It Doesn't Have to be This Way

Hi, musers, and welcome back!

A few weeks ago, I was visiting one of my patients in a skilled nursing facility. She was in one bed, with her husband of 50+ years beside her, with her roommate over in the next bed.

We all know that live music tends to carry, so even though I wasn't there to see her roommate, I did keep her in my periphery because if she begins to have a distressing response to music I am using with my patient, I am going to need to adapt my approach.

I noticed that she was lying in bed, sort of curled up on one side, not making eye contact with anyone, and very much withdrawn.

So as my patient is getting her need for increased meaningful interactions met via music she and her husband used to dance to, I notice out of the corner of my eye that her roommate has rolled in bed a bit to look more closely at us. She catches my eye and begins mouthing the words to songs that are familiar to her, as well.

A nurse from the facility comes in to ask Ms. Roommate if she will be getting up for lunch today. Ms. Roommate sighs and says she doesn't feel like it, and just doesn't want to.

The nurse leaves.

Ms. Roommate continues to appear more and more interested in the music we are sharing. Within minutes, she has pushed the button to lift the head of her bed and is full-out singing along with me. And nodding her head. And moving her arms and hands in time to the music. And grinning ear to ear. She's engaged in this.

The nurse returns. And begins explaining to my patient that if she doesn't get up and move, if she doesn't find a way to start taking some deeper breaths, she is going to get pneumonia and that will be a quick ticket out. Ms. Roommate listens for a moment, then turns and continues to belt out the big band number I am singing. The nurse gets frustrated that this woman isn't taking this request to get up and breathe seriously.

Did you cringe? Do you see what happened here? Ms. Roommate was already sitting up and breathing more deeply. At this point, she had scooted herself to the edge of the bed and was sitting UP. And singing like she meant it. You can't sing like that without drawing deep, sustained breaths. You can't wave your arms like an enthusiastic band director and not be moving some blood around.

Now, don't get me wrong. I understand how easy it is to develop "tunnel vision" when it comes to making sure your patients get their care plan goals met. I know this nurse just desperately wanted to see this woman get up and around as a way to keep her healthier, longer. I know that this nurse hasn't had the chance to learn about MT applications, and that at she is right there at the top of the list of professionals who are overworked and underappreciated and under supported.

So I don't blame her for not seeing that Ms. Roommate was already well on her way towards getting what she needed that day without any poking or prodding. We have a society and a healthcare system that tends to view anything involving the arts as nice fluff and filler when you have the surplus budget, and not as a serious clinical tool for motivating people towards compliance with their treatment plan.

But it doesn't have to be this way.

Can you imagine a world full of nursing homes with access to group and 1:1 music therapy? Where instead of trying to pester people into engagement with their peers, you could simply allow them access to natural avenues to accomplish that? Instead of begging them to get up and move, you just make sure they have access to their favorite toe-tappers and a music therapist who can use techniques to encourage them to move? What if we had a modality that has care plan goals "baked in" to the experience of something these people already know and love? (Hint: That modality is MT!)

One last word about Ms. Roommate. She grabbed my hand as I was packing up, told me that I had played songs she and her late husband used to dance to, as well, and that now she felt so cheerful and energized that she wanted to get up for lunch and maybe even eat something.

I'm on a mission to change the thinking and culture within healthcare, one interaction at a time, so that one day, other direct care staff will see someone singing along and instead of thinking "entertainment," they will think, "blood oxygenation." Because it just doesn't have to be this way.