Old Ira raised his head and squinted at me. "Do you happen to know 'Among My Souvenirs'?" he asked. "Of course," I said. "My father taught me that song a long time ago."
As I began to sing, Ira joined in with unmistakenable enthusiasm. Soon the other residents, shiles returning and toes tapping, were sing too, and sharing memories. I was seeing in action a phrase I had heard once: "Music - we love it for what it makes us remember and for what it helps us to forget."
A short time earlier, following an interview with the volunteer supervisor at a Bloomington, Illinois, health care facility, I had been given my first assignment as a volunteer in the activity therapy department of the long term care unit. I found Ira Thomas and other residents sitting around a table cutting nylons to stuff pillows for a bazarr, picked up a pair of scissors and joined them.
In a few moments Ira was sharing some of the many poems he had memorized. At one point, he looked searchingly at me, as though wondering if I could be trusted with one of hes deepest secrets. "Have ya ever heard the poem called 'The Shooting of Dan Magroo'?" he asked. "I learned that poem when I was a kid and I guarantee ya that was many, many years ago."
Part way through the recitation, Ira had difficulty speaking. The tears gathered in his eyes but he was determined to allow his secret to fall out of the poem, hoping it would be caught by a gentle heart. He cleared his throat with much effort and uttered words that seemed to come from the depths of his soul - he spoke of the longing for home and all that it means as being the hunger of a lonely man. Ira had shared his deepest need with a total stranger and his incredible yearning for home immediately started me on a personal quest to discover the elements of home that Ira and other residents felt had been left behind.
Shortly thereafter, Vickie Lannie, staff person in charge of the activity therapy department, introduced herself, mentioning that she had learned of my interest in music and wondered if I would sing a few songs for the residents since they too had a love for music. As a nurse in training, Vicki had often brought her guitar to sing to the residents, so she knew that music was more than entertainment - it was therapy. I was invited to bring my guitar and sing in the activity therapy department and other areas of the facility on the following Thursday.
This was the beginning of my musical journey into the human heart and the dawning of an awareness that music can bring "home" to those who cannot go home. Indeed, music can have a profound influence on the long term care resident in at least 10 major ways. It can:
"The purpose of the activity therapy department," Vickie Lannie explains, "is to provide long term care residents with meaningful activities by teaching them new skills and helping them feel the satisfaction of personal accomplishment - to keep their bodies and spirits active by encouraging social integration through group situations. In the very sick or elderly, the desire to act, plan and achieve is very low and music can often work wonders with them."
As therapy, music can bring back memories that reinforce a sense of self. It can stimulate, soothe and heal when the home one remembers is the "home within the heart." Following his attendance at one of my music therapy workshops, Marcus Kaya, a long term care administrator from Hawaii, was inspired to write about the nursing home resident's need for personal identity. He had recognized just how valuable music could be in helping the resident to retain this personal identity: "Home is the primary environment in which your sense identity develops and is reinforced. Home gives you a sense of history, roots or heritage. Moreover, home represents your personal history since your home is a unique expression of you and is as individual as you are. Your home holds and reflects your memories - precious memories of when, where and with whom you grew up, and of your dearest relationships with your family and friends.
"Thus, when you lose your sense of home, as often happens when one is institutionalized, you can lose a great deal of yourself. As I see it, one of the most important responsibilities of a long term care facility is to protect and nurture that sense of home and personal identity."
One of my first experiences came when a woman hurried over to Vickie and me with the request, "My mother has been in a coma for some time. I don't know if she will be able to hear you, but her favorite song is 'In the Garden.' Would you mind going into her room and singing it to her? Even if she can't hear you, it would mean so much to me."
We sang the first verse and chorus of the song and were just beginning to move into the second one when the resident began moving her lips, ever so slightly at first, and then broke into wavering sounds of song. We sang the chorus together and when we finished, she opened her eyes and looked at us searchingly. "How did you know this is my favorite song?" she asked. Somehow the familiar strains of music had reached and motivated her to respond physically and come out of a coma.
We quickly became aware that other patients, in spite of their comatose state, could hear what was going on around them. One woman who had been hospitalized with paralytic encephalitis wrote me about how she was unable to speak or communicate in any way with hospital staff and family members. She said that she felt like she was in a small, black, thin box - small because she couldn't move, black because she couldn't see and thin because she could hear everything going on around her. The two nurses who sang to her and spoke about the weather and what was going on in the world kept this woman in touch with life.
Vickie and I became even more convinced of the unique stimulative qualities of songs as we used fast, up-tempo tunes with the residents during excercise and physical therapy sessions. Those who had suffered strokes or brain damage were able to move their bodies more easily to music, even if it was just a toe tapping under a sheet.
Residents who had suffered speech impairments because of strokes or other illnesses often made strong attempts to hum or sing with us. Once they realized they could perform a simple task with music, they were ready for the next, more difficult steps of their rehabilitation.
Slower, mellow tunes had a sedative effect. They helped patients relax and let go of fears and anxieties. Many of the songs that were popular when our residents were young brought back healing memories, some of them life-giving.
One cold Christmas afternoon, in a room next to the nurses' station on the third floor, I found an older man who had been admitted for his second suicide attempt. There was no evidence of Christmas in his room, not one card on his dresser. I san one of my favorite songs, "Silent Night." He loved the carol and quickly asked for the song "I'll Be Loving You Always."
After I sang it, he said there was one song that reminded him of a time when he was loved - "How Great Thou Art." As I began to sing, he joined in, his mellow voice filling the room.
This man had been a professional musician in his younger years and loved to sing and play a trumpet. Soon he became a volunteer in the long term care unit and within a year had contributed 700 hours of service. He assisted the residents in many ways, but his favorite time was the weekly sing-along when he delighted them with his own special renditions of such songs as "Ain't She Sweet."
Perhaps one of the greatest gifts music gives is the sense of emotional freedom that often diminishes with living in a group setting.
I once visited a facility that would not allow the residents to hear their favorite gospel songs because these songs made them cry. In my seminar there, I explained that tears are not always evidence of our failure to make residents happy - tears can be a gift of trust. Music helps us to laugh and cry, to identify and accept our feelings of sadness as well as joy and therby facilitates emotional release for those who are in need of long term care.
Music therapy programs should always allow for group interaction as well as one-to-one experiences. When appropriate, residents should be allowed to sing and to play music and rhythm instruments. If a particular song strikes a responsive chord in someone, it might be well to ask why the song is so meaningful. When we hear a song that reflects our personal needs, we have the feeling that we are not alone.
I believe that music has a far greater mission than has yet been realized in affecting achange in the physical, emotional, mental and spiritual well-being of long term care residents. It was recognized as a therapy by the American Medical Association in 1950 and, currently, a growing number of universities offer a degree in music therapy. It is my hope that every hospital and nursing home will one day have a registered music therapist on its staff.
The music therapist, volunteer or professional must truly care about the long term care resident. Indeed, music combined with love is a powerful antidote. I will never forget an old man sitting in his room near the window, staring into the fading light as if he were watching his life go by. After singing, I put down my guitar, went over to him, hugged his frail body and kissed his cheek. Tears appeared almost instantly and he said, "Folks don't kiss old people anymore."
Was this true? If so, why? I began watching residents in other long term care units more closely and noticed that many of them experienced minimal body contact with others. Joyful reunions with family and friends had turned to courtesy calls and big hugs to handshakes. Soon after, I wrote the song, "Folks Don't Kiss Old People Anymore," with the hope that it would help increase the awareness that we are never too old to need and give love and affection.
Music can be a language of love. It can help heal a broken heart, inspire an indigent spirit and unite a family. It can help us express our capacity for sensitivity and understanding in a world where there is loneliness and despair. As we use music to show we care, we can more effectively help long term care residents and patients deal more openly with their losses and find a home away from home.