When I started my training as a music therapist, my first placement was in a long-term care facility. From one week to the next, many of the residents did not recognize me due to their advanced dementia. I soon realized that the value of our time together was to be had within the moment, and not from tracking progress on a weekly basis. There was something so special about this realization - it forced me to learn how to be fully present in each moment with the residents and to accept that this was transformative and meaningful for them.
This lead me to begin thinking about how the practice of mindfulness can be helpful for music therapists working in dementia care. Jon Kabat-Zinn, a pioneer in bringing eastern mindfulness practices to the West, explains 9 attitudinal foundations of mindfulness practice outlined in several of his writings including 'Mindfulness for Beginners: Reclaiming the Present Moment - and Your Life'.
Below, I've outlines just 3 of those attitudes and how they can be applied to music therapists working in dementia care:
1. Generosity: The attitude of generosity is all about giving someone your complete presence. It is so important to be completely present with those living with dementia by not trying to change or alter their perception of the present moment, and instead being with them in it. Here is an example as it applies to music therapy. Let's imagine a woman who used to be a school teacher. When attending a music therapy session, she is brought back to this time and feels that she is the teacher and the rest of the group members are her students. She is insisting on teaching the students music during this time. Instead of redirecting this individual and trying to make her aware of the reality of the moment, as music therapists, we can offer our generosity / our full presence, and meet her where she is. We can offer her ways to lead the group by asking her to make choices for her students such as who should play which instruments, which activity we should do next- singing, improvising, drumming. etc.., or have her use a conductor's baton to lead the group throughout. How generous of us to have been present with her in this moment!
2. Patience: It is easy and quite common to be anxious to go onto the next thing and therefor miss out on the present moment. This is true in our daily lives as well as in music therapy sessions. Practicing pacing throughout sessions is something that is taught during music therapy training programs and internships and it directly relates to the practice of patience. Pacing means not jumping from one intervention to the next quickly to try and fit it all into one session, but rather trying to run the intervention's full course to reap it's full benefits.
If music therapists can be begin to practice patience in their daily lives, I feel this will help them to practice patience and pacing in their music therapy sessions. I find this attitude to be of particular importance in long-term care settings where everyone's overall pace tends to be more moderate. I remember during my Master's degree practicum, I was feeling very excited and ambitious and my supervisor pointed out that I was hurrying through the hallways very quickly and almost frantically. She reminded me to be aware of my surroundings and that no one else there was moving at that pace. Just by slowing down my walking from one resident's room to the next I feel I was practicing the attitude of patience and that seeped it's way into my sessions.
3. Beginner's Mind: This attitude is all about how each moment is new and we have never been in it before. It is inevitable that we come to each music therapy session with some form of a session plan in place and/or ideas on how the session will happen. However, in dementia care, the individuals we see may be in a completely different state than we had thought leading up to the session. It is important to yes, bring what we have prepared and bring our expertise, but also bring the attitude of the 'beginner's mind' so that we are open to new and unexpected possibilities in the moment.
I am finding that practicing mindfulness and making the correlations between the 9 foundational attitudes to enrich my practice and the outcomes for those I see living with dementia. Do you use mindfulness in your work? I'd love to hear about it if you do in the comments below!
Kabat-Zinn, J. (2012). Mindfulness for Beginners: Reclaiming Your Present Moment - and Your Life.
Manteau-Rao, M. (2016). Caring for a Loved One with Dementia: A Mindfulness-Based Guide for Reducing Stress and Making the Best of Your Journey Together.