The Magic of Music

Music-key to memory-editedEnjoying and appreciating music may still appeal to persons living with dementia, but music may offer a lot more than pleasure: a connection to memory and emotional expression that might not be otherwise accessible. Read these simple but powerful stories to be reminded of the myriad ways we might incorporate music into daily life, to both entertain and ENGAGE!

 

The following story is from The Piper Assisted living and Memory Care in Kansas City, KS. Steve Harman, a Household Coordinator, is working on his CNA, and during a recent clinical at another community, he had this great experience.

Bologna Song Whets one Appetite!

Recently I spent a few hours with Mrs. B., who has pretty severe dementia and is known for not eating her meals. Usually when Mrs. B. sits down to eat, she is “full” before the meal is even served. The more people try to get her to eat, the more she refuses to eat. My experiment was to ask her about anything but her meal. My niece and I used to sing songs at the dinner table, which kept her from getting bored, so I tried this with Mrs. B. “Mrs. B., do you know any songs?” She replied, “Yes, all of them.” That being the case, I chose a musical masterpiece, the Oscar Mayer Bologna song. “Mrs. B., do you know this song? My bologna has first name...” She sang back to me, “it’s O-S-C-A-R!” “My bologna has a second name…,” I sang, and she replied with a full mouth. She had taken a big bite of food! So I patiently went through all the songs I knew the words for (5 commercials, Jessica by the Allman Brothers, and You Are my Sunshine). Somewhere in the middle, Mrs. B. started making up her own songs about the food on her plate. One was the word Gravy sung repeatedly to the tune of Happy Birthday. Another was a song about how good vegetables would be if they were cake. When she finally finished, she had consumed half of her plate, doubling her intake from the last three meals combined. Throughout this experience, she would occasionally ask to be taken to the front of the room where people congregate to watch television and other things. That was when it occurred to me: Mrs. B. was bored. She never asks to go home, or simply to leave the facility. She wanted to go to the front of the room because that’s where she can be entertained.  I took her to the area where a volunteer had started playing guitar. On our way up there, I overheard one of the staff say, “I’ve never seen Mrs. B. so lively or excited like that. She seems to be excited about music.” I’ve only spent a small amount of time with Mrs. B., but several people have informed me that this was very different from her usual behavior. She was deemed difficult or grumpy. This was such an encouraging experience.

Shared by Stephen Harman, Household Coordinator


The next four stories are from WindsorMeade in Williamsburg, VA

The Tide is Changing….

A few weeks ago I worked on an evening shift as a CNA on the HealthCare unit. When I came on to the shift, which wasn’t my regular shift or job duties, I was very task oriented. I was focused on what needed to be done: who needs vitals taken, who gets a shower, what time is the meal, etc. After dinner I went to give a shower to one of our residents. The resident, Mr. W., was not happy about me interrupting his evening; he was quite happy just flipping through his magazine. This resident usually doesn’t speak words, and if he does speak them, it is normally just a few that don’t make a complete sentence. Many times he communicates only with sounds like bee-bops. It had been a few days since his last shower, though, and he needed one. I was too focused on what I had to do next and the tasks of the evening, but then I just stepped back, looked at his blue eyes and smiled. The tide had changed… I started singing “ I got the whole world in my hands….” He started humming and by the third verse he was singing with me, teary eyed. I have never heard him sing before. Then I quickly thought about what other songs he might know. So I started singing Amazing Grace, and he began singing with me — and we sang all the way to the shower. We sang during and after his shower until he was all clean, dry and cozy in his pajamas, under his warm blankets and off to sleep.

Shared by Angela Peay, LPN, AL Nurse Manager

Our Song

Working in the Health Care dining room, I have had the pleasure of witnessing many beautiful moments.  This one brought tears to my eyes.

Mr. D has both memory and hearing loss.  His wife, Mrs. D, is an independent living resident, and comes to visit him regularly.  I have heard her say many times that she knows he recognizes her as his friend, but she isn’t sure if he remembers the life they made together.

Recently, WindsorMeade installed a new piano and placed it in the resident lounge next to health care dining.  On the weekends, we have volunteers come and play the piano during lunch and dinner services so the residents get to enjoy music while they dine.

A few weeks ago, Mr. D was already seated in the dining room and Mrs. D was walking up the hallway to join him.  The pianist was playing a song that I don’t know the name of, but Mr. D certainly did.  As he listened to the music, he stood up and called Mrs. D out by her nickname.  I had never before heard him call her by any name at all.  As she answered him from across the room, she stopped, looked at the pianist and said, “They played this song at our wedding 65 years ago.”  As they hugged each other, it was obvious that in that moment of clarity brought on by a familiar song, he knew exactly who she was.

Shared by Brian Eck, Health Services Dining Supervisor

Happily Lost in Music

I worked upstairs today in the HCU and ALU areas for the first time again in about two weeks. During lunch, a woman named Mrs. Kathy came in to play the piano. She started in the HC dining room and ended in the AL dining room. In HC, a few of the residents nodded their heads as she played. Mr. W. was one who stood out to me the most. He was nodding his head with his eyes closed, tapping his feet, and lightly tapping a fork on the table, enjoying the music. To be quite honest, I haven’t seen him this happy in such a very long time. His mood nearly brought tears to my eyes — tears of joy that is. Mrs. Kathy’s music generated so many smiles today that I asked her to return to us soon and to come more often.

Shared by Marquera Delk, Lead Server

Music Makes the Body Move

One of our residents loves music! Whenever he hears music, he is clapping his hands, moving his feet, and sings a long. We have purchased an Ipod shuffle for him and have downloaded music (Elvis is one of his favorites) onto the device. Family members have also brought in CDs for us to download music. Throughout the day, we give the resident his Ipod and he absolutely loves it! When he hears the music come on, he gives you the biggest smile and hug. When you walk onto Healthcare you will see him with his Ipod just dancing away. We are in the process of becoming “Music and Memory” Certified, where we will receive Ipods for the residents to listen to their preferred music. When that happens, I will sing, dance and clap, too!

Shared by Caroline Kaliris, Recreation Therapist


Dancing:  It’s not just for feet!

<p>Lakewood Hand Dancer from <a href=”https://vimeo.com/user37978821″>Marsha Poulsen</a> on <a href=”https://vimeo.com”>Vimeo</a&gt;.</p>


 

The following story is from Uniting Wontama Orange in NSW, Australia

Love for Dancing Remembered and Shared

Last Friday evening we held our Annual Cocktail party with the theme of ‘Mad Hatters’. All of our residents across the site were invited along with their families and participated in making a hat to wear. We had a wonderful turnout and brought many smiles to many faces. We also had our Old Time Dancers come along and dance for and with our residents. It was heart-warming to see our residents enjoy themselves so much, and to watch those people who either have limited mobility or changed cognition ‘come to life.’ Once the music and dancing started, a gentleman who faces some of the more challenging aspects of living with dementia, was on his feet and danced the night away. The conversations that were possible with him during this time were both insightful and emotional, especially his ability to talk about his love for dancing in his younger days. An important objective we have been working towards focuses on making every moment count, even in the smallest of ways. This felt like a big success.

Shared by Helen Mobbs, Service Director


This sound of life – music –  is SO IMPORTANT for us all. The common thread in these stories is that someone took the time to notice. The observations shared and then more people notice and are encouraged to provide music, share in the joy of music, or use it to help someone feel better and/or engage in a way they might not otherwise. So go out and look, listen and find ways to share music with those folks you serve. You will make life better in big and small ways, as Helen says above!


If you are fascinated by brain research and what scientists have learned about music, you must read the article “New Ways Into the Brain’s ‘Music Room’,” just published in the New York Times!   Read it now.

SEE ALL OF OUR LATEST STORIES

Sim-plis-i-tea

I was recently interviewing a team member at a CCRC campus, and I asked for her thoughts on what she felt the organization does well. Her answer was tea. Wait… what? Turns out they had a new client moving in, and when the admission interview was done, a few things were learned, one being that the woman was English and that she had a customary love of tea. Upon returning to the facility, this information, along with all the medical needs, was shared with the nursing team. Move in day came, and as the woman was settling in the nurse came in to see her and introduce herself. Normal stuff, but instead of a clipboard or a blood pressure cuff, this nurse was carrying a shiny silver tray with a fancy tea set full of piping hot water. I’m not sure what words wereTeacup handoff-2 spoken in greeting, but I don’t think she had to say anything. Her actions spoke louder than words, and those actions offered the warmest welcome possible.

A cup of tea. Now mind you this cup was served in style and with forethought; imagine the difference in the story above had it been a Styrofoam cup with a tea bag soaking in it. How powerful though, that this affinity for tea was something that the nurse grabbed onto and followed up on. Sometimes in our rushed worked day we complicate things too much – we get tied up in our tasks and our documentation and…and…and. Stepping back and taking the time to honor another person like this nurse did is the real heart of the matter. The old saying is really true – It is the little things that matter the most. What opportunities are there in your normal day to seek out and then follow up on making someone’s day in some simple way? What do you do in your organization to encourage and recognize staff who routinely act in ways that make life better for those around them? Challenge yourselves to take some time to work on building stronger relationships with those around you – staff and resident alike. Use tools like Action Pact’s Daily Pleasures interviews to discover the little things that would put a smile on someone’s face – and then follow through on it. Be bold and visible, be anonymous if that is what you prefer, but work to create a climate where random acts of kindness become the norm rather than the exception. And remember – it can be as simple, and important as a cup of tea.

Read all recent posts here

Transformative Leadership: Reinventing How We Age

With emotions running high, Steve Shields, Action Pact CEO, shares his personal experience with his mother who was placed in a nursing home, and the devastating aftermath of her time there. Through his determined efforts, Shields has transformed the senior living industry, and his talk reflects the need to change how we think about our elders.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

Culture Change – An Inside Job!

The following heart-felt piece illustrates what often happens to folks during their time at one of Action Pact’s intensive educational offerings.  Karmen Payne, of Fair Haven Retirement Community in Birmingham, AL, recently attended the Nurse Leader intensive, and a fire was lit.  These are her thoughts as she headed home.


The journey to understanding household models is more than learning a management style or philosophy to me. The vision is unique, individualized and as alive as the people living and working in the households. The characteristic “schedules” of the nursing home are absent and the resident is the driver of the pace, style and atmosphere in the home. The critical attitudes, noise and tension are gone. The hierarchy of departments melts away. Rather than entering a “hall,” households truly seem to offer residents, families, staff members and visitors like me, a piece of their home for a time.

At first, I expected to attend a nurse leadership intensive and get a “how to” experience. I had my pen, paper and standard three ring binder at the ready. I quickly put most of that away in favor of walking the hallways, sitting at tables and engaging with members of households to discover what made their household tick. The atmosphere was so shockingly different from my own experiences. The quiet, peaceful interactions were personal and calm. There was no running about by anyone. The residents of each house I visited seemed to come and go at leisure. Everyone was joyful and attentive from the nursing assistants to the licensed dietician serving at the grill. Even the families I encountered were happy!

Returning to the classroom for reflection and discussion, I discovered I was not alone in my shock. There were others on the same journey as my building. That is a trek to finding our pathway to creating home for our residents — the way the residents want home to be. However, rather than a “ten-step plan to compliance and home,” I discovered a guide to self-examination that challenged me to change. If we are to become a household, I was going to have to think differently, respond differently and lead differently. Ten steps were not going to fix the problem on the “floor.” No. The changes I needed were an inside job that would become contagious as we build homes, teams and families to care for our residents’ needs as our residents desire us to.

So,Heart inside person I am beginning the journey with a change of heart and a renewal of spirit. I want to serve my residents and my team by honoring them, empowering them and getting out of their way while motivating them to do what only they can do. Create home. Pursue life. Honor the spirit of each individual in each household in their own unique way. I realize the standard I have lived by for the last 20 years is going to change. I am not the decision maker. Every water pitcher won’t be sanitized on Tuesday any more. Yet, every resident will be honored, fulfilled and respected every single day. I am losing nothing and they gain everything, especially their right to pursue life in their later years on their own terms.

This change will not come without pain. There will be less gossip and more accountability. Confrontation and discussion will replace accusation and blame in our lives. I will have to be brave and bold. Trust will grow as a foundation and control will crumble under its weight. Character and principle will replace compliance and enforcement. Our number will shrink to only those with a heart to serve at first. However, in the end we will become a stable team of servant-leaders dedicated to our calling.

Each home will be different. Each schedule will not follow my best-laid plan. No longer will “my” team spend half their day meeting with me and others like me anymore. Silo jobs will die out. Assignment sheets may well vanish into the abyss with shower schedules and get up lists. Yet, at the end of this pathway of curves, valleys, laughter and tears, maybe we will have created something valuable and lasting to leave as a legacy. Maybe we will have transformed our facility into a home.


Would you like to Hear the Voice of Households? Click here to watch video clips with stories, testimonials and great ideas! 

Photo Op: A Lesson for All

This story comes to us from Sarah Bishop, Social Services Mentor/Household Coordinator at The Davis Community in Wilmington, NC.


The husband of a resident (“Mr. Smith”) was in the team room saying that what he appreciated most about the house was the fact that the staff cares so much for both the residents AND families. Here is what triggered this affirmation: Dana, a Social Worker, walked into Mrs. Smith’s room. Everyone knew she was in her final days, and Dana observed Mrs. Smith in a most peaceful state, holding Mr. Smith’s hand and rubbing his arm. She looked so contented and at peace, and after her struggles with dementia, it was awesome to cell phone-2see. Dana asked Mr. Smith for his phone and was able to capture that moment on video for him, and Mr. Smith shared it with his wife’s out-of-town family, to show how at peace and comfortable she was then. He said the family members were so appreciative of this captured moment, and he became a bit tearful, saying, “Not every place thinks that this is important, but you’ve all made it so. And I don’t know what to say to that, except thank you.” Sarah knows that other families at The Davis Community have similar feelings, and is sure such thoughtfulness happens throughout the community. She says that, “‘death with dignity’ has become such a customary way of doing things that we overlook how special this event is. When we’re looking at household progression and successes, I hope we focus on this one in a huge way. Talk about this in your learning circles, and the impact that everyone is making without even realizing it. Staff deserves to feel good about this because really… what better gift to give?”


Hear more voices from households

Staff Get a Feel for Person-Centered Service at Camp Culture

“People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

–Maya Angelou


Everyone who attends “Camp Culture” at The Hermitage in Richmond (VA) literally carries Maya Angelou’s message with them when it’s time to go home.  

Camp Culture
Camp Culture participants holding their framed quotes and certificates

There is no getting poison ivy or lost at this camp: Self-contained for six hours in a comfortable room away from all distraction, 10 staff team members and their facilitators relax and share about themselves, thoughts on home, and ideas for making life better for their residents at this CCRG. It’s proving to be an exhilarating means of introducing staff to the fundamentals of person-centered service.

Camp Culture is held one day each month for a different group of 10 team members. So far, 60 have attended. The goal is for the community’s entire team of 150 including part-time workers to attend, says Gale Knox, Executive Director.

The day begins with warm-up and team building exercises. Campers write down two truths and one lie about themselves. A facilitator reads what they’ve written to the other participants, who try to guess which statements are true. As campers begin to learn about one another, they feel more at ease and share more about themselves.

“They only share what they are comfortable sharing; we don’t ask them or pry … sometimes it feels like group therapy when they talk, and every session is different,” says Knox.

Meanwhile, the social worker takes positive information learned about each camper to a workshop across the hall where personalized, wooden frames are being constructed. Frames are stenciled with the individual camper’s name and adorned with pictures and words cut from magazines that describe him or her. Maya Angelou’s quote sets in the center of it all.

Back at camp, sessions designed to open participants’ minds and stimulate ideas are in progress:

  • They are asked to write down what home means to them, and to imagine what beCampfire-marshmallowsing homeless feels like. And what about our residents: Do you think they feel more like the words you use to define “home,” or do they feel like “homeless?”
  • Participants play “Dirty Word Jenga,” a game of identifying vocabulary that dehumanizes residents and encouraging more appropriate language.
  • They imagine having a “gazillion dollars” to spend on making life better for residents at The Hermitage: what changes would they implement? Suggestions often become part of the organization’s person-centered strategy moving forward.

Facilitators include Knox, the director of health services, director of dining, business office manager and social worker. “I think it almost blows (session participants) away that we (formal leaders) are admitting that our current system may not be serving our residents well – it encourages them to think outside the box,” says Knox.

No one is called upon to speak, but tokens are given to team members who do. Those earning the most tokens get their choice of the prizes displayed on a table throughout the day, though the incentive to participate seems scarcely needed.

“By the end, they’re all fighting for the floor, but not because of the tokens; they just get caught up in the excitement,” says Knox.

Camp Culture concludes with the distribution of the newly-constructed, individualized frames to all participants. “It’s our way of showing team members that this is what it feels like to have someone care enough about you to get to know and pay attention to you. The reaction is just unbelievable when we pass the frames out,” says Knox.

One team member cried when presented with a frame that reflected her true self.  “You really listened to me!” she told Knox. Many leave voicemails thanking her and ask if they can return for another day of camp.

Camp Culture “is probably one of our best accomplishments (in the initial steps toward person-centered care) … It’s a very honest, open day,” says Knox.

Contemplating Person Centered Care in the Expanding Continuum

This article was originally published by The Beryl Institute.

by Steve Shields

We know how it is. 

Anyone with a complex medical condition knows the feeling: Your doctor refers you to one or more specialists and therapists, and with each comes a new round of appointments to schedule, forms to fill out and recitations of your medical history, current diagnosis and the medications you’re on to a stranger focused only on one part of your total wellbeing. Continue reading “Contemplating Person Centered Care in the Expanding Continuum”