In July I had my second work anniversary as a music therapist at Theodor Fliedner Haus, a nursing home in Mannheim, Germany. It is crazy how fast time goes and I thought this would be a good time to reflect on what I have learned the past 2 years.
1. Old age can be very hard
Ok, this observation is not necessarily groundbreaking. Yet, it has become very real for me through my experiences where I work. It often prompts me to contemplate the intricacies of aging.
Each day spent at the nursing home brings a recurring realization: the journey of growing old is far from idyllic or effortless, especially when compounded by acute or chronic ailments.
Reaching the milestone of 80 or 90 years inevitably entails diminished mobility, often coupled with the burden of various health conditions. Moreover, the absence of numerous cherished individuals further exacerbates the challenges. Many seniors find themselves grappling with formidable adversities during their twilight years, and regrettably, some reach a point where life’s purpose appears elusive.
As per the insights provided by the World Health Organization, prevalent ailments among the elderly encompass an array of issues such as hearing impairment, visual impairments like cataracts, back and neck discomfort, osteoarthritis, chronic obstructive pulmonary disease, diabetes, as well as mental health concerns like depression and dementia. With age, the likelihood of contending with multiple conditions concurrently increases.
However, it’s important to acknowledge the perspective put forth by the WHO as well. Contrary to a strictly linear correlation between chronological age and biological aging, some octogenarians exhibit mental and physical vigor akin to those two or three generations their junior.
Conversely, certain individuals may encounter the onset of cognitive and physical decline even before reaching their golden years. It’s vital to emphasize that what I witness at my workplace is by no means representative of the entirety of the elderly population.
2. You can connect with people so different from you through music
One might be wondering what a young Mexican boy like me has in common with a group of elderly German ladies (I say ladies because most residents are women). Well, on the surface, not much. But music has this incredible ability to bring us together and help us in a whole new way.
I’ve had the privilege of spending time with these amazing residents at my workplace. It’s truly remarkable how they’ve grown to recognize and trust me, genuinely looking forward to our interactions. Now, while I’d like to think my friendly demeanor plays a part, the truth is, music plays a significant role in all of this.
Music acts as a universal language that disregards age and background. It’s a bridge that spans generational and cultural gaps, serving as a common ground for everyone. It brings forth smiles, laughter, and even evokes nostalgic tears.
As a music therapist, I’ve been fortunate to witness some truly special moments. A simple song can kick-start a conversation down memory lane. A familiar melody can light up a weathered face. And sometimes, a tune can even prompt tears of sweet reminiscence.
So, the next time you see me engaging with a group of lovely elderly German ladies, know that there’s more beneath the surface. It’s not just about strumming a guitar or singing a song; it’s about forming connections, igniting joy, and weaving a tapestry of shared experiences through the enchantment of music.
3. A ton of folk songs and German hits from a while ago
I maintain a repertoire database using Notion, where I track the songs I’ve been working with. Over the past two years, I’ve been engaged with more than 280 German songs, either performing them, singing along, or simply listening. Out of this collection, I’ve managed to internalize more than 100 songs to the point where they’re almost second nature. So, if you ever find yourself in need of song recommendations for engaging with the elderly in Germany, feel free to reach out to me!
Interestingly, even though these songs may not align with my personal musical preferences, I’ve discovered tremendous value in learning and performing them. My repertoire now spans a wide spectrum – encompassing beautiful melodies, poetic lyrics, and even some lighthearted tunes.
Despite having a few residents who lean towards classical, rock, or jazz, they represent a minority. It’s quite evident that, for the majority, traditional folk songs and those beloved “Schlager” hits strike the right chord. So, if you’re ever seeking musical suggestions to create connections with this demographic, I’m here to assist!
4. Therapeutic Atmospheres are important
This year, I’ve been exploring Jan Sonntag’s “Atmosphere” concept. He has various writings in German, a detailed book, and some content about it in English. Even though I’m taking my time with the German texts, I’m making progress with the book and learning quite a bit. This plus my practical experiences are shaping my thoughts on the topic.
In essence, I’ve come to understand that therapists are architects of atmospheres. This concept is particularly crucial when dealing with dementia, where creating a therapeutic environment holds great value. I’ve seen firsthand how small things like smiling while singing, making eye contact, and speaking calmly can make a significant difference in making people feel comfortable.
As I continue to learn, I hope to share more insights on how these subtle elements combine to create a therapeutic atmosphere. It would be wonderful if everyone working in elderly care contexts could recognize this, allowing us to collaborate in establishing universally beneficial settings.
5. How to modulate my voice, whether it is during singing or speaking
I mentioned earlier that hearing impairment is often an ailment in the elderly. Yet, not everybody has the same degree of hearing impairment, or any impairment at all. It has been interesting to learn how to modulate my voice to speak louder, softer, quicker or slower, depending on what I know about a particular person.
I have particularly struggled as German is not my mother tongue, so sometimes I am not as clear and articulate with my words. This fact plus the fact that some people are hard of hearing sometimes makes it very hard to communicate. This has definitely been a learning curve but I feel like I have made great progress.
6. Not forgetting anybody, even when they reject you a few times
I have had a few cases where I keep visiting certain residents every once in a while to say hello. They often do not want any music… until they do. Having a bond already means when the time is right and they accept the music, you can do your job.
7. Take small reactions as a positive sign, even when it seems like nothing is getting through
There are some folks with very advanced dementia who mostly lie in bed and have lost all verbal communication abilities. In these cases it can be really hard to assess whether there is a positive or negative reaction to the music.
Little gestures tell me that there is something going on, but it is very hard to know the meaning of such gestures. I often wish I had met these residents earlier when I could talk to them and figure out what they liked to listen to.
I did have the experience a few times where having that bond and some knowledge about them previously allowed me to do my job better when their cognitive or speech abilities diminished.
Unfortunately, this is not always the case. There are some residents with advanced dementia where there is no documentation about their music preferences so I often just have to guess. I often do get very positive signs that I’m going in the right direction, such as sustained eye contact and big smiles, but more often than not I don’t get a big reaction.
8. Trauma can stay with people for a lifetime
Seventy years have passed since World War II, yet the war remains a significant subject of discussion among the residents at my workplace. The fact that they continue to share their experiences from so long ago speaks to the enduring intensity and impact of those times.
Witnessing how these memories continue to affect them is truly heartrending, shedding light on the lasting repercussions of trauma.
This serves as a poignant reminder for me to approach each resident with empathy and a profound understanding of their sensitivities. Their past experiences, still echoing within them, remind me to be considerate and gentle in my interactions.
As a music therapist, my mission is to forge a secure and encouraging space wherein they can freely express themselves and derive solace from the therapeutic potency of music.
9. Above all, music remains a beacon of joy and hope to the residents I see at Theodor Fliedner Haus
In conclusion, the past two years have been a meaningful blend of music, learning, and love. Witnessing the impact of music on individuals facing challenging circumstances at my workplace has been a humbling and fortunate experience. The role of music as a source of comfort, hope, and joy in their lives has been evident every day I’ve been on this journey.
Now I need to think about the things I want to learn the next two years, but I will save this for a future blog post. Thanks for reading!
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