When partnering with long-term care facilities throughout the Greater Toronto Area, our music therapists often spend 1 or 2 full-days working with residents both individually and in groups.
In order to admit a resident to individual or group sessions, the music therapist first receives a referral from a member of the long-term care staff, conducts an assessment, evaluates if the resident can benefit from music therapy, and then develops a care plan with goals and objectives.
It is very important for this process to work most effectively, that the long-term care staff know when and why to refer a resident to music therapy. Here at Miya Music Therapy, we aim to accomplish this in 2 major ways. 1) In-services and presentations to the staff and 2) a referral form. Through both of these methods, we aim to educate staff on reasons why a resident might benefit from music therapy sessions. Below are 10 possible reasons for referral with brief explanations:
1. Difficulty transitioning to long-term care environment.
When a resident first moves into a long-term care facility, they may experience a lot of emotional difficulties in relation to this major transition in their lives. They may feel heightened confusion around their new living situation, frustrated, lonely, and may be missing their loved ones and the home they lived in. Those experiencing a particularly difficult time may not be interested in attending any programs or socializing. In this case, it can make a significant different in their overall transition and quality of life to develop a strong therapeutic rapport with the music therapist who can guide them through the transition through validation and providing a means of self-expression.
2. Experiencing anxiety or depression.
A resident in long-term care may be experiencing anxiety or depression for a variety of reasons. Sometimes, due to a resident living with dementia, it is not always possible to access the source of what is triggering them. However, music therapy can provide relief from anxiety and depression in a number of ways, including providing a means of self-expression/release of emotion, bringing a form of a connection to others and to self, acting as a means of relaxation during moments of particular anxiety, and bringing a sense of empowerment and autonomy over one's life.
3. Exhibiting aggressive behvaiour.
Often times, residents in long-term care living with dementia will exhibit what can be perceived as verbal or physical aggressive and/or disruptive behaviour. Often times, this will occur in reaction to something such as being taken for a shower or being given their medication. When staff notice this occurring, it is often a good idea to refer the resident to music therapy. The music therapist can then establish a rapport with the resident, and draw on both the music therapy interventions and the relationship established to intervene in moments when the resident is emotionally triggered.
4. Exit-seeking/wandering behaviour.
It is not uncommon to observe residents in long-term care who are constantly seeking a way out of their unit out, as well as residents who are constantly wandering the hallways without taking a rest. Sometimes, music can be the only thing that successfully redirects this behaviour and refocuses attention. This can be very powerful as music therapy can bring a resident from a state of concern for finding a way out, and help to centre them, where they can experience meaningful moments with the therapist and other residents through music.
5. Experiencing pain.
Staff in long-term care monitor residents' pain through pain scales on a regular basis. When they are noticing an increase in perceived pain, this could be an important time to make a referral to music therapy. Music can reduce pain perception, as it holds emotional attention in a way that is an effective distraction from pain.
Sometimes, residents will choose not to attend any programs and appear not to have an interest in mingling with other residents in the facility. Often, this individual may still allow the music therapist to come for visits, if they enjoy music and have an association with it from their past. The music therapist's 1 to 1 visits can help to reduce the resident's isolation. The therapeutic rapport built over time may encourage the resident to eventually also attend group music therapy sessions, helping them to create a social experience in their home.
7. Decline in cognitive abilities.
When staff in long-term care notice a steady or dramatic decrease in a resident's cognitive abilities, this can be an important time to refer the resident to music therapy. The music therapist can utilize types of interventions such as improvisational, re-creative, and compositional to work towards cognitive stimulation and maintaining active engagement throughout session.
8. Decline in physical abilities.
If a resident is experiencing a decline in physical abilities, the music therapist can assist in a number of ways. A decline in physical abilities can often also mean a real sense of loss of empowerment for the resident, especially if it means they are transitioning from using a walker to a wheelchair. The music therapist can then create scenarios within the sessions for the resident to continue to exhibit their independence and showcase their abilities. On the other hand, in order to continue to work on and improve physical abilities, the music therapist could work along side the physiotherapist to incorporate music therapy and physiotherapy to optimize motivation towards physical goals.
9. Decline in verbal abilities.
Many residents in long-term care will experience a decline in their verbal abilities for a variety of reasons including dementia, Parkinson's disease, or aphasia. Referring these residents to music therapy can help to provide them with a means of non-verbal expression which can be a powerful outlet, as well as a means of maintaining communication through singing interventions.
10. Identifies strongly with music.
Residents often have a strong history and background involving music in their lives. Perhaps they sang in a choir all their life, or taught piano lessons, or grew up in a home where their family sang, danced, and played instruments. If this is coupled with another reason for referral, such as isolation, or anxiety and depression, music therapy can make a significant impact for the resident. It can help them to connect with their identity, feel a sense of confidence, and provide a space for reminiscence and sharing.
Although all of these reasons for referral provide a starting point for staff to make referrals to the music therapist, they do not guarantee that the resident will benefit from music therapy. In-fact, sometimes there are factors that make music therapy contraindicated (that's a whole other post)! Additionally, there are many more potential reasons for referral not listed. However, these are some of the most common ones in long-term care. With most resident's enjoyment of music, the music therapists experience in building therapeutic relationship, and the specific goals and objectives planned, it is really rewarding and incredible to see how music therapy can truly be a beacon of light in a resident's life when they are experiencing one of the above reasons for referral.
Are you a music therapist working in long-term care? What are some of the ways you communicate reasons for referral with staff?
We would love to hear from you!
#musictherapy #longtermcare #musictherapylongtermcare #musictherapist #dementia #musictherapythornhill #musictherapydementia #musictherapyalzheimers #alzheimers #alzheimersdiseasetoronto #alzheimersdisease #parkinsonsdisease #seniorstoronto #musictherapyseniors #olderadults #depression #anxiety #isolation #music #therapy #therapist #toronto #torontomusictherapist #torontomusictherapy #musictherapynorthyork #musictherapyyorkregion #northyork #yorkregion #thornhill #richmondhill #musictherapyteam #musictherapymississauga #mississauga #retirement #retirementtoronto #longtermcaretoronto #longtermcaremusictherapy