There are so many gratifying aspects of working as a music therapist! These may vary across the populations and settings we work with as well as our particular interests and training backgrounds as music therapists. Today, I'd like to focus on our work in dementia care. Miya Music Therapy works primarily in dementia care settings in long-term care and retirement living facilities. We truly love what we do and feel lucky to provide these services. Below are 10 reasons why I, personally, love working in dementia care as a music therapist.
1. It's Rewarding
After finishing a day of work in dementia care, I always leave knowing that I have made a significant difference in the residents' quality of life. Sometimes, it feels rewarding in small ways, like de-escalating an anxious resident or engaging them in an intervention that increases their understanding of their surroundings. Other times, it's by being with the resident during their final hours and helping them to connect with family members through music. In all the big and small ways we make a difference, it is always a greatly rewarding experience.
2. It's All About Connection
Building a trusting therapeutic relationship with residents is of key importance in providing music therapy services. We know that building a connection, a relationship, is a fundamental step in the music therapy journey. With those living with dementia, building a connection sometimes takes more then verbal interactions. A typical conversation with a resident with moderate to severe symptoms is not always possible. This is where you are reminded as a music therapist that connections depend on respect and dignity: the music therapist must ensure that the resident feels safe and comfortable enough to let us into their space, without always having to rely on words to do so. Sometimes, this is accomplished simply through a calming presence and a gentle approach. Other times, it is truly accomplished through the musical interactions introduced.
I have been referred many residents in long-term care homes, for example, who wander the hallways over and over again throughout the day. Several of these residents were referred not only due to their wandering behaviour, but because they tended to get frustrated when a staff member would attempt to interrupt them and invite them to programs or even to the dining hall for meals. One way I have begun building rapport with such a resident, is to simply join them for their walks around the hallway, if they will allow it. Not asking them to go anywhere or partake in anything other than some company. Over time, this helped the residents to feel comfortable and trusting toward me. Music interventions would then be slowly introduced to work towards specific goals and objectives.
I truly feel that making a connection with a client with dementia is about much more then following rules and standards on building rapport, but it's about an intuitive feeling that they perceive from your intentions when you approach.
3. It's Important Work
As of 2019, the number of individuals living with dementia in Canada was approximately 564,000 (Source: Alzheimer Society of Canada, “Dementia numbers in Canada,”) It is estimated that an additional 25,000 cases will be diagnosed each year, with the numbers reaching to more than 937,000 over the next 15 years. This is a critical mass of people; each of whom deserves quality care. With these numbers increasing, there will be further need for multidisciplinary approaches to dementia-related diseases and conditions.
I believe that music therapy plays an integral role in this regard and that music therapists should be a part of every long-term care team. Music therapists can address such a wide variety of domains of functioning for residents from social, communication, physical, cognitive, spiritual, to emotional domains. Doing this work feels, to me, like I’m part of an important movement towards improvements in the dementia care space.
4. It's an Honour
I feel that it is a true honour to work with any and all individuals who allow me into their space. When working with seniors, we often come across those who have lived through loss, immigrations, wars, and much more. With all of their life history, I always feel thankful and honoured that I, a new individual entering into their lives, am entrusted to get to know them and provide the best possible care I can.
5. It Extends Beyond the Resident
The Alzheimer Society of Canada estimated that 1.1 million Canadians were directly or indirectly affected by dementia as of last year. Each person contributes to a large constellation of Canadians who are touched by dementia, including caregivers and family members. Working collaboratively with long-term care staff, caregivers, and families is something I truly enjoy. There are many ways in which this can occur, including providing group sessions to relieve the stress that caregivers are under and providing family music therapy sessions that include the partner and/or children of the resident.
6. It’s About the Moment
The reality of working with clients with dementia from week to week is that they may not recall working with you or having met you the week prior. This means that our goals and objectives often need to pertain to a resident's quality of life within the given moment that you are providing a session. I find this to be really powerful. As a therapist, it can be easy to get caught up in tracking progress from week to week, and that can take us out of the present moment. This work truly helps me to stay grounded and present at all times.
7. It's Challenging
Working with clients with dementia is something that not only requires experience and training, but continued professional development over time. I love that there is so much to learn about working with this population and so much room for continued improvement in our work. In this work, I feel the constant desire to grow in many aspects including musically in order to meet the variety of music preferences of my clients from various backgrounds, and in my understanding of the various types of dementias and the symptoms they present.
8. There's continued research
Another gratifying aspect of a relatively new profession is that research yields new findings and innovations fairly constantly. Research on the use of music therapy in dementia care is gaining more traction as the aging population increases. This research results in continued ways for us to advocate for music therapy, for the integration of new interventions and techniques that have shown promising outcomes.
9. The music!
Let’s not forget the music! The music of the past that I have discovered while working in dementia care has been vast. Of course, when I began my career in music therapy, I had learned repertoire to draw upon, but I could never have imagined all of the music that I would learn from my clients over time. They have opened my eyes to music of their backgrounds and cultures, of many genres and from varying decades. Sometimes, it is the client that brings forth the music and other times it is through
learning about their backgrounds, reading their intake information, or connecting with their family members that we discover the music they are most drawn to. In my first internship experience in long-term care, I worked with an individual with Alzheimer's disease who only verbalized on rare occasions. When I would come to visit her, she would sing just a few words of a song that I was unfamiliar with. I went around singing those few words, "...waiting for the moon' to everyone I knew to see if they recognized the song. Finally, I found it! When I brought that song in for her, her eyes lit up as if to say 'You found it! That's the one'! She sang the entire song with me, making eye contact, toes tapping. It's still one of my favourites!
Here it is:
10. Learning from Clients
Clients are teaching us from the moment we first meet. Sometimes, this happens indirectly, just by being witness to their story, or by learning how to be a better music therapist through our work together. Other times, and this is often the case when working with seniors, learning from our clients/having our clients take on a teacher-like role may in fact be a part of our treatment plan. This is because it may contribute to their goals of feeling empowered, autonomous, or reconnecting with their sense of self.
Whenever I am concluding work with a client, whether it be due to a short-term program or if they are at the end of life, I always write a few notes in a journal about what the client has taught me. Some of the themes from my work in dementia care include not taking it all too seriously, laughter and humour is key, music brings it all back, courage can always be found, feeling connected is everything.
I'd love to hear why you love your work in dementia care too! Please feel free to leave a comment on this post sharing your experiences.