a personal journal of therapeutic harp sessions

In therapeutic situations, is a short performance enough? On Friday I played in several patient rooms, about 8 in an hour. That means that I can't stay any one place very long. Did the shortness matter? The nursing staff thinks not. The music still brought distraction, soothing and joy. The memory will linger and the benefits replay themselves. What a great use of my time! (July 2011)

Late Winter/Early Spring 2011  As family has gathered around one of my hospice ladies (for the second time this winter) I'm reminded that the music benefits everyone. The family is obviously as soothed by the music as the patient. Staff walking in the halls will linger outside our door and other residents gather close by to listen as well. Music attracts attention. By doing that, it draws attention away from the unpleasant and gives the soul a chance to relax and recover from the stress of the moment.


Late Winter 2011 One lady in hospice has developed a liking for specific music. She wants to start every session with the same music: my own compositions and the music of Bernard Andrés. It's interesting that what she finds soothing is not the familiar but the new.  She enjoys the old and familiar but she delights in the new and fresh.

November, 2010 I see music helping to make interpersonal connections. Twice a month I play for a woman at the local convalescent center. She pretty much keeps to herself, can't move on her own and doesn't hear too well. Sleep occupies much of her day, except when the harp arrives. Then other residents begin to linger in the hall outside her room eavesdropping on the music. Helen always invites them in if she notices them. Sometimes her room is filled with people she doesn't even know, at her invitation. An interesting study on on entitled Music: The Language of Well-Being  cites an "upliftment factor” intrinsic to musical engagement". The music is certainly uplifting to Helen, to the extent that she wants to share it with everyone around her. It transforms her from a sleepy tired woman into as much of a social butterfly as one can be in her situation, a bit of a glimpse into who she was in younger, healthier years. Music for her is not simply a distraction, it's social, cheerful, uplifting, and so much better for her than the blaring TV provided in the room. I doubt there's ever been a conversation started between strangers over a nursing home TV. There have been plenty started over my harp.
Therapeutic music sessions have a reach beyond the patient. Everyone coming in contact with the music is soothed and refreshed. I can't think of one visit in which staff didn't stop to linger outside the door to soak in the music before returning to work. When the visits include close family or friends, in particular, the regular caregivers of patients, there's a double impact. It's hard to be a full time caregiver and music can cheer and comfort them just as much as the patient. It's important to remember the role of caregivers especially in chronic situations. Their attitude has an impact on their care and on the attitude of the patient. It's always my preference to include caregivers in music sessions when possible. Not only do they benefit from the music but they have a new fresh, enjoyable topic for conversation that does not revolve around treatments in any way. It's a pleasant escape from intrusive medical routines. We all need to feel a sense of normal routine in our lives. Those coping with limiting medical issues need to have a sense of that from time to time to prevent a sense of hoplessness. When music sessions include patients, caregivers, family and friends, it becomes a shared experience, a lovely social time that is often lacking when illness set in.

October, 2010 It seems to me that far too often people view the sick and suffering and homebound in terms of their illness alone. It's too easy to focus on the infirmity and forget the person inside. My hospice and homebound friends have taught me that illness and frailty doesn't change ones character at all. It might hinder the expression of it, but it's still there. So too are tastes in music. What I don't understand is the theory that certain types of music are healing while others are not. The people to whom I take music all have very distinct tastes in music and what they want to hear, what I see cheers and soothes them, rarely fits the formula that we are taught when we study therapeutic music. There is a study done by researchers at the University of Maryland that concluded that music found enjoyable by the listener is far more likely to have a healing effect than music found to be annoying. Isn't that something we all knew already? It seems intutitive that the music I like to listen to would also make me feel better. My patients tell me the same thing. They want the familiar music that they've always loved. Their illness and frailty hasn't changed their tastes in music on bit.
Summer 2010 visits to a woman who just entered hospice reminded me how music lingers. In one of my repeat visits I asked, as always, what she'd like to hear. "Start with the same music you started with last time", she answered. Wow, I didn't remember immediately how I'd started her last session but she remembered. She remembered vividly as the music lingered in her memory while she waited my next visit. She's been a delight as she has made a point to share each visit with a special friend or family member. Even in hospice care with failing health, she is ever the hostess, entertaining, sharing music that she enjoys. We never have a session that is just her huband and me, someone else is always part of the "party".
Spring 2010 takes music to a man who is suffering, for the most part all alone. The music slows his labored breathing and calms his cries for help. He responds far more noticably to classical music than the popular music that one of his rare visitors recommended. The unfamilar, lilting melodies distract from discomfort in a way the familar does not. Perhaps because they have no memories attached to them, they are simply beautiful, slow, calm and structured.
Mid-winter 2010 finds the response of my primary progressive aphasia patient less pronouced, but we still see it. If he's agitated when I arrive, he's calm when I leave. Even if he no longer speaks much during the session, his state of mind is less on edge. His wife reports that the effect lingers for several days before the agitation returns. It's evident that the music ministers not only to my patient but to his wife, his primary caregiver. She needs respite too and the music is a bright spot in her week. A good reminder that when possible, family should be included in the sessions of harp music.

Some types of dementia include difficulty with word retrieval and speech becomes difficult. Patients know what they want to say but the connections are garbled and often what comes out of their mouths makes no sense. During a session in mid-December 2009, one of my dementia patients became very verbal. His speech didn't make sense until we noticed that the strings of words he uttered were sprinkled with words from the Christmas carols I was playing. As we paid attention to his words, it was clear, the "sentences" still didn't make sense to us, but each included words from the carol he was hearing at the moment.  He became more chatty as the visit progressed and that response continued after the harp and I left his room.

October 2009 begins my association with a local hospice. My first assignment is a man with primary progressive aphasia. He's losing the ability to speak. It's very helpful to have his wife with me to guide music choices to things he'd enjoy. After the first visit he became very chatty, for the first time in months and, he said his wife's name. Something wonderful happens after the ministering of the music and he is always more calm when I leave than when I arrived.  It had been so long since he uttered his wife's name she wasn't sure he knew her anymore.  At a visit in late November he was so agitated we weren't sure how long he'd sit and listen but as the music continued, slow soothing music, mostly in minor keys, we saw the stress that was keeping him agitated melt away until he sat, smiling and watching my hands on the strings. He reminds me a lot of my friend from 2002, who, without speaking, communicated with us. This time as well, we're sure that the music allows for connections that had been lost. It's a brief respite for his family, giving back a few moments of communication. As long as we can bring it back, we'll keep the music playing.  

 

September 2008 brought Harp Instead to a private home as a gift from one friend to another. The recipient was so appreciative at the gift of music. Illness has kept her from attending concerts and she's missed the beauty of live music. As I played her requests, she held the hand of her dear friend and it was obvious that the gift would linger in her memory for weeks.  I'm sure that a vase of flowers wouldn't have brought her nearly as much joy.

In July 2008, during the course of one of the monthly birthday parties in Wilmette, a resident asked, as she always does at her birthday, that I play her husband’s favorite song. I knew him while he still lived with her in independent living. He moved to nursing care well over a year ago but we continue to celebrate his favorite music even though he can’t join us at the party.  Her request sparked conversation at the table, explaining to new residents that didn’t know him and the activity director about the impact that my music has on residents. Even though he hasn’t heard me perform Ravel’s Pavane since he moved to nursing care, his memory of it is strong and each year when his wife comes to celebrate her birthday and she asks me to play it, he remembers it again when she relates to him that I honored a request for him in his absence. I marvel at how music brings joy even through a remembered experience. There’s a specialness in sharing music in person as we do at these parties that recordings cannot duplicate. Live music impacts the listener long after the performance in a way that I cannot measure.

I’ve been performing on a monthly basis since 1999 at some independent senior living complexes, entertaining for the birthday celebrants of the month. It’s a joy to get to know the residents and celebrate with them but included in that work is watching them as their health changes. Ann and John live in one of these complexes and as Ann’s Alzheimer’s has progressed, John has hired an aide for her. She has difficulty with her memory and with simple tasks and yet she recognizes me every time we meet in the hallways. We got to know each other through music and I learned some music from her native homeland of the Netherlands. We made a point, each time she or her husband celebrated their birthday to share music of Holland and she’d sing along in Dutch. In early 2007 I learned of her diagnosis, and yet, each time she and I cross paths, even if the harp is not by my side, she recognizes me. The music placed something significant in her mind that transcends her Alzheimer’s so that when she sees me, even if the harp is not included, she remembers me and the music.

August 2007 takes Harp Instead to Westbridge Assisted Living in Wheaton to see a friend who recently entered assisted living. It's a difficult transition for her as she's had to give up a lot of freedom. My visit was met with a string of complaints, things that are obvious but she wanted to say. When we finally got to sharing music, we propped her apartment door open so neighbors could hear. Before the first song ended, my dear friend was smiling. Within 5 minutes, the neighbor across the hall opened her door and propped it open with her walker so she could listen too. Then the care givers wandered in to listen, wishing it was break time and they could stay longer. By the time the 30 min. visit was over, my friend was all smiles, a complete attitude adjustment! Other residents will slowly learn that she had a private concert and she'll be a celebrity! This visit just turned lemons into lemonade.  Try doing that by sending flowers!

A lady from church spent most of the summer in hospice care. By June 2007 she was in discomfort nearly all of the time, off food completely and often restless and exhausted. The harp visited her weekly during her last weeks and she started to plan what kind of music she'd like to hear next time. She'd close her eyes and her breathing would slow down, opening them only long enough to ask that I repeat something she particularly liked. At a time when conversation took too much energy,  Harp Instead visits gave her company that took no effort on her part, except to enjoy. It was a pleasant time spent, soothing her in a way that the IV and medications could not. An email from a church member said " I spoke with Carl* the other day and he mentioned how soothing it had been when you came to play for Anna* -- I know it meant a lot to her."  

June 2007 brought a visit to a neighbor with MS who was admitted to Central Dupage Hospital for treatment. MS patients are fraught with constant medical attention and it can become tiresome. Hospital stays only emphasize the dependence on medicine this disease brings. As I brought the harp into the room, my neighbor's mother and friend were there comforting her. As I played, they commented that her color looked the best it had all week. Indeed, she perked up with the music and she was less pale. Again, the harp brought a response filled with happiness that surpassed any response she'd had to the flowers sitting on the shelf. Her roommate enjoyed the music too and we pulled the curtain back so she could watch the harp being played. Nurses and doctors stuck their heads in to listen and the music brought a moment so peace to many.

Early June sent Harp Instead to Marianjoy Rehabilitation Hospital to bring music to a lady who'd recently had hip replacement surgery. In her note of thanks she wrote, "I'm so grateful to you and so many...for all the help they have been to me during this very difficult and vulnerable time. God has been so good and he's sent you as one of His Angels to minister to me when I needed it most. That was one of the worst days I have had since my surgery and the wonderful "service" just brought His face so clearly before me and renewed my faith again so I could go on."  A friend of Bev's arranged for me to take music in and Bev benefited.
I spent several Sundays playing at Wynscape for a dear family member that had knee replacement surgery. Even with medication, this procedure brings discomfort. I knew that the rest of the family would be in church so I could visit uninterrupted at that time. The first time I visited she apologized that she wasn't up to a visit. Knowing that, I explained that I was only there to play for her. The harp brought hymns to her on Sunday when she couldn't be in church. Together, we shared music reminding us of the Lord and his goodness. With closed eyes and open ears, the music distracted from the discomfort of post surgery stress and eased the fatigue of physical therapy that filled each week day. When she got back to church, she wasn't telling everyone about the beautiful flowers I saw on the dresser. She was talking about the harp visits!

January 2007 brought Harp Instead visits to a lady at Wynscape Nursing Center as she was recovering from a fall. The table in her room was full of greeting cards and flowers, yet the harp was the gift that brought the most cheer. Her complaining about being laid up ended and bragging about her personal concert became the principle topic of conversation.

August of 2006 brought an opportunity to bring harp to one of the founders of Healing Harps. As an advocate of the power of music to transform lives, this man was in a position to benefit personally from his own research and advice. I followed his advice and took music to someone that needed soothing. I found him recovering from a hip replacement at Marianjoy Rehabilitation Hospital and the music brightened his day. He'd been watching that afternoon's chapel service via in house TV but my harp wasn't amplified well for the TV reception and he'd been regretting that he couldn't hear it well. The surprise of having the harp show up in his room for a private concert later was received joyfully. He was happily surprized with my visit and he enjoyed hearing the Silberjahr-Ländlers. Listen to Ländler Nr. 2 and Nr. 3 (mp3).

One summer Private Harp Instead regularly visited Brown Wing of Marianjoy to see a friend who was recovering from a traumatic brain injury. I soon learned patients who are physically and mentally paralyzed in hospitals, rehabilitation facilities and nursing homes all miss their everyday life. Visiting friends will often carry long, sad faces and look upon patients with sympathy when all the patient really wants is to feel part of some sort of balanced interaction. The harp empowers the conversation, something normal in this particular friend's life as he is a musician too. We shared music as usual and talked about the familiar things of life, taking the focus away for the moment from the unique therapies and discomfort that his accident brought unexpectedly into his life. 

Private Harp Instead visits and more public Concerts of Comfort offer exceptional activities that modern medicine often neglects to provide.
Winter of 2001/2002 brought weekly visits to a man at the Dupage County Convalescent Center.  His condition had taken away his ability to speak so visits with friends and family were limited to one way conversations.  The music shared weekly was personalized to his tastes, classical music and favorite hymns. His wordless responses let his wife and me know that he appreciated deeply what the music brought to his life. Without speaking a word, this dear soul thanked me every time we were together.  Favorite music brought pleasant memories of a long happy marriage and faith that did not waiver.

Winter of 2000 brought several visits to a patient suffering from a rare form of blood cancer. The only treatment for pain was a blood transfusion, which extended life and suffering. Keeping Lorraine comfortable proved difficult so her daughter brought music to soothe. At the first visit her home care nurses were skeptical and cautioned that Lorraine was tired and probably couldn't tolerate much music. She enjoyed the whole visit. The next week, visits were greeted with the same nurses' caution. Each time as I arrived, I announced to Lorraine that I'd brought the harp back. Each time all the tension left her face at that announcement. Just the thought that the music would fill the air soon brought her comfort. Each week, the same story repeated itself, with Lorraine asking me to repeat her favorite music. Eventually the nurses admitted that as Lorraine would remember the music between visits she'd relax.  The music brought the only relief from pain she had in those last days.  She loved the music of Bernard Andrés and waltzes like Westphalia Waltz.

The mid-1990s I took the harp into the dementia unit of the Dupage County Convalescent Center. What an interesting place to take music. When the concert began the residents were pacing, sitting alone, not interacting with any one at all and within 10 or 15 min. not only did they settle down to listen, many started to talk with each other.  There was always recorded music in the wing. The response of residents to the live harp music was vastly different.

In the early 1990's my grandfather was suffering from Alzheimer's. He hardly spoke more than one or two syllables. One summer while visiting him in another state I took my harp along to play for him. I chose to play traditional hymns from the Lutheran Church that he'd have stored in his long term memory. It wasn't long before he was having quite a conversation between hymns. Then the real surprise: this man who disliked exercise stood up and declared "Wait right there, I'm going to get your mother." Amazing. My mother lived just down the street, too far under normal conditions for him to walk but the music moved him out of the haze of Alzheirmer's to motivate him to want to share the music with someone he loved.  We started taking harp to the restaurant down the street. If I'd play while everyone read the menu and got settled, Grandfather could read the menu too, decide what he'd like and communicate to us in a way that was locked up without the music. His response to the music was predicatble in this manner for several years.  Music brought us a way to unlock communication for a while longer. It was wonderful to get more than a few words from him.

* Real names have been withheld.