Just awhile ago, I wrote about how I found it difficult to see the work we do in aged care come to fruition, and wondered if there we were indeed adding any value to the clients’ lives, given their limited potential and time frames.
This week, an incident took place which made me reflect on this again, and allowed me to see that there is indeed some value in the work we are privileged to do in aged care.
The incident centers around a lovely old lady, one of the residents at the facility who was referred for individual sessions. I’ll call her Penny.
Penny is extremely musical. She used to sing in show choirs, and has a beautiful, amazing voice, despite her age. One can only imagine what she must have sounded like in her prime. During our very first session with her, she took to singing like a duck to water, improvising vocally and singing with us in perfect pitch and harmony. Despite her wonderful state of engagement, after her session, she almost immediately reverted back to her confused, disoriented state, the symptoms of her dementia revealed once more. Hence, my slightly wistful thoughts about how the work we do might just be limited to the moment, and not able to result in prolonged or lifelong improvement. Even though the moment(s) we get is(are) better than nothing, I couldn’t help but wish for more concrete or long term measures of therapeutic success.
Halfway through her second session last week, just after Penny had finished a few rounds of “Singing in the Rain”, including doing an improvised solo, she suddenly told us: “I have to go.”
She meant the toilet, of course.
Long story short: We informed the nurses immediately, but by the time the nurse came with the proper wheelchair to take her, Penny had already gone. In the chair she was sitting on. Just as it was happening, she said, with full awareness, helplessness and despair: “It’s coming now. You can smell it.” I felt my heart breaking for her.
What is it like to live a life like that? To have to rely on strangers to help you with your basic bodily needs, and having to apologize for your body when it is not able to control it’s own functions? To have to say “sorry” in a voice so small and meek, for something that should be a natural part of life and living?
Because of this incident, I got reflecting and thinking about the role we play in her life. During our reflection and note-writing time at the end of our day, I suddenly said to the Coursemate: “We help her fulfill existential goals. The nurses take care of her basic needs, but the music provides a path to existential fulfillment.” I myself had not thought about it until I actually said it. It’s one of those thoughts.
The sessions give her a voice. It gives her the opportunity to make decisions within a meaningful context. Whether she wants to speed up or slow down her vocal improvisation. Whether she wants to sing loudly or softly. Whether she wants to copy the patterns initiated by the therapist or initiate her own musical material, and how to respond when her voice is being validated and reciprocated. It provides her a setting in which she can interact with people who are not there to simply take care of her physical needs, but also to take care of her inner-self, expression, and emotional well-being. In a life in which almost every basic aspect has been taken over by others… The music gives her a chance to be a human being with the freedom to make her own decisions, respond in the way she wants to, and steer the boundaries of her own social interaction and co-activity.
Some time after the incident in the chair, Penny was back in her room with a new change of clothes. We went in and saw her looking rather pensive. A 15-minute vocal-guitar-drumming improvisation later, she seemed slightly more perked up and cheerful.
“What did you like about the music?” The Coursemate asked just before we packed up.
Penny paused for only a split second before answering: “It made sense.”
Because sometimes not everything in life does.