Suggestions for Musicians in Elder
Care and Healing Arts Programs
Please remember that one of the single most important duties you
will have when entering any medical setting as a professional is
that of confidentiality. This confidentiality extends beyond
the patients themselves to include their family and friends as
well. DO NOT discuss the people you encounter when outside of
the medical setting. It is advised that you do not approach
people you may have met in these settings when you see them
elsewhere; leave that opportunity to them, at which point you
are free to talk to them about whatever they please concerning
their own situation, but not that of others.
Care, Assisted Living, Skilled Nursing
These locations are all
united by having patient/client populations that for some medical
reason cannot attend to their own activities of daily living (ADLís)
and therefore require assistance and constant care. There are a
multitude of reasons for why people come to these environments, some
of the most common being dementia, mental retardation, and
significant physical disabilities without any cognitive problems.
Listed below are some guidelines to follow in these situations.
To start: Make a
You are a guest where they
live. So, even if you are carrying instruments or gear, put
down your load and audibly greet whomever may be in the room.
Be sure to speak clearly, loudly and slowly. Make eye contact
if possible, and donít immediately be focused on setting up.
Look sharp and make your visit an occasion.
it helps to take a few minutes to focus your energy and remind
yourself why you are doing what you are doing.
Be animated and outgoing,
regardless of your own mood or the mood in the room. Do not
react to anything that takes you off your agenda, such as people
coming and going, or needing staff attention. In memory care
and assisted living situations, people can say and do seemingly
random things quite frequently.
Always defer to
the staff on audience management.
As an example: If there is
background music playing, or a TV is on, ask a staff member to
turn it off and redirect peoples attention as opposed to taking
care of it yourself.
The less one plugs
in the better.
If you can be comfortable and
audible, sing without a microphone. Many old people are wary of
sound systems and sometimes have hearing-aid problems with
Interact with your
audience as much as possible, for both you and them.
Move around the room during some
numbers. Approach individuals and sing and play directly to
them. Donít be squeamish about approaching extremely disfigured
or disabled people and singing and playing right to them.
Crouch or kneel in order to look straight across or up to people
in wheel chairs and beds. Some may have very limited range of
vision, so find their individual field of focus and try to meet
their eyes. If their eyes are not aligned, as with many stroke
victims, try to determine which eye is in focus and look into it
as you play. Many seemingly unresponsive individuals can become
quite responsive with this technique. Move from one person to
another without losing track of the whole room.
Be easy and
Talk about the music, talk about
your day, or tell a story. Many people in these facilities seem
to miss ordinary non-clinical conversation and humor. Be very
careful with sarcasm, pop culture references, as they can be
easily misconstrued. Those with problems with dementia or brain
injury, in particular, can have problems as they can have key
parts of their brain damaged that work to process these kinds of
more complicated human interactions.
Ending with a
sing-along is very effective.
For seniors, songs such as Side
By Side, You Are My Sunshine, Sentimental Journey, I Got Rhythm,
This Land is Your Land, or America the Beautiful always seem to
work. There are many great songs to choose for this, but the
best ones are old, mid-tempo, easy to sing, and donít cover too
much vocal range.
or Rehab Room Visits
patients in these settings are likely to be much more acutely ill,
usually with some kind of difficult cancer, or recovering from
severe illness such as a heart attack (myocardial infarction, MI) or
stroke. They are going to be fatigued from both their illness and
their treatments and procedures. You may even be in a palliative
care or hospice setting, where treatment has transitioned from
intention to cure the disease to a complete focus on reducing the
severity of symptoms and suffering in that stage of the disease.
Dress cleanly but casually.
a visitor, not to be confused with staff member or medical
professional. Wash your hands before going in hospital or rehab
rooms, and always be aware of any safety precautions regarding
contact, gloves, masks or gowns. If you have any questions or
concerns about a giving setting, ask a nurse at the nursesí
Determine what the function is in each situation.
It may be
to entertain, evoke memory, change mental focus, aid in sleep,
provide guided meditation, or simply pass time and relieve
stress. The function may evolve throughout that visit or in the
process of several visits. It is not about your performance.
Music can be palliative without addressing symptoms, just as it
provides relief in everyoneís life.
When entering, take note of the patient.
Consciously note their posture, physical attitude, rate of
speech, vocal pitch, and rate of respiration. Try to match
their speed of breathe and speech before playing any music. Do
not talk more or faster than they do. Even if there are visitors
or family member present, stay focused on the patient.
Do not inconvenience the staff in
Always remember there are very
serious, expensive, life altering decisions and procedures going on
around you. Be careful how you set up, and donít impede the staff.
Try to bring as little baggage and extra volume of materials with
you as possible, as hospitals are often quite short on space. Be
prepared to get out of the way and wait. Be aware of volume, and be
sure that audio bleed over does not bother patients or staff in
Always talk to
Do not ask how people are, but be
prepared to be told in great detail about grave conditions. Have a
compassionate response. Sometimes people want to vent to someone
through your mouth and not your nose.
Do not gag or show disgust. Do not
flinch or react to smells, sights, sounds, conditions or