Thanks to the efforts of Emily Cornish and Linda McNair, both board certified music therapists at Bethesda Dilworth and Bethesda Meadow, respectively, an increasing number of residents at Bethesda are involved in music therapy. Music Therapy a form of therapy that that benefits seniors in a number of ways such as:
- Mental stimulation
- Pain management
- Stress reduction
To date, nearly 120 Bethesda residents participate in music therapy at least once per week.To find out how music therapy impacts seniors, we interviewed Emily and Linda about their first-hand experience—even with those that have been non-communicative or suffer from dementia. As music therapists at Bethesda Health Group, the stories they are able to tell are incredible.
Q: What made you decide to pursue a career in music therapy?
Emily Cornish: “I majored in music performance but I knew after my freshman year I didn’t want to be a performer. I was exploring options of what I could do with a music degree and discovered music therapy. I went to Maryville University and got my master’s degree in music therapy. Working as a music therapist has allowed me to combine my passion for music and my love of helping others.”
Linda McNair: “Upon approaching my retirement as a Strings Instructor back in 2010, I knew that I wanted to move into a second career involving music in one form or another. I began researching my options and became very interested in music therapy. I looked into the requirements and decided it seemed like something I could get excited about. I enrolled in the Music Therapy program at Maryville in the fall of 2010 as a part-time student and completed my degree requirements in 2013.”
Q: How long have you been in music therapy?
EC: “I have been a board-certified music therapist since September 2013. I was just starting up my own private practice when I started as a music therapist at Dilworth in January 2014.”
LM: “I became a board-certified music therapist in October 2013. I began doing private service work shortly after that and became the Music Director for the Tremble Clefs of Greater St. Louis in January of 2014.”
Q: Why did you decide to work with seniors rather than, say, children? How does the approach change from one group to the next?
EC: “I have always enjoyed spending time with the elderly. After I graduated from college I worked in the activities department at an assisted living community and I loved building relationships with the residents and hearing about everything they had experienced in their lifetime. As a music therapist, you can work in almost any setting with any population. Most music therapists are naturally drawn toward a certain population and tend to focus their work there. I was naturally drawn towards the senior population so I knew that’s where I wanted to work.
The approach that is used in music therapy sessions can change with each individual you work with as well as each population. In working with the elderly, most of the goals we work toward are maintaining or improving physical or cognitive functioning, whereas children are often working to gain new skills and improve upon the ones they already have. Each music therapy client is assessed for strengths and areas that need improvement, so the approach used from client to client can change based on what they need.”
LM: “Having been a teacher, I have spent many years working with children. At the time, I loved what I did but after over 32 years as a teacher, I was ready for a change. Music therapy is such a wonderful field because there is such a wide variety of populations you can choose to work with. I love working with seniors and having the chance to build a relationship with each of the residents.
Unlike the students I once worked with, working with seniors gives me an opportunity to really learn their background and the lives they’ve led. The residents have a lot of wisdom to share and are so appreciative of those that will spend the time to listen to their stories.
At the risk of overgeneralizing, the approach for each differs in the basic idea that for children you tend to use music therapy more for teaching concepts and modifying behaviors whereas with seniors, you would use music therapy more to maintain cognitive function and increase mobility.”
Q: When do you recommend music therapy to a patient?
EC: “Residents get group music therapy sessions on their floor at least once a week, and those sessions are available for all residents. Usually those sessions involve singing familiar songs and playing small percussion instruments to increase participation in activities and socialization with their peers.
Nursing staff, activities staff, and social workers recommend one-on-one music therapy sessions if a resident is isolating themselves and not participating in group activities, if they have depression or anxiety, or if they have specific goals that can be addressed with music therapy. After a resident has been referred, their responses to music therapy techniques are assessed to see if they would benefit from one-on-one sessions.”
LM: “We have specific areas of concern that may trigger a referral with a resident. These may include someone who is isolating themselves in their room and not socializing with other residents, a resident who is at risk for depression, or a resident who may benefit from singing for voice strengthening, to name just a few. Since music therapy is non-intrusive and non-threatening, it is especially ideal for seniors who find other forms of therapy uncomfortable and frustrating. It stimulates the brain, which, when combined with movement, promotes physical health.
Our referrals can come from the nursing staff, activities, and the social worker. Any one of those individuals may see someone who can benefit from music therapy and make a recommendation for an assessment.”
Q: What would you say is the best part of being a music therapist?
EC: “I feel privileged to be able to provide the residents with a tool to access memories from their life and to give them moments of joy in their day. I often have residents thank me for playing music and tell me they had fun singing. I always tell people I have the best job because I get to play music all day and bring joy to the residents. I can’t adequately explain the gratification you feel when you are with a senior who had been completely uncommunicative starting to move his or her hand or even try to sing along with the music.”
LM: “I think the best part for me is knowing that you are making a real difference and improving the quality of life for the clients you work with.”
Q: What is the most difficult part of your job?
EC: “Keeping up with repertoire is always a challenge. It seems like every time I do a session a resident will suggest a song that I don’t know. There is always new music to learn!”
LM: “For me, I think one of the hardest parts of the job is coming up with fresh, new song ideas. Many times though, the residents will want to sing their favorites again and again.”
Q: What are your favorite or most effective techniques?
EC: “The technique I use most often is therapeutic singing. This is when familiar songs are used and residents are encouraged to sing along. The music therapist adjusts the key and tempo for the resident so they can be successful in singing the song. One of my favorite techniques is dynamically cued singing, which is a technique often utilized with residents who have challenges with verbal communication. This is when the music therapist sings most of the phrase and the resident will finish it. For example, the therapist would sing, “You are my…” and the resident would fill in “sunshine.” There is a desire to finish an incomplete thought or phrase so residents are often motivated to fill in the missing word or phrase.”
LM: “One of my favorite techniques is one called the “Iso Principle.” This is a technique in which the music therapist begins by matching the music to the client’s mood and then gradually changes the tempo and music to evoke a desired mood change. This is oftentimes done to decrease anxiety, in which case a fast tempo song would be sung and played first, then the tempo throughout the remainder of the songs would gradually be slowed down to bring the client to a calmer state.”
Q: Are there any common misconceptions about music therapy that you’d like to debunk?
EC: “There are often misconceptions about the difference between music therapy and music entertainment. While listening to live or recorded music can be therapeutic, it is not music therapy. Music therapists complete an accredited degree program, a 1040 hour internship, and must pass a board exam in order to practice music therapy. Music therapists are also clinically trained to individualize music selections and interventions based on the client’s cultural, emotional, psychological, and spiritual background.
Music therapists are also taught to make quick judgments and decisions to support the clients during the session. For example, if a client is sad, do you play an upbeat song to try to elevate their mood, or do you play a sad song to validate their feelings and empathy with them? The answer to this question varies depending on the client and the situation.”
LM: “Many believe a participant must have some musical talent to benefit from music therapy. This thought couldn’t be further from the truth. Music therapy is an intervention technique, meaning that the intended goal is nonmusical. A group who sings along with a musical therapist once a week is not doing so in order to perform. Rather, they are learning how to increase breath support to help with breathing difficulties.
The field of music therapy is an evidence-based practice, which simply means the techniques and methods we use in our work have been shown through research to be effective. We set specific goals and objectives with each client through assessments and we base our interventions on work towards measurable outcomes. It is much more than just playing music with our clients, although that can certainly be part of the process.”
Q: Do you have any especially inspiring stories you’d like to share?
EC: “There was a resident who had several strokes and spoke short words and phrases only on rare occasions. I started singing Let Me Call You Sweetheart and paused at the end of the first line to see if he would sing the last word. He hesitated, but sang it. Then he sang the entire song with me. After the song he was able to answer a couple of yes or no questions and then flashed a big smile. It’s breakthrough moments like these that remind me of why I got into this profession in the first place.”
LM: “One story that was especially inspiring was shared by the spouse of one of my Parkinson choir members. He has advanced Parkinson’s Disease and has been regularly attending our weekly Tremble Clefs rehearsals for some time now. She told of a neurology panel at SLU for a physician assistant training class that her husband had spoken for. He had spoken before the group several times before.
On this occasion, when he had finished, the program director came up to him and asked him about his voice and speech because it was noticeably improved over the previous times he had come to speak. His wife credited the singing in our Tremble Clefs choir for his dramatic vocal improvements. That validation of the effectiveness of the singing meant a great deal.”