Topic: Music

Topic: Music

I’ve spent over 25 years of my life working in nursing homes. My first nursing job was working nights as a floor nurse in a secured Alzheimer’s unit in 1991.  From there I moved into management and with my current work as a nursing home surveyor I spend a good chunk of my waking hours in a setting that a lot of people see as depressing.  But it’s not all bad.  

In 2014 I was working as the Director of Nursing for a skilled nursing facility in Cincinnati.  That fall a documentary called “Alive Inside” came out.  I went to opening night at the Mariemont Theater and had to share the space with about a dozen others.  It was just as well, cause I cried like a baby throughout the film, which shares the story of the “Music and Memory” movement in America’s nursing homes.  A social worker in New York got this idea that if you took an iPod Shuffle and loaded it with music from a nursing home resident’s past and you introduced that music back into that person’s life you could effect a dramatic change.  I left the theater inspired.  We had to try that at my nursing home.  

I convinced my boss to let me buy a few iPods.  Initially he felt that it was something the activity department should do, but they weren’t jazzed about it like I was.  I finally told him that if the facility didn’t want to pay for them, I’d buy them myself.  He relented.  

Our first “test subject” was a 86 year old lady named Shirley with end stage dementia.  She hadn’t spoken in years.  She was incontinent and had to be fed and dressed and bathed. After breakfast the aides would wheel her Geri chair, which is basically a big recliner on wheels into the lounge by the window.  She would people watch, at least that’s what it looked she was doing.  She seemed to follow passers-by with her eyes.  We had called her daughters to find out what her favorite genre of music was when she was young.  Gospel music was their answer given without hesitation.  “What’s her favorite song?” I asked.  I learned from the movie that this was a very important question, because the personalized playlist on the iPod had to be meaningful to that person.  You couldn’t just pick some popular songs that were age appropriate, because maybe that wasn’t that person’s jam.  Shirley’s favorite song according to her daughter was “The Old Rugged Cross.”  The night before I loaded Shirley’s iPod with gospel tunes from my music library.  We used cushioned headphones instead of ear buds, because most seniors seemed to be more comfortable and familiar with them.  Putting anything INTO the ears of a dementia resident could frighten the person.  There was something to the notion of playing the music through headphones as opposed to just setting the person next to a boom box and playing it for them.  When you listen to music through headphones it blocks out everything and it’s as if the music is coming from someplace inside of you.  

My assistant Director of Nursing was skeptical about the whole thing.  I made the nursing management team watch the movie.  In morning meeting I laid Shirley’s shiny new iPod on the conference room table.  “Who wants to go with me and see how she likes this?”  A few of them joined me.  My assistant told me not to feel bad if we didn’t get a strong reaction from her like they did with the people in “Alive Inside.”   We went upstairs to the lounge about 10:00 A.M., and Shirley was up and dressed.  I decided to start with Whitney Houston’s version of “I Go to the Rock”, a gospel standard, which features the lyrics, “Where do I go when there’s nobody left to turn to and who do I talk to when no one wants to listen?  I go to the Rock of my salvation. . . When the earth all around me is sinking sand on Christ the solid rock I stand.  When I need a shelter, when I need a friend, I go to the Rock.”  The pink cushioned headphones matched Shirley’s floral night gown.  I placed them over her short grey afro and pressed play.  Her eyes flew open, and I feared at first that we had frightened her, but then she began to bob her head in time.  She started to vocalize.  You couldn’t really call it singing, and she didn’t make intelligible words.  I’d call it making a joyful noise.  And then tears ran down her face.  And I realized that I was crying too.  My assistant said, “Oh my God,  you were right.”  

I couldn’t wait to try one on my next “subject”, Joe, a man in his fifties who had suffered a traumatic brain injury about five years prior that had rendered him paralyzed.  I thought it was from an accident but some of the long term staff told me he had been in a bar fight, and that he  had lived a hard fast party life before ending up at the nursing home for his final years.  I heard he died of pneumonia in 2016, and when I got the news, I was glad that we had given him back “his music” for the final years of his life.  His girlfriend said Joe liked classic rock and that his favorite song was “Don’t Fear the Reaper” by Blue Oyster Cult.  

More people joined us when we played the earphones on Joe.  After seeing Shirley’s response to the music staff started making lists of people we thought we could draw out with an iPod and the right playlist.   Joe didn’t sing when we started playing his song, but he did start banging his hand on the armrests of his wheelchair.  And instead of his eyes flying open he closed them tightly shut as if to block us out.  One of the aides came up beside him and touched his shoulder, “What do you think, JoJo?  How do you like that music?”  Joe put up his hand as if to say, “I’m here inside my music, and I do not wish to be disturbed.”  

In the movie they said the part of the brain that interprets music is the most enduring even in the face of dementing illnesses and brain injuries.   I have my iPod loaded and when I’m a 98 year old demented old lady in a nursing home I want them to play “I Melt With You” by Modern English or anything by The Cure or Depeche Mode.  I think they’d be able to reach me, no matter how far into myself I may have retreated by that time.  

Working in nursing homes isn’t so depressing after all.  Some days you get to reach inside and make a connection.  Some days you get to touch someone’s very soul.