November is National Hospice and Palliative Care Month in the United States, so I am focusing a few posts on the music used in hospice music therapy. In my last post, I shared the special place one song had for my grandmother and what can make that song powerful in music therapy applications.
In this post, I want to share the story of one woman I saw for hospice music therapy and how the music of her culture helped us form a relationship despite the challenges of dementia and a language barrier. As with the other client stories posted on this site, this patient’s name has been changed and other potentially identifying information has been left out to protect her privacy.
This woman – we’ll call her Sandy – was a resident at a nursing home and was in the final stages of dementia when she was admitted to hospice and referred to music therapy. She had been born and raised in the Philippines but had spent most of her adult life in the United States. Sandy did have strong English speaking skills at one time, but because of her dementia process, her understanding of English seemed to be inconsistent and at times she reverted to speaking in her native language. In any case, her speech was limited and difficult to understand. Music therapy was meant to provide Sandy with social interaction and emotional support to enhance her quality of life.
In my early visits with Sandy, she was often smiling and laughing and had strong eye contact with me. She sang parts of familiar folk songs, including “You Are My Sunshine” and “Home on the Range” and held my hand while tapping out the beat for songs like “She’ll Be Comin’ ‘Round the Mountain.” She seemed to like all of these songs, but when she really responded, it was to the few Filipino songs I learned for her. These included three folk songs about the foods from her native country – “Isang Butong Mangga,” “Planting Rice” and “Bahay Kubo,” as well as a lullaby entitled “Ili, Ili, Tulog Anay.” With these songs, Sandy responded with a huge smile, saying “wow!” She knew all the words to “Bahay Kubo” and recognized the other three, and even as she declined further, Sandy still brightened when I sang these songs for her.
Sandy was not able to verbalize how these songs made her think or feel, but her response showed that this was music that touched her in some way. With these songs, we were able to connect with each other, despite the barriers of culture differences and Sandy’s disease process. I think the value of forging this kind of connection is significant, especially as people approach the end of life. Even though the hospice team and the nursing home staff were limited in their ability to connect verbally with Sandy in her native language, I believe she was able to feel the support of her caregivers through the music of her childhood and her native culture. This is the strength of music therapy.