When I talk about my Musical Memories service where I sing to/with dementia patients, I refer to the sessions as “musical conversations”. Lately I’ve been working with a few people who are definitely more interested in the conversation part.
One of the most poignant conversations took place recently at a memory care center while I was making my rounds to visit some of my “regulars”. As I went from room to room, I kept seeing a woman in the hallway who I first assumed was a family member visiting one of the residents. But I noticed she kept stopping to check on the staff as they were going about their tasks, asking what they were doing and whether they needed help. It finally occurred to me that she was, in fact, engaging in the fairly common dementia behavior of “roaming”.
She seemed a bit distressed, so I approached her and asked if she might like to come sit with me on the couch while I sang. She very politely told me that I was welcome to do so, but that she simply could not join me. So I said I’d just walk along with her for a while. She seemed very agitated and concerned about what was going on around her and kept talking about how much she’d like to relax but couldn’t. Then I realized what was going on. In her world, there was some big event or party or meeting that was going to happen, and she was completely and entirely responsible for all of it.
I finally convinced her to sit down with me for a minute, and started pointing out what was going on around us, but in terms I thought might fit her reality. “See, that woman over there is vacuuming, so that’s taken care of.” She heaved a small sigh of relief. When she gave a worried look toward other staff members going about their routine work, I said, “Looks like they’ve got all that under control.” When she asked if I thought they would do it right, I said, “Oh, yes, and besides, it will help them build confidence if you let them do it themselves”. She seemed to think that was a fine idea. She kept talking about how she would love to not have to “do it all” and just stop for a bit, but obviously that wasn’t an option. That’s when I said, “I think you and I should just put our feet up and relax for a bit. After all, you’ve already done so much.” This is where she got a sweet, shy little smile and said, “Oh, I haven’t really done that much”. To which I replied, “You’re just being modest. Everyone knows how much you’ve done. And everything’s under control, so now you can just relax.” That seemed to please her very much, and she was able to sit and just visit with me happily for quite a while.
I love this story because it demonstrates something I’m learning about people with dementia. And that is, though their “realities” might be different, the common thread is that they seem to want to know two things: 1) That everything is okay; and 2) That there’s nothing they need to do. I think it’s a matter of feeling safe and believing that things are as they should be and under control, probably because they feel so confused and out of control themselves. And it must be a relief to hear that no one is expecting them to perform or solve problems, probably because their confusion makes that seem like an absolutely impossible demand. So what I try to do – whether it’s through music or through actual conversation – is enter their prevailing reality as best I can, and assure them that they’ve done enough and now it’s time to put their feet up and relax. And even if I’m not singing, I get the feeling that’s music to their ears.