Giving through grief

The first time I ever went to visit my husband's family was for a meeting that was being held at the church where he grew up. It was about an hour and a half away from our little college, across the unfamiliar gravel roads of his childhood. Between giving directions he laughed at his city girlfriend white knuckling through the back roads of southeastern Iowa.

After the meeting we went over to his grandparents house to visit for a little while to visit. Upon entering I was bombarded with offers by his grandfather. Would I like any one of the following:
1. Cheese sandwich (something my husband considers a delicacy and I really just do not understand)
2. Oreos
3.Ice cream
4. Homemade chocolate chip cookies
5. Doritos
6. Ice Cream and Oreos
7. Water
8. Milk
9. Mountain Dew
... the list could continue.

Forget the fact that it was about 10pm, but also in an effort to be as low maintenance and an unobtrusive "easy" guest, I turned down most of what was offered. Opting for a water and a few Oreos (I mean who can say no to Oreos?).

After we left and headed back to Monmouth, I remember looking at my new boyfriend (and now husband) and asking, "Do you think they liked me?" He answered, "I'm sure they loved you... but you could have eaten more." :)

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Just a few days ago my supervisor and I were out seeing patients when we got a call to see someone actively dying. We headed right over for what would be one of my more memorable visits so far. We were greeted by the patient's daughter who showed us to her room. Upon entering we met the most distraught young boy. He showed us his iPod, instructing us on what music she likes, and requested in the most grown up way a preteen boy can, "Make her happy. Just make her happy." My heart broke for him. He told us stories of how he is the favorite grandchild. The special nicknames his Grandma had for him and the music they listened to together. Looking around the room it was clear he was a cherished child as his pictures graced a majority of the frames, were slid into the sides of mirrors, and covered the side table.

Her priest came and gave the anointing of the sick. Her daughters crowded into the room to take turns caring, holding her hand, and whispering their love between kisses to the cheek.

After about an hour and a half of providing music for pain management and to "provide a peaceful holding environment" (one of my favorite documentation phrases often used here)... my supervisor and I made our way out of the family's house. Before we could get to the door though, we were stopped.

"Do you want something to eat? Come here! We have more than enough food... please, eat!"

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A few days later and a visit to a different patient, with a family I could easily have just fallen in love with... ok let's be honest, I DID fall in love with... upon our arrival we were met with offers for food or a drink (which included a list of various beverages probably 15 varieties long).

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A separate visit to another family with a 1 year old on hospice care I sat with the social worker, the chaplain, and the sweet girl's family. As we were walking out the door I was presented with a Minnie Mouse invitation to the child's birthday party a few weeks away. The family who hardly knew me more than an hour wanted to share with me the awesome joy and accomplishment of celebrating a 2nd birthday with a child who was not expected to live past the first 24 hours of life.

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It has been these encounters of pure gratitude and the need to give back that have caught me off guard. I always seem to walk away from patients wishing I could do more... or even still having that feeling of "what am I doing here?" as if I am an impostor.  These people let us into their home and see them at their most vulnerable. We enter their lives only for a short while and yet they are so grateful. My first inclination is to deny their efforts... they don't need to serve me. I never want to ask for anything or require any attention. However, it may be the therapeutic! It's very different for me, but it's also very nice of them to do.

Be prepared!!

The past few days I have been out an about visiting patients with MTs, interns, and CNAs. Tomorrow I will go out with another intern, Next week I will go out with a social worker, two more MTs and a RN. All in all, it is FANTASTIC. Not only am I learning a ton by watching them but I am really getting a feel for the population I will be serving. It has been shocking at times. There have been moments where I was glad that I was just there observing and moments where I wished I could jump in with a song I knew. There have been families I wanted to stay and get to know more.

One big lesson I want to highlight with two stories:

BUILD YOUR REPERTOIRE!

1. Monday I went out with a MT intern who is just about to wrap up her time with Seasons. July 1 will be her last day and I wish her all the best. She is a great MT. Monday we met downtown and visited a few patients. Then she got a phone call and we needed to head over to Rush to be with an actively dying patient and their family. The patient was Hispanic. "How's your Spanish?" She asked me, "Do you know any Spanish songs?" **GULP** The only song I could think of was a song about "La Llorona" or the Weeping Woman, a sad and kind of scary tale about a ghost searching for children (and possibly killing them). It's from a play I was in. It's probably not the best choice to sing to a person dying OR their family. I kept my thought to myself and instead watched her mind race as we drove to the hospital. A

After parking and walking and going up elevators and signing in and getting lost and walking/wandering some more we arrived at the patient's hospital room. She talked a bit with the family, talked with the patient (who was not responsive), and started playing. A few spiritual songs, a little instrumental here and there, and three songs in Spanish. How awesome was that!? Right there on the spot she pulled out a few songs and was singing beautiful Spanish.

2. Today I went out with my supervisor to see a bunch of people. Our first stop was at a facility where we saw three patients. Two of the patients who had diagnosis of ADRD were uninterested in having music therapy for the day either sleeping or wanted to be left alone, but the third (with a diagnosis of COPD) we found up, alert, and ready for music. After the first song, for some reason, the client mentioned that he had recently been to Iowa to hear a music program. Of course my supervisor asks, "What town was it?" After a while of thinking he finally managed to say "Iowa City". And thus began my first real interaction with a client.
"I went to the University of Iowa in Iowa City," I said.
"I was born in Iowa," He said.
"So are you a Hawkeye fan or a Cyclone fan?" I asked.
"Hawkeyes!" He answered breathlessly.
"Is there a Hawkeye fight song you could sing?" piped up my supervisor.
Oh dear I thought, "Yes...If I remember all the words." There had been a competition each semester to see who knew all the words. Last semester I even used the fight song in one of my practicum sessions. But I had only been a Hawkeye for 2 years and I have YET to go to a game...

But, I sung it. And in the middle of a quiet facility in a small suburb of Chicago about 4 hours away from Iowa City, two Hawkeyes bonded. It ended up being a great session for life review and reminiscence. When we were about finished with our visit it was such a blessing to hear this man who had played Iowa basketball, who had loved the ladies in high school, and who had served his country say, "It was some life. I could live that life over and over and over..."

I guess there are actually two lessons here:
1. Be prepared. Learn and remember songs. A variety of songs. You never know when you'll need them. Whether you need to know a song in a foreign language, country music, Frank Sinatra, the Red Hot Chile Peppers, or heavy metal (all of which I have seen since I've been here) - you can never be TOO prepared.

and...

2. Live a life that in old age you can look back and say, "That was some life."

I am certain that my rendition was not nearly as cute.

Wow

Here at Seasons Hospice it is a part of orientation that every discipline or division of care shadow all the other care providers.

Today I shadowed an Certified Nurse Assistant... an absolutely AMAZING woman. She was so much fun and worked so hard. She cared so much about each and every one of her patients and in the end was so generous. She has probably the hardest job - dealing with some of the hardest (grossest??) stuff. She didn't take anything too seriously or get upset. But! At the same time the care and love that she give in everything she does was 100% serious. You could see how much she meant to the people she cared for. It was inspiring and I was humbled knowing that I could never do what she does every day. Wow. Amazing.

Also... CNAs do not make nearly enough money.

What is music therapy?

So, we took a little personality test in orientation. The test was written in response to the Meyers-Briggs test and is a little more fun as well as much less time consuming. I'm an otter. Adorable, yes? I know I am.

Anyway! Here's why I am an "otter":

Otters

Common traits
            they are:
                 - our entertainers
                 - a party waiting to happen
                 - visionaries
                 - eternal optimists
                 - motivational (people believe them)
                 - the fun bringers
                 - they tend to be: fast paced (easily bored)
                 - networkers
                 - people oriented
                 - quick starts but slow finishes
                 - bored by details
                 - good communicators
                 - people pleasers

Communication:
                 - surround an otter with positive feelings - don't harp

If you are an OTTER, caution:
                 - finish what you start - details DO matter

Why do we need otters?
                 - to make the world a fun place
                 - to have great ideas and visionaries
                 - so that we don't take ourselves too seriously

All that excitement is exhausting!!

Even though this was just a fun little thing to do... it is amazing how accurate this describes me. I am always coming up with (what I think are) great ideas... birthday parties, TV shows, trips, songs, etc. I often have to be reigned in as to what is actually possible to happen as opposed to the big huge ideas that formulate. I am someone who has a million bubbles popping up, ideas floating around all over, and I need someone who can come by and tie down all my crazy ideas and help me follow through with them. I can't work as a "sales person" probably because I feel like I would lose my mind AND paperwork is NOT my friend. However, I am exceptionally loyal and very good at selling the things that I believe in. In ever conversation I am a moment away from saying "Oh! Did you know the music therapy would be perfect for that?" or "Hey! My husband, sister, best friend is just the perfect person for that _____ (job/project/idea)." I always have been great at getting pumped up about an idea, wanting everyone to get excited too. Case in point? This past weekend I invited 20+ people on vacation to a home that really only comfortably sleeps 11. But I love big parties, lots of fun, and tons of activity. I invited people from all areas of my life... friends from college, high school, and work... everyone is welcome. And when friends wanted to back out of the weekend because they didn't know anyone, or didn't like so and so, or didn't want to sleep in a certain room... whatever, I will admit I am let down. I just want everyone to be happy, excited, and all together. So! I have to work on understanding that not everyone is an otter. There are those that are beavers (schedulers/detail oriented) or people that are lions (aggressive/task oriented) and that's ok.

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We are still trudging through orientation... but we had a highlight!! The music therapy orientation session! One whole half hour of "What is music therapy?" How do you condensce the awesomeness that is MUSIC THERAPY into just 30 minutes!? My orientation room was filled with CNAs, social workers, and administrators new to Seasons. I could see the skepticism on their faces. What a hard task!

Here's some brainstorming I did on what I would share, because I very well may be teaching about the therapy to someone at any point in time. I would cover a range of goal areas in hospice such as:

• Grief and bereavement
• quality of life
• life review
• social interaction - family and friend relationships
• weight loss
• anxiety, stress, and mental health issues
• pain management

• and more

All of which are proven to be effectively addressed by music therapy. Also, concerns of safety such as moving a client or staff support can be aided by music therapy. RAS (rhythmic auditory stimulation) may assist a client needing to walk from one place to another and decrease the risk of a fall. I would think that if another professional explained how their services could assist me and my services, I might be more open to their profession. Maybe?

Even though Seasons takes music therapy more seriously than I think many other institutions, the presenters (non-music therapists) have not really gone into dept on the music therapy profession. They have of course made sure to mention that music therapy is a tool to be used but I think that since the presenters are not music therapists it's not necessarily the first thing that pops up for them. The music therapist only had 30 minutes to teach the room about MT. That seems like such a limited time to shared all the possibilities of music therapy intervention!!  I would have wanted to show videos or statistics. I would want to handed out fact sheets like those on

• Alzheimer
• Pain management

provided by the AMTA would be fantastic. Or made my own! It's an opportunity to educate and market the profession. I want my colleagues in the room to fall in love with music therapy. To really know why I changed my whole life to go into this profession. I would want to share my passion... pass it on. But I'm sure I could have rambled forever. How do you effectively share information on music therapy in a timely and engaging manner?

I'm wondering... if you were given 30 minutes to teach a room full of various professionals about music therapy what would you say? What would you feel is important to share when teaching about our profession? Comments are requested please! I am sure in the future I will in fact have to do this. My otter personality wants to make sure everyone is thrilled about the possibilities with music therapy. What aspects need to be reigned in? What areas do you think are mandatory for a presentation?

Let me hear your thoughts!

First Day

Yesterday (May 31st) was really my "first day". I went into Season's to meet with Lindsey (my supervisor) and Shelby (supervisor of the other intern, Gina). Basically we just did some preliminary information, signed some papers, copied my licence/car insurance and went out for a GREAT lunch! Oh la la...

Today the real fun started. Orientation. Orientation that is going to last for 2 weeks. For 7 hours a day. Wow. I can't really complain though. I think I am still on cloud nine just being there. The greatest thing is that the Executive Director came to talk with us about the philosophy of hospice. We learned about the history of hospice care and the goals of Season's Hospice care. This may sound corny but it sounded like the descriptions and vision were describing me. We talked about hospice in general... my orientation including nurses, administrators, and social work... but I kept feeling like "I can do this. I can really do this well." It really just fired me up to get started.

I'm not going to lie though, going through all the OSHA and HIPAA guidelines, the payroll and insurance information (which don't even apply to me), and the more tedious details are... well... tedious.

So today in honor of my awesome TA and practicum supervisor Sarah, I am going to share some positives and negatives from today. In practicum she limited it to 3 positives and 1 negative but I think I need to add in my own flair and provide some insight to the ridiculousness (it always seems to happen to me)...

Positive

1. I successfully navigated commuter traffic, bought an I-Pass, and made it to work on time.
2. I loved some of the readings from today and want to (will) share them with you in the future.
3. The information shared was not as boring as I was afraid it would be.

Negative

1. I had to have a TB test. I have a diabetic husband, watched a friend give birth, and visited enough hospitals. Needles don't bother me. Unless they are penetrating my skin. Ugh... dislike

Ridiculous

1. I locked myself in the bathroom stall. No joke. I wish I was lying. I was panicking for about 30 seconds until I just slammed my fist on the door and busted out. Yeesh
2. I believe that Orientation is also synonymous with some sort of torture. The air conditioning would kick on and freeze me to death, then the room would warm up, then the air would come on again, etc. About ever 20 minutes. Tomorrow I will dress in layers. It's only 90degrees outside, a cardigan seems appropriate.

1 day of orientation down, 7 (at least) more to go.