:28 Well, I'd like to.
12:51:33 I just like to take it.
12:51:34 I don't do the interview, because I have my own thing going on here but I just like to put out for the students if anyone was interested in starting their own program.
12:51:45 And that's something that I have a lot of experience in, and what what I what I did and I definitely suggest doing this is, I, I got in touch with you can get in touch with any not for profit but I got in touch with my local Alzheimer's Association, and
12:52:01 I volunteered with them for a number of years. And and I volunteered at the walks and I handed out wristbands but they knew I was a music therapist so eventually they had me do something.
12:52:13 And then they had zero money for social programs but twice a year they meet at the local bakery and they asked me to bring my guitar and I played for like 20 minutes.
12:52:24 And so one day I said to them as musicians as music therapists and musicians. I had this idea. I said, What if I got a whole bunch of my musician friends together and we did a fundraiser.
12:52:42 Could we start a music therapy program, and they said yes. So I, I got a bunch of my musician friends together. And for some reason I didn't know that a friend of mine, son in law said hey you want to check.
12:52:52 He gave me $1,000 well he gave the Alzheimer's Association, you got to do this with a not for profit. You gave the Alzheimer's Association $2,000. I started doing in my county.
12:53:04 One group every month. Then the next year I did two groups every month then the next year I did three groups every month.
12:53:11 And I kept doing fundraisers, I knew nothing about business and marketing I was knocking on doors I found out about what a sponsor is they actually give you money.
12:53:20 Well you have to say Hey Joe Blow gave me money I couldn't believe it. So, so on the radio or in print or on a flyer or on a poster that be a hand right and that program ended up.
12:53:35 They use that program as a model, we did it for six or seven years, and then New York State had a grant, and the Alzheimer's Association one the grant and in it, they put that program and I continued that program for a full 14 years and it's still I left
12:53:51 but it still exists now I'm doing my own thing a lot of the people came with me to my own thing with another not for profit now, and that guys check that used to be $1,000 is now $5,000.
12:54:04 So now I give it to my other not for profit.
12:54:09 Wow.
12:54:11 That is really you know we have such a diverse panel in terms of working situations and I, and it really to me just speaks to the role flexibility that we have as music therapists and also to something that I'd be said earlier, which is that Seeing is
12:54:27 believing. And sometimes it doesn't matter if it's called, you know, music therapy as sanctioned by a full time, you know, residential facility, or if it is, you know, I'm playing guitar for 20 minutes or we're doing a stroll through a place, you know,
12:54:42 I'm seeing is believing and I really want to just affirm and validate that that no matter what you're called if you're called the music lady or if you're, you know, whatever, however it is that people see you they will believe in the power of your work.
12:54:57 And so I'm just so grateful that we have such a diverse panel of clinicians to share from all those different experiences and how similar the work, the work really looks.
12:55:08 No matter how you're called.
12:55:10 So, we have just five more minutes, and I want to just close with this question.
12:55:18 Knowing what you know now.
12:55:21 What advice would you give to your former self starting out as a new music therapist, working with older adults.
12:55:29 I'll go ahead and go because I actually have a student coming in a group, starting in. Okay.
12:55:36 I would tell myself Don't be married to one model of facilitating music therapy, so have many tools and skill sets to in order to be flexible and we're truly operating from that, you know, person directed place then we have to have all these tools so
12:56:01 me yes I mentioned I've done at Mt training I'm also Hospice and Palliative Care music therapists, it's all these things that I think you never know when you're like, Oh, this is the moment that I need that tool. So, I think, For me it was just the Adobe
12:56:04 married to just one way be open, you know, which also includes just always learning, you know.
12:56:12 Thank you. And if you have to hop off I completely understand it. Thank you so much for being here.
12:56:20 The one thing I will tell.
12:56:32 And when I first started out, I was really geared towards getting the songs right and I started realizing it's not about the songs, it's about the authenticity of how you brand, particularly it's about the verbal processing in between songs and your ability
12:56:40 to improvise using set tunes to things in the room that really changed the whole thing of a song if you're saying I'm a really changed the name from a really to the name of your patient.
12:56:45 It feels completely different. The other thing that I think is really important is really being aware of racial tensions within facilities and how that affects things and I I didn't really understand that in the beginning, like, Oh, here you know I got
12:56:57 my nice little job and okay I don't sing Al Jolson anymore but you know it's okay but you gotta go beyond that, when I went to intern supply they did blind admissions.
12:57:07 I secure subtype in so that people that don't have means can drive around and not worry about their cars and stuff. And I think that's really important important.
12:57:15 Those are important lessons I've learned over the years.
12:57:20 Thank you.
12:57:22 I want to share two things that actually I somebody had told me at the beginning of my career but they've continued to stick with me and really grow and change.
12:57:30 So it was my professor in college.
12:57:34 First she told us Let the music do the work. You know when you're not sure make music and watch the response, and then adjust accordingly and that has meant a lot of different things to me over time as a student, it did sometimes mean that when you don't
12:57:47 know what to say that's okay, move on to the music and now as you know a more seasoned professional. It really means make sure that you're using the music to make the positive change because that is your role.
12:58:02 And that looks a lot of different ways and different settings.
12:58:04 But then the second thing that she told me she told all of us before we went into our first clinical placement was remember that your client was somebody's baby.
12:58:19 That was somebody's baby and they deserve that tender love and care and no matter how challenging their behavior is that was somebody's baby.
12:58:24 So for me that's gone down this huge rabbit hole of research into retro Genesis which I encourage anybody to to check into which is just this you know this this theory which is true about how for Alzheimer's disease at the end of the lifespan, you, your
12:58:38 skills go away in the same order that they were gained. That looked really real to me when I had my own babies, but it also is just so useful. So, that was somebody whose baby is something that has continued to grow with me and again you know I work in
12:58:54 an acute psychiatric setting so there's plenty of people who you could say are hard to love, but I'm taking that with me and just remembering that they all do deserve that that true mother's love has really helped.
12:59:08 Thank you.
12:59:10 I say to stay focused on, on your clients your patient whatever they're called and really have them in in the front of your mind and not get distracted by other things, and, and remember this politics if you're going into a place and just be careful and
12:59:31 maybe be in therapy yourself to be, be aware of what's, you know what's triggering you and what you know I said the wrong thing. Many times, and I didn't realize I was never taught, it was the wrong thing but it's just from the way I was brought up.
12:59:47 So it's it just and trust, trust your gut, you know what's right, you really do.
12:59:53 And and I had a I had one boss the boss who I didn't like who told me who yelled at me she was slammed the door yell at me, and then she would say, be creative.
13:00:10 Be creative, be creative.
13:00:14 Again, in my head I was like what are you crazy lady.
13:00:18 Um, but trust your gut trust your gut your gut always knows the right thing, and be there for your clients that's all I could say, older adults are amazing.
13:00:27 They give you so much enjoy enjoy enjoy.
13:00:33 It's our wise words. Thank you.
13:00:35 I would say, if I was talking to myself get out of your head, so that you can really be present in the moment to connect with the people and the person the full person that's in front of you.
13:00:49 And so, that relationship is so important creating that relationship and it opens up so many doors within the music to to explore together, and so that that relationship is just so important.
13:01:09 And being able to see that, see that person in front of you and witness and have them feel seen.
13:01:17 Thank you.
13:01:19 Don't be afraid to try new things, just if it doesn't work, it'll be fine.
13:01:27 They work the next time we somebody else so just go for it. Just go for it.
13:01:34 Good work the next time we somebody else so just go for it. Just go for it. Also if a not for profit tells them well we're not for profit we don't have any money. Don't let that stop you.
13:01:41 You can make this happen. Don't let the minute someone says well we can't do well. And I'm like, I can help you I can't tell you how many people have said I don't want to help.
13:01:51 Hmm.
13:01:53 program so I'm like, Yeah, right.
13:01:57 Well, and I see that Pauline's been popping some resources in the chat she taught guiding articles on hospice so those are in there for people who are interested.
13:02:09 And also, I just wanted to give a huge thank you to all of our panelists today for sharing your time and your wisdom, with all of us in the region.
13:02:19 It's been a real honor to serve as a moderator for this panel and just a I have learned so much from all of your experiences and everything you've been willing to share.
13:02:29 So thank you thank you thank you. This has been really wonderful. And for everybody else this recording will be available through the MAR MTA website.
13:02:40 As soon as I get it uploaded as a YouTube link and do all the technical things to make sure that the chat is there as well. And the audio only that will all be posted to the MTA website for future reference.

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