Social isolation is a profound issue at skilled nursing facilities for low-income residents; a problem that has become worse during the recent COVID pandemic. Family visitation has been limited and maintaining adequate staff is a challenge. There might be only two aides covering a 60-bed floor. Residents are kept relatively safe and clean. They are fed. The staff often shows immense care and love. But the resources to spend quality time with residents aren’t available
Here is one story: Nora was blind. Aides got her up in the morning and dressed her but she sat alone in her chair until the evening when they undressed her and put her to bed. Her human contact was limited to meals and toileting. But then, one day, there was music. Then there were smiles and then foot tapping. Nora would see the harpist and say, “Oh! My friend is here!”
Add the issue of Alzheimer’s and dementia and we have a double deep isolation. It takes so much time to really reach someone with these conditions. It’s especially hard for overworked staff. Naomi Feil, founder of the Validation Training Institute has worked for decades with people with Alzheimer’s and dementia. She names the problem very well. “We have living dead people and this doesn’t need to be.” People are, too often, left alone to retreat deeper and deeper into themselves.
Music is a shortcut, a way in, a special kind of stimulant to help awaken. We all know this. We have witnessed it. There are films, studies, and research about it. We know it’s true—music can reach people. That’s why CompassionHarp exists.
This essay started with the challenging issue of elder care in our country, but we want to focus on something intimate and personal. Jayne regularly visited a resident at a skilled nursing facility; let's call her Barbara. When Barbara came to the facility about three years ago, she had dementia but was happy.
Over three years, her mental state eroded into a kind of paranoia. She was frequently upset, saying, “I’m afraid. Where are my children?” But when Barbara sings, she starts to focus and calm down. Jayne remembers, “She might take my hand and I can sit with her. The last time I saw Barbara she was very upset and confused. She would say things like ‘All the fathers are gathered in the corner.’ I said, ‘You’re upset.’ She answered, ‘Of course, I’m upset!’ When I asked, ‘Can I play my harp by you?’ she said something with the tone of ‘whatever.’ As I started singing My Bonnie Lies Over the Ocean, Barbara began singing with me despite her distress. Then I began to play Edelweiss. Startled, she turned to me and said, ‘It’s so beautiful!’”
“It’s so beautiful,” followed by tears. This reaction is a not uncommon experience when visiting with residents in long term care. Pamela remembers visiting with another woman, we’ll call her Linda. At the start of the visit Linda was tired but cheerful, happy to have the unusual experience of harp being played just for her in her room. Partway through a verse and chorus of I’ll Fly Away, Linda started weeping. Pamela quieted the music, asking, “Are you OK?” “Yes—it’s just so beautiful. I didn’t expect to have this reaction. I’m usually not so emotional. Please, please play some more.” Over the next 15 minutes, Linda released a lot of emotion—gratitude, wonder, sadness, and delight. “I didn’t know I needed this,” she said.
In hospice work, there’s something called, “breakthrough pain.” It’s what it sounds like: pain that arises even though there’s pain management in place. There are “breakthrough pain meds” to address it.
What happens with Barbara, Linda, and others can be thought of as, “breakthrough beauty.” Someone in the midst of emotional and mental anguish—or simple isolation and loneliness—can say, “It’s so beautiful” and “I didn’t know I needed this.” How is it that an experience of beauty can “break through” crisis and confusion? This is the wonder and magic of therapeutic music.
This is what CompassionHarp offers, moment by moment, person to person. We are interrupting loneliness, confusion, and suffering of elders who otherwise don’t have the means or access, by bringing beauty, the beauty of human companionship which we offer through our presence, through harp and voice.
The neurologist Oliver Sacks wrote in his book Musicophilia, “I have seen deeply demented patients weep…as they listen to music…I think that they can experience the entire range of feelings the rest of us can and that dementia at least at these times is no bar to emotional depth. Once one has seen such responses, one knows that there is still a self to be called upon, even if music, and only music can do the calling.”