Playing music for the hearing-impaired is a challenge. Unfortunately, a large number of hospice patients have lost much of their ability to hear well due to their advanced age. Until I can sit with the patient and try different sounds and gauge their response, I don’t know if therapeutic harp will benefit them or not. Sometimes, just the experience of trying to hear, agitates and frustrates the patient because it is a painful reminder that they’ve lost the joy of sound along with so many other deep losses. I have been dismissed by some with little regard for social graces and a lot of anger focused in my direction. In contrast, some profoundly deaf patients delight in the experience that someone went to the effort to lug a harp into their space and sit with them for awhile even though they will never hear a single note that is played. Intention and presence are gift enough for these people. One of my profoundly deaf patients once said to me, “Honey, I can’t hear at all anymore so you just play whatever you like. My wife enjoys the music and that makes me happy. Come back anytime.”
Yesterday I met a new hospice patient for the first time. John is in his 90’s, and when I arrived, he was quite agitated about something he thought was on his pants that needed to be removed. He was bent over double in his chair in his living room trying to pluck the offending substance off his pants. The printed pattern on the pants looked like something that didn’t belong there to him. His caregiver, a family member, was present and was concerned that John was not behaving appropriately for his “private concert”. He tried to reassure John that nothing was on his pants; John was not reassured in the slightest.
I had been informed before I arrived that John had 2 favorite songs that I should play which I practiced before I went. One, a traditional American song, the other a hymn. I introduced myself to John and shook his hand. He looked confused and asked, “Do I know you?” “Not yet” I assured him, “But you will.” I had to get very close and shout and it wasn’t clear if I was being heard at all. Initially, I sat about 6 feet back from the chair John occupied and began playing the songs a family member had told me he loved. I got no response. John had stopped fussing about whatever he thought was on his pant leg and now was agitated over the towel that he was sitting on to protect the chair. He wanted it removed. He kept trying to stand up so he could pull the towel out, which he wasn’t able to do without risking a fall. His caregiver kept jumping up and trying to calm John, encouraging him to just sit and listen to the music. John was having none of it and the caregiver appeared to be getting frustrated with John’s behavior. No matter how loudly I played, John was paying no attention to me at all. I was invisible to him. I suddenly realized John couldn’t see me or hear me. Clearly, this encounter was not producing the desired effect of soothing peace and calm for either John or his caregiver.
I stopped playing and told the caregiver I wanted to try something a little different. I moved as close as I could get to John with the harp and managed to get his visual attention. He did not seem to remember me and acted surprised that I was there. I placed his hands on the harp pillar and began to play scales, arpeggios, and glissandos. John’s face lit up. He could feel the vibrations. He began to comment on the size of the harp and the strings. He tentatively plucked a string and beamed his delight at me. He asked questions about the harp and told me about someone he knew long ago who played the harp. I was getting a glimpse of the charming, intelligent and caring man John was inside. He stopped perseverating on the chair and his pant legs. I tried again to play his favorite songs but there was no visible recognition to any melody from him. I continued to play familiar tunes, more to calm the caregiver than John. John appeared to find joy in the closeness and novelty of my presence and the harp vibrations he could feel. The caregiver found peace in the music and ability to relax, momentarily, from his demanding job. The tension in the room began to dissipate quickly as the calm settled. John kept his hand on the harp pillar and continued talking to me, quietly. I couldn’t understand his words so I just kept playing, looking at him, smiling and nodding. When it felt like the right time to leave, I bid John and his caregiver goodbye and was encouraged to return anytime, any day.