Music can soothe Alzheimer’s patients
The patient had Alzheimer’s disease and could no longer remember who his wife was.
The man had been a football player at the University of Wisconsin, so music therapist Ken Boerner, RMT-BC, MSW, learned the Wisconsin fight song and began to sing it for him.
"The song helped him recall many different memories from that period of his life, and his wife was able to recall that song and would sing along with us," Boerner says.
While the couple sang together, they were husband and wife once again. "We all have many different associations with music," Boerner says. "We can hear a particular song, and it takes us back to that exact moment in time."
Creative therapy inservice
Boerner, who is a music therapist and expressive therapist for MedCentral Health System in Mansfield, OH, gave an inservice on creative therapy for home health care employees at MedCentral Home Care/Hospice. The hospital-based agency serves a 40-mile radius in north-central Ohio.
Jane Versaw, RN, BSN, home care coordinator for MedCentral, says she asked Boerner to provide the inservice to help patients cope with pain and their feelings about death.
"Mainly, we saw a lot of issues with pain control with hospice patients," she says.
"He gave us techniques in singing, some music, videos, music tapes, different games, including word games, feelings-type games, and poetry readings," Versaw says.
Boerner taught the inservice by using the same creative therapies with the staff as he would use with patients. "I just went over a variety of activities that they could use with their patients in the home care setting."
The activities are designed to help people express their feelings and thoughts, to increase their self-esteem, to increase their coping skills, to increase socialization, and "just to have fun," Boerner adds.
Here are some of the activities that can be used with home care and hospice patients:
• Music.
Boerner sometimes sings or plays music for patients. But home health care professionals, who are not comfortable with this could play musical tapes of sing-along songs for patients.
It’s music, not method that counts, he says. "A song right now that maybe I would use if I were working with a patient in the home is In the Good Old Summertime,’ and that would lead to summer reminiscing about past activities they’ve done in the summer with their spouse or family."
Another musical technique Boerner uses is to help a terminally ill patient write a song. "This way, they could express their feelings and thoughts, and maybe they could record it on a tape recorder, and that’s something they could share with their family," Boerner says.
"Music can be real non-threatening and an easy way to get people to open up and express themselves," Boerner says.
Songs that might encourage ill and dying patients to talk about their feelings include "The Dance" by Garth Brooks, Boerner says. One lyric says, "I could have missed the pain, but I would have had to miss the dance."
Encourage patients to let go’
Another Boerner often uses is the country song "Letting Go" by Suzy Bogguss. The song is about a mother and her daughter, who is getting ready to attend college for the first time. One line is "She’s had 18 years to get ready for this day; she should be past the tears, she cries anyway."
After playing this song, a health care professional might start talking to the patient about the concept of letting go, Boerner suggests. He says the song might encourage the patient to think, "I have to learn to let go of my job; I have to learn to let go of doing the laundry,’ and maybe even, more seriously, I have to learn to let go because I’m going to die.’"
• Craft projects.
Boerner has found that craft projects help to build patients’ self-esteem because they are success-oriented activities.
Patients could try wood projects that come in kits that require a little sanding, gluing, and painting.
Other projects could be needlework types if the patient has fine motor skills. Or maybe the patient could try a stained glass kit in which they fill in little cavities with stained glass paint.
"It’s good for coping skills, and it’s something they can leave their family member with."
• Self-portrait collages.
"What you do is have a patient cut out pictures and words from magazines which represent themselves," Boerner says.
A patient who likes to fish could cut out pictures of fishermen, or a grandmother could place photos of her grandchildren on it, Boerner says.
If a home care worker has time, he or she could help the patient glue together the collage, he suggests. "Then they can get to know each other better."
• Scarf exercise.
"Another fun activity includes music and a little bit of exercise that can be done from a bed or chair," Boerner says.
Here, a home care worker could play some Glenn Miller band music and give the patient some brightly-colored scarfs to hold.
"You do different movements, and then the patient mimics your movements," Boerner explains. "It’s a fun, creative way of having the patient get some exercise."
• Board games.
There are many educational and therapeutic games on the market that can help people improve their self-esteem, communication, and coping skills.
"But you also could use the simple games that people have grown up with, such as scrabble," Boerner says. "All these activities kind of take the patients’ minds off their particular problems for that moment in time."
• Planting seeds.
Boerner says the major concern he heard from home health care workers was that they didn’t have time to do any of these creative activities with patients.
"I think it’s important to sometimes make the time and do something as simple as bringing in a flower pot, some seed, and some soil," he says. "And you could help this woman who maybe worked in the garden her whole life and really misses this. To take the 15 minutes it would take to help her plant these seeds and then to place it in the window for her to be able to watch them grow."
On follow-up visits, the home care worker could help her water the plant, and soon the patient will see the nurse or aide in a different light, he suggests.
"So maybe the next time this patient is refusing to take her medication or is giving you a hard time about taking a bath, the fact that you took time to do something meaningful for her might make that task a lot easier."
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