I read this article, interested in the authors work with the elderly using music therapy. I have recently begun my first year internship at a nursing home in south Boston and have become very interested in this population. An issue that the author brings up in this text is the use of music to evoke memories. I felt that it was especially poignant that the author and his associates used key songs, not only to evoke difficult war time memories in WWII veterans, but also used these song to help the veterans work through the loss that they felt for their fallen comrades (Lehtonen 2002). Another issue that the author touches on is the use of music to create "meaningful experiences" by using music (and lyrics) to evoke emotions, images and ideas within the minds of the clients.
I feel that the use of music to evoke memories and experiences is especially important when working with the elderly in the nursing home setting. When confined to a wheelchair on a single floor of a building, there are limited chances to experience anything new in day-to-day life. By using music as a means of mental escape, we can allow people to mentally and emotionally explore their world without being dependent on television or movies. The author also suggests the use of visual images such as photographs, post cards and paintings to enhance these experiences.
Upon reading this article, I found myself wishing for additional information regarding this population. Fukumi Kitamoto's "Psycho-social Aims of Music Therapy for Elderly Persons" explores the cultural context of music therapy for elderly populations in Japan. Like Lehtonen, Kitamoto writes about the use of music to work through difficult emotions. Kitamoto, however, has found that his work focuses more on present emotions then past. In one situation, Kitmoto writes of working with an elderly woman who has estranged herself from her family in order to lessen the perceived burden of old-age. She did not want to expose herself to the public, seeing herself as "dead" (Kitamoto 2003). She attends music therapy sessions where she writes "parody" songs describing her current life and feelings. By singing these songs with the other elderly members of the group she comes to find herself in a new community, one where she can still feel happiness and companionship. Along with Lehtonen's work with memory and mental escape, Kitamoto shows us that music can also be used as a means of working through the new challenges of the elderly, as well as a means of building community and friendship within the hospital/nursing home setting. While the past plays an important roll in our lives, the transition into old age can bring many physical, emotional and social changes. I feel that Kitamoto's work is especially important for those adjusting to nursing home life.
Community building and relationship formation are also discussed by Vicky Abad in her 2002 articles. Abad writes of using music therapy with a man with Dementia to decrease his risk of social isolation. The man participates in Music Appreciation and Music Therapy Stimulation Sessions multiple times a week. Abad's client is able to meet his goals of decreased social isolation, minimized agitation and increased motivation, social interaction and cognitive stimulation over the course of five years of group attendance (Abad 2002).
I found these articles to be a thoughtful and well rounded look at music therapy with elderly populations. I appreciated Lehtonen's approach of using music to induce memory recall and work through repressed emotions. Abad's and Kitamoto's approaches to socialization and working through new emotions to be helpful as well. I have seen all of these approaches used in my own internship site, and these articles have given me a better understanding of the approaches as well as their importance worldwide.
Abad, Vicky (2002). Reaching the Socially Isolated Person with Alzheimer's Disease Through Group Music Therapy-A Case Report. Voices: A World Forum for Music Therapy. Retrieved November 16, 2007, from https://normt.uib.no/index.php/voices/article/view/101/78
Kitamoto, Fukumi (2003). Psycho-social Aims of Music Therapy for Elderly Persons. Voices: A World Forum for Music Therapy Retrieved November 13, 2007, from https://normt.uib.no/index.php/voices/article/view/128/104
Lehtonen, Kimmo (2002). Some Ideals About Music Therapy for the Elderly. [online] Voices: A World Forum for Music Therapy. Retrieved November 13, 2007, from https://normt.uib.no/index.php/voices/article/view/71/61
Being an intern in the nursing home, it is my first time to see how music therapy works in reality. Before entering the field, I have a lot of imagination and expectation. I want to put theories into practices. I can apply music therapy to improve my clients’ physical, emotional, mental, and psychological problems and can help them become healthier and more normal. For instance, for addictions, according to the article “Music Therapy and Addiction” by Soshensky (2001), music therapy gives individuals who are outside the mainstream of society an opportunity to reclaim their humanity and to give them the dignity and right to be just as they are. However, some of my perspectives of music therapy were changed when I started working with the elderly in my practicum. Music therapy is powerful, but it cannot stop dementia from progressing or to cure it. However, I learned from the practicum that music therapy for the elderly, may not make them have “big” changes, but it can give them a great moment that can improve their quality of life. This is the therapeutic goal for them.
So, I am really interested in looking forward to learning about what I can do for this population and how the elderly can gain something from music therapy. “Some Ideas About Music Therapy for the Elderly” is the article that helps me find ideas that I can apply to my practicum. Lehtonen (2002) mentions some points that through music it is possible to reach vivid pleasure-giving memories and meaningful experiences connected with earlier phases of life, which could otherwise remain out of reach. I can see these ideas in my clinical work.
Firstly, Lehtonen mentions how music promotes memories. In music therapy sessions, we sing a lot of Oldies or Hymns in order to activate the elderly clients’ memories, social relationships and expression. For example, one of my clients, who has Alzheimer’s disease, used to have alcoholism and traumatic experiences. She cannot participate in the nursing home’s activities and always wanders around the unit. Sometimes she says “my house is burning”. Her dementia brings her memories back to her past traumatic experiences. In the music therapy session, when the therapist sang “Home on the Range”, she remembered that she and her children played in the backyard. Music reminded her of pleasurable memories about her home and her children. Sound brings the images.
Secondly, the author mentions music as a meaningful experience. One client who is in the Sub-acute Unit after suddenly falling into a coma and recovering from it loves the song “The Way We Were”. She used to sing this song in a bar. One time, the therapist invited her talk about one line of the lyrics “If we had the chance to do it all again”, and the client said that she wanted to tell the doctor to “try harder to make her healthy”. What was important for her was the opportunity to talk about her and to express her thoughts. Taking every song request from participants enhances their self-expression and singing with others improved their well-being. (Nashimoto, etc, n.d)
Lastly,music can easily be linked with poems, literature and spontaneous recollection and narration. People may be therapeutically-affected by different artistic modalities. Some people may be more affected by visual art or movement. For instance, one client loves to have music sessions with the therapist and participates fully in the sessions. However, the therapist knows that she is more affected by visual art. One time, the therapist invited her to draw the mandala circle about a thanksgiving wish. She was engaged in the drawing for an hour and talked about what she wished for and which colors she used. It was an amazing and therapeutically-affected moment for her. Music sessions can, in time, give opportunities to express emotions and experiences.
This article provides some ideas that correspond to my clinical work and also gives me a lot of inspiration and encourages me to implement music therapy with my clients. In the future, I can use music to promote memories, and create meaningful experiences for my clients.
Reference
Nashimoto, M., Onchi, Y., & Maruyama, K., (n.d.) An approach to introducing music therapy to the elderly with dementia in small-scale, multi-functional facilities-Aiming to practice empowerment. The Niigata Journal of Health and Welfare, 7(1), 39-42
Soshensky, R. (2001). Music therapy and addiction. Music Therapy Perspectives, 19(1), 45-52.