Harp Notes

UTHN Meeting from 9/17/19

Harps from the MTAI Conference

Attendees:  Peggy Cann, Kristen Rogers-Iverson, Chris Watts, Tamara Oswald, Tristen Adair, Kathleen Dougherty, Heidi Jaeger

Singing and Harp Accompaniment

What to do with patients who don’t want to passively listen to instrumental music and want to sing?  Chris put a book together for one of her patients that includes the lyrics to the patient’s favorite songs and a lead sheet for herself so they could sing and play harp together. Chris  incorporates techniques of guitar for use on harp to accompany sing alongs.  She demonstrated all of the techniques on her handout so that we could hear how they sound which made the handout easier to understand.

Handout provided: Chris Watts, Chording patterns to add variation when singing songs. These were adapted from Elaine Stratford’s guitar course and sound somewhat like the strums by the interesting manes Stratford gives them like:  Pussy Willow, 3 Away, Boom Chuck, etc. 

References:

Ray Pool’s Hymns and Harmony Catagory A, pg 1

Angie Bemis’ Simply the Harp website, Traditional Songs and Lullabies Key of C, www.simplytheharp.com

Ray Pool’s 3’s a Chord video https://www.youtube.com/watch?v=hmBvia892jI

Peggy showed us how to start with a song with only 2 chords and then play just using the root of the chords.  We all practiced singing and playing He’s Got the Whole In His Hands, You Are my Sunshine, Kum By Yah. The easiest way to start is to just play one note of the chord, mainly the root note. If the chord is C, play C. 

The second step would be to add the 5th note of the chord in a broken chord pattern.

Then add  1, 5, 8 of the chord.  Also,  steps 1,5,10 of a scale makes a nice bass.  These steps work in any key, begin with the root of that scale.

Many songs only use 2 chords. In the Songs That Teach Book, songs are categorized as 2 chord songs, 3 chord songs, etc.  

When playing lullabies for babies as Peggy does in the NICU, she often only uses root and the 5th note of the chord in a lub dub heart beat kind of rhythm which she demonstrated. 

Other sources for Easy Music to play for groups:  Readers Digest Book of Music and look for the Guitar Guy on the Internet for lead sheets to common songs. http://www.theguitarguy.com/

Peggy mentioned that Certification for playing in NICUS can be obtained by Therapeutic musicians as well as Music Therapists. The program is based in Florida and that is where certification is granted. https://music.fsu.edu/NICU-MT/upcoming-trainings     The 2019 information– out of date— is on the site.  2020 has not yet been posted.

Report from the Music Thanatology Association International conference in Portland OR Sept. 13-15, 2019

Approximately 55 people attended the 17th annual MTAI conference.  The Theme of the conference was, From Music Into Silence. The highlight of this conference was the first US screening of the documentary film about Music Thanatologist, Peter Roberts, life and his work in Australia titled From Music Into Silence. https://vimeo.com/263142820

This is a fabulous documentary filmed over four years about what one person (Peter Roberts) can accomplish when he answers his true calling: becoming a Music Thanatologist and playing harp at the bedside of the dying. In spite of the subject matter, this film is not so much about death and dying but triumph of the human spirit, compassion, and what can be done for others when there is nothing more to be done. I found it uplifting and appealing with it’s focus on universal themes of beauty and peace. Action/conflict junkies may be disappointed, but it is a beautiful documentary shot in Australia and Turkey with archived footage from Missoula Montana. The poetry of Rumi runs throughout the film spoken in Persian with English text as a Rumi poem was Peter’s initial inspiration to change his life and become a Music Thanatologist. This film will be shown in various cities in Oregon the week following the MTAI conference and then the filmmakers will return to Australia.  Further release plans are not known at this time.

Conference, Day 1:

While I traveled to this conference I had no expectations that I would know anyone there or what it would be like.  The agenda had not been published when I registered so I committed to going based on an intuitive feeling that I just needed to be there. When I arrived I found people I had extended relationships with through mutual friends and family ties and by the end of the weekend I had 55 new sisters and brothers of the harp.  Though our training is quite different, Music Thanatologists, Therapeutic Musicians, Music Therapists ultimately find ourselves in similar situations on a day to day basis in the field and so we shared with each other how we approach these events with music and found there are more similarities than differences between us. Singing and the application of voice to bedside offerings is emphasized by the MTAI program so we sang a great deal and I was able to take home many pieces of shared music that I plan to incorporate into my own practice.

Scola Cantorum

The meeting was opened with a ritual of singing/humming and meditation and a formal processional into the meeting space. After a business meeting, which I did not attend, we resumed our educational gathering with a demonstration of three different approaches to bedside therapy provided by Bethany Lee, Therapeutic Musician; Anna Fiasca, Music Thanatologist; and Jake Beck, Music Therapist.  Bethany first played and sang a version of Blackbird by the Beatles for a patient who had just been diagnosed with Stage IV lung cancer and given a prognosis of 3 months to live. Bethany played a second piece that was not familiar. 

Anna demonstrated how a Music Thanatologist would approach this scenario by playing a metered piece in Dm Dorian mode to address the patients sorrow and loss and create an environment of safety. Her tempo matched the patients breathing. Then she played an unmetered piece to include minor intervals allowing more freedom for the patient to rest without rhythm that included short phrases and repetition.  She finished her offering with the song, “You Dwell In the Heart” which is a blessing delivered in a major key to provide a sense of intimacy and warmth.  Voice and harp were used throughout this session.

Jake played a guitar and sang to the patient.  He first asked the patient what kind of music she liked as he explained patient preference is important for patients to reminisce and music familiarity helps patients open and relax. He played and sang, Somewhere Over the Rainbow and finished with Will Ye Go Lassie, Go (Wild Mountain Thyme)Jake said if he had more time he might finish with another song, Hard Times Come Again No More.

We broke for individual self care sessions and I was able to hike one of the many trails in old growth forest around the property which was quiet and peaceful.  I even had the opportunity to sit and play my native American flute in the forest. accompanying the birds and crickets.

After dinner the film, From Music Into Silence, was shown.

Day 2:

There is a part of the film that is shot in Turkey and honors and remembers the Gallipoli battle of WW I fought in 1915 in Turkey.  For the morning musical offering James Excell sang a capella “And the Band Played Waltzing Mathilda” a haunting ballad that commemorates that battle from the point of view of an Australian survivor.   https://www.youtube.com/watch?v=cZqN1glz4JY         James shared with me afterwards, the most difficult thing about singing this song is getting through it without breaking down emotionally. No one in the audience managed it. It took great courage for him to share this song with us.

An interesting fact that I was unaware of was in ancient celtic times, War Harps were used which were giant harps place on a hillside and caught the wind in their strings creating an other-worldly sound in order to scare the enemy.  Peter plays wind harp at the Gallipoli sight that is quite moving.  As he said in our discussion, “What song could I play that would be appropriate for such a sacred site?  Better to let the wind play the song for dead.” 

We spent the morning discussing the film with the cast (Peter) and the producers and director:  Farshid Akhlaghi and his wife Sammi Ghafari.  Farshid was unable to get his travel visa approved by the US state department in time to join us so he was Teleconferenced in from Australia to join the discussion and answer questions about the film, his message, technical aspects of filming and many other details.  Sammi was able to join us in person and of course Peter was present. It is disappointing that after 3 showings of the film to the public in Oregon, the film and its creators will return to Australia and figure out next steps for its sale/release/showing to the public. It has been to at least 5 film festivals and no more are planned. It was shown in Australia to the public in 5 major cities and all shows were sold out before the screening.  Farshid said that his original intention was to make a film about peace and beauty. Peter’s story was his vehicle for delivering that and it changed his life, he said.

After Lunch the presentation was a tribute to two long time members of the MTAI who have passed away in the last year, Sandy LaForge and Abigail Robinson with musical offerings and remembrances by other Association members. There was group singing and harp playing during this session.  

Joshua Ward presented a session of Harp Fundamentals. He was a lifelong student of the Salzedo method and rediscovered his passion for the harp through MTAI training.  No new material but good reminders for us all:  remember proper hand shape with fingers curved downward and thumbs up, wrist bent inwards, arm bouncy without being parallel to the floor, sit straight, shoulders relaxed, bounce the harp off your shoulder to find it’s center of gravity, don’t lean over with your bass hand shoulder (because many MTs play harp off their left shoulder he avoided referring to left and right hands or sides and simply called them bass and treble sides), Be fluid and make adjustments as needed, develop hand gestures and remember your hands are dancing.  

Day 3:

We began with a panel presentation in playing harp in the NICU.  In spite of the program focus of playing for the dying, many MTs play in a NICU environment where premature babies, the parents and the staff all benefit from Therapeutic Harp music. Simple quiet music is necessary for this work below 50 decibels, ideally, even though machines and monitors in the NICU may be louder.

Comments:  All babies have musical preferences based on family culture, what they may have been exposed to in utero, and their own unique personalities.  Best to play warm music (major tonalities) and short duration, no more than 20 minutes.  By calming the staff and family, that calmness will help calm the baby. Metered music at a slow tempo is best for babies. 

The panel consisted of Music Thanatologists who work in NICUs and Ruby Lee, an RN from one of the NICUs. One of the most interesting comments came from Ruby where she said that until participating on this panel, she was unaware that MTs actually watched the baby monitors in the NICU to gauge the effectiveness of their playing and altered their delivery based on the bio metrics.  This is an opportunity for education of the clinical care team in the future.  Ruby has been a NICU nurse for almost 30 years and she also said that she believes it is important even for babies who will not survive to experience music before they die.  She is obviously a big supporter of the MT program at her hospital.

We finished the final session with Scola Cantorum led by Elizabeth Markell.  We learned and sang in 4-6 part harmony, This Old Brown Earth and For My Soul’s Desire. She also included a 4 piece orchestra to accompany us with harp (of course) accordion, cello and guitar.  Two more songs which I can add to my personal repertoire.

Final thoughts:  I learned a great deal about the Music Thanatology Association International program and their emphasis on prescriptive music as well as the power of the human voice to facilitate the comfort and gentle passing of souls. While the training and the certification requirements of the program are different than the program I certified in, (International Harp Therapy), many of the practices are applicable to both and we can all learn from each other.  Christina Tourin, IHTP founder, was mentioned frequently and she was the guest speaker at the MTAI conference 6 years ago held in Utah.  I plan to attend the MTAI conference annually as often as time and money allow to continue the friendships made and the my own learning process.  

I found the practitioners I met at this conference warm, welcoming, inclusive and very willing to share their experience and knowledge with others.  I would recommend attending this conference to anyone already practicing Therapeutic Music or aspiring to do so. I intend to incorporate many things I learned in this 2.5 day conference which were very practical and useful tools to add to my skills, knowledge and abilities as a Certified Therapeutic Harp Practitioner.  In order to be invited to this conference, one must register with the MTAI program as a “Friend of MTAI”. This costs $40 and must include an application for membership. This also grants access to their Slack website.    

The next meeting of the UTHN will be in October and Tamara will lead this one. Topic and date to be announced but keep your Tuesday mornings open!

UTHN Meeting April 23, 2019


UTHN Meeting April 23, 2019 held at Kristen’s house

Attendees:  Kristen, Peggy, Laurel, Cindi Chris, Kate, Angela, Heidi, Tristan

Today was Tristan’s and Chris’s birthday which we celebrated with good food and a potluck lunch.

I: Heidi Reviewed the Generations 2019 conference Music Therapy Track held 4/16/19 at the Salt Palace Convention Center; Peggy, Tamara, Pam and Heidi attended and Peggy presented: 

Conference Session I: A Continuum of Music in Healthcare: From Music Listening to Music therapy

Presenters: E. Christensen, SCMT, MT-BC; P Cann, CMP; S Cheek-O’Donnell, PhD; M. Frani, PhD; M , Hearns, PhD

Massamiliano Frani, PhD is the CEO of Genote  see www.genotelab.com, recorded music to achieve various outcomes working with specific populations. He graciously offered attendees a 2 month free trial if we email him and mention his offer at this conference. He discussed his research using his product with long distance runners and the effect it had on their Ck, Hb, Cortisol, and Testosterone levels. Statistically significant results include an decrease of Ck and increase of testosterone and better motivational and coping skills.  See Youtube videos for more information   https://www.youtube.com/channel/UCm4tiXyX_axzIq1Ty9q7eYA

I’m not sure when this discussion came up but the reference is to an article about a Therapeutic Musician who plays the harp. See the article   http://www.washingtonpost.com/wp-dyn/content/article/2008/12/19/AR2008121903041.html?referrer=emailarticle&noredirect=on

Sydney Cheek-O’Donnell, PhD, Assoc Dean for Research at UU

Discussed Time Slips, a storytelling method to work with Dementia patients. TimeSlips opens storytelling to everyone by replacing the pressure to remember with the freedom to imagine. The open, poetic language of improvisational storytelling invites people with dementia to express themselves and connect with others. https://www.youtube.com/watch?v=9yxxbw7YIys

The UU has an Arts In Health Innovation lab, free yoga at the UMFA for the public and recently produced a play about a blind woman called Molly Sweeney

There will be an Arts in Health Symposium at the UU in the Fall of 2019, see http://artsinhealth.utah.edu/

Maureen Hearns, PhD, Chair of the Music Therapy Dept. at Utah State University, Logan

Music therapy In Dementia Care:

  • Music therapy provides opportunities for:
  • Memory Recall which contributes to reminiscence and satisfaction with life
  • Positive Changes in Mood and emotional states
  • Sense of Control Over Life through successful experiences
  • Awareness of self and environment which accompanies increased attention to music
  • Anxiety and stress reduction for older adults and caregivers
  • Nonpharmacological management of pain and discomfort
  • Stimulation which provokes interest even when no other approach is effective
  • Structure which promotes rhythmic and continuous movement or vocal fluency as an adjunct to physical rehabilitation
  • Emotional intimacy when spouses and families share creative music experiences
  • Social interaction with caregivers and families

Peggy Cann, CMP gave a great presentation on what Therapeutic Musicians do and demonstrated by playing the harp for the group as she would for the NICU patients she plays for. She discussed the differences between Music Therapists and Therapeutic Musicians training and scope of practice. 

Session II:  Music therapy in Utah: Current Trends, Reimbursement and More

Presenter: Emily Polichette, MM, SCMT, MT-BC

MTs can bill for restorative care if their work is in support of other outcomes.  They need an MD to sign off on this.

If insurance companies deny billing, ask to see their exclusion policies.

Utah Association of Music Therapists  has a group devoted to legislative lobbying and they are always trying to get more billable services approved by Medicare/Medicaid See Utah State HB 277 which created the designation of State Certified Music therapist (SCMT).  Only MT-BC people can apply for SCMT certification.

The term “Music Therapist” is not owned exclusively by BC-MTs which is one reason why they pushed for HB 277.  It is important for the public to understand the difference between music therapists and Board Certified Music Therapists. One difference is in the amount of training and internship hours BC-MTs receive versus other certification programs.

Session III:  Music and Mental Health in the Medical Settings

Presenter: Heather Fellows, SCMT, MT-BC

An experiential session.  We all took up instruments, drums, guitars, and played together.  Heather and some of the other Music Therapists present sang. Heather provided stories of her 20 years of practice as BC-MT working with all kinds of patients and how she used music, usually guitar and voice, to hold space for patients.

References: 

  • Group Music Listening with Adolescents for Self-Expression in Grief Recovery (McFerran, 2011)
  • Active music making, songwriting and analysis, and music assisted grief rituals with hospice workers (Wiodarczk, 2010)
  • Singing and vocal improvisation with adults with mental illness in complicated grief (IIliya, 2015)
  • Live Music Based experiences improved pain control, physical comfort and relaxation in terminally ill hospice patients (Krout, 2001)

 Heather told a story about a family member of a terminally ill patient who requested she play and sing Charley Puth’s song, See You Again. 

Session IV: the Power of Your Individual Voice: Songwriting and Voice in Music therapy

Presenter: Brandtley Henderson, MM, MT-BC

Why we sing:  Everybody can do it!

Muisc can create and reinforce neural pathways.

Singing is a way to create a shortcut from the prefrontal cortex (decision making) to the amygdala (emotional processing).

Singing permits the individual to acknowledge and process emotion in a way that is engaging, accessible, and non-threatening.

Another experiential session. Everybody can sing who can breath and make any sort of vibrational noise from their throat. You don’t have to be a trained singer. Brandtley  played guitar and sang songs and had us all write a song in 15 minutes as a group which we then sang.  It was pretty easy to do actually:  pick a rhythm, create a phrase about a preselected topic, attach the phrase to a melody.  Sing.  Brandtley works with the Utah State Hospital patients.  

II. We were all requested to watch the TED talk You Are Contagious by Vanessa Van Edwards

https://www.google.com/search?q=ted+talk+you+are+contagious&rlz=1C1LOQA_enUS668US681&oq=TED+talk+You+Are+&aqs=chrome.0.0j69i57j0l4.6794j0j8&sourceid=chrome&ie=UTF-8

and listen to the podcasts: 

End of Life University  Dr Karen Wyatt  Mortal Wisdom

Episodes:

181  Impermanence

183 How to let go of what you thought should happen

167 Kathryn De Longi and Music Thanatology  (Kathryn is Kristen’s cousin and inspiration).

Using these sources as inspiration we talked about our own experiences when we were not centered and focused on our patients and the effect that had (or did not have) lending support to the concept that our intention and mindfulness is critical to the work we do.

We discussed the importance of focusing on gratitude as a way of improving not only our own emotional and physical health but that of others around us and how HeartMath measures and encourages this practice of cardiac coherence.

Cindi quoted: “Gratitude allows grace to complete it’s cycle”  I cannot find the source for this citation but I did find the following via google search:  https://mentalhealthgracealliance.org/christian-mental-health-and-mental-illness/what-you-get-when-you-give-thanks

Tristan shared an experience she had recently of an estranged family coming together at the bedside of their dying loved one and how the music helped them heal at this critical time before their loved one passed.

We also shared experiences of how times of brokenness can allow us to utilize other gifts we have to make a positive impact on the world in spite of our own disabilities and limitations. Laurel shared her experience from living with a chronic illness for the last 25 years and finding gratitude for all the blessings of her life.

We finished with lunch together and a healing ritual for one of our members using harp, intention and holding space for support. 

UTHN meeting of 7/9/19

(Notes provided by Kathleen Dougherty as I was on vacation)

Our speaker was Melou Stewart Cline, Music therapist. Melou has her NICU-MT, a national certification to practice Music Therapy in the NICU. Melou also is a Neurologic Music Therapist, NMT.

Melou outlined a multimodal approach to NICU music therapy, which included humming, singing, humming with harp, singing with harp, and touch. The latter, as I understood, is only employed by NICU nurses and parents (or other approved persons).

Provide music geared to the developmental stage of the NICU infant. For instance, at six months gestation, singing and playing harp will stress the child’s immature physiology. Proceed hierarchially: Start with gentle humming (Brahm’s Lullaby has had good results) and pay attention to startle responses. Keep sound levels below 70 dB.

Startle response: The Moro reflex is when an infant suddenly extends arms and legs, arches the back, then curls everything in again. The child may gasp. (Infants may startle not only to sound, but bright lights, physical touch and other unfamiliar stressors in the NICU.)

Watch for improvements of oxygen saturation, heart rate, and relaxed states. If humming is tolerated, move to singing, then humming with instrument (harp), then singing with harp. All interactions at slow tempo and low volume. Note: I can’t recall discussion about harp alone.

These MT interactions with NICU infants can also soothe the medical staff and the parents.

NICU sessions are usually brief, 10 to 20 minutes, to avoid overstimulating the baby.

Before birth:

Singing one specific song to an unborn child can help Mom sooth the infant after birth. Perhaps Dad’s singing, too.(Generally in gestation babies start to respond to sound at 18-20 weeks.)

Music therapy in NICU can decrease length of stay. NICU nurses and parents may also employ gentle human touch to soothe preterm infants along with gentle humming or singing.

UTHN meeting notes from 6/3/19

Attendees: Heidi, Peggy, Laurel, Chris, Tristan, Kate, Tamara

Today we are celebrating and honoring our member, Tristan Adair as she retires from 25 years of work as a Music Thanatologist.  Before Tristan embarks on her next adventure traveling the country in search of Sasquatch in her RV and teaching harp, we wanted to hear more about Tristan’s journey as a Music Thanatologist and learn from her vast experience.

Tristan was a music student of piano from the age of 3. Lucky enough to be born into a family of talented musicians she was recruited early to play in the family string quartet on violin and String Bass.  Tristan attended BYU on a full music scholarship and also trained at the Royal Academy of Music in London playing String Bass. 

After graduation, Tristan was living in Oregon and was recruited (voluntold) by her mother for the Bend Oregon Hospice, where her mom was a volunteer.  At that time, Tristan had never played a harp or been interested in hospice work.  As serendipity usually happens, while Tristan was volunteering, Therese Shchroeder-Sheker  was invited as a keynote speaker to present at the hospice. She spoke about her Chalice of Repose Music Thanatology training program and Tristan was intrigued.  Tristan and Therese had a long conversation after the conference and Therese encouraged Tristan to apply to the program. Even though Tristan did not play the harp at that time, she was admitted to the program in Missoula Montana.  Tristan recounted that long ago she had had a memorable dream about a harp which made no sense to her at the time but was obviously prophetic in hindsight.

A short Youtube video of Therese Shroeder-Sheker you may want to watch: https://www.youtube.com/watch?v=gppfjwu4xXk

The Bend Oregon Hospice was so supportive of this training that they partially funded Tristan’s training at the Chalice of Repose. When she graduated Tristan came back to Bend and was hired to work as a Music Thanatologist for them.  Even with Tristan’s vast musical background and experience, the Chalice of Repose experience was daunting and demanding, according to Tristan. Many applied, few were admitted to the program and of those, many were redirected to other occupations before graduation. (It sounds like Harvard Law School.)

Tristan met Ann Dowdy at Chalice of Repose and Ann recruited Tristan to come to Salt Lake City where she said there was a great need and opportunity for Music Thanatology. Tristan has worked for a number of different hospices in Utah: Applegate, Care Source and CNS were the most memorable. Tristan recommends working in an inpatient hospice with a clinical team who truly understand the benefits of Therapeutic Music for the best experience in the world, as she had at CareSource. The most difficult misconception hospice and palliative care team members have is that music is a performance to entertain patients, which of course, it is NOT.

Some of Tristan’s most memorable experiences playing harp at the bedside occurred when she was privileged to play for patients who were actively dying and passed in her presence.  One experience she remembers was a patient who seemed to generate a golden spiral from the top of his head upward and as they took their last breath, the spiral began to evaporate from the head moving upwards and then totally disappeared.  Tristan believes that was when the patient’s soul took flight from their body.  Another time she was playing for a young ALS patient and she saw a golden tapestry hanging midair over the patient prior to their passing.  She has witnessed a glow of patients who are on the verge of dying that is unexplainable.

Tristan wished to thank all the members and guest of UTHN for their support and friendship over the last 2 years.  As this work can be very solitary and most people don’t really understand what we do and why we do it, having a support network like UTHN is most valuable to share ideas, experiences and learn from each other.

Cyndi Bowen wanted me to thank all of those involved in her therapeutic harp healing experience last month.  She found it a profoundly healing experience and couldn’t adequately express her gratitude at the time.

As a followup to our discussion, the Music Thanatology Association International will be holding their annual meeting in Portland Oregon September 13-15 at Still Meadow Conference & Retreat Center
16561 SE Marna Road
Damascus, Oregon 97089

Potential presenters include Peter Roberts and Farshid Akhlaghi

All are welcome to attend. More information can be found on their website: www.MTAI.org

Our next meeting will be July 9, location to be determined.  Peggy Cann is hosting and one of our Music Thanatologist friends will be presenting on Music Therapy in the NICU.

Our UTHN meeting was followed by the Heartland harp trunk show featuring the Serenity, their newest addition to their line of carbon fiber harps. Dave Woodworth was present and incredibly generous as he hauled one of each model into my house for us all to try.  The Serenity weighs 5 lbs, fully levered and has 25 strings.  It is retailing for approx.. $2500.  If I was in the market for a new therapy harp, this would be the one I’d buy. While Dave was here he fixed a chronic intermittent buzzing problem I have been having with my Lewis Creek Jessie harp.  I can’t believe how great it sounds now. 10 years old and still serving me and my hospice patients well.  We all enjoyed playing them and lifting them and envying the built in light system.  Safe travel wishes for Dave as he continues on his cross country show of harps.

UTHN meeting of March 26, 2019

Attendees: Kate, Heidi, Angela, Kristen, Laurel, Peggy, Tamara, Chris and guest, Cindy Bowen

  1. Introductions 
    1. We each introduced ourselves, told where we got certified (or are in process  of certification) and where we currently work.  Cindy is enrolled in the CMCP  program that Pam, Kate, and Tamara went through. Cindy will be added to our email distribution list and can be reached at chordsofjoyut@gmail.com
  2. Chris Watts shared with us her presentation that she uses with Senior Centers, Sir Gwain and the Loathly Lady, a story of chivalry, romance, honor, overcoming fear, and the answer to the ultimate riddle, “What does a woman really want?” Chris uses storytelling, harp playing and visual aids to facilitate the telling of this tale which was charming and had us all engaged.  Chris said that she has a different presentation for almost every month. March would be Irish stories, April Jewish stories, May Mothers Day stories, etc.
  3. Chris asked us each to bring or play a happy song.  Everybody either discussed, sang or played the harp for their piece:
    1. I’ve Being Eaten by a Boa Constrictor (Kate)
    1. Oh What a Beautiful Morning (Heidi)
    1. Wo Betyd thy Wearie Bodie –an Irish melody for the wire strung harp c.1627 (Angela)
    1. Kristen reminded us all that happy songs are very personal and depending on the circumstances she has used What A Wonderful World, Frere Jacques, You Are My Sunshine, There is Sunshine in my Soul Today and others.
    1. Dark Gaick of the Wandering Stream, a Scottish piece from the 1800s for the wire strung harp was played by Laurel
    1. Tamara played Petite Waltz combined with My Sun and Shield. She recommended Lorinda Jones Harp Concert Book which is full of popular happy pieces and Carolyn Bame’s book of waltzes which had the pieces that she played for us.
    1. Peggy played and sang:  How Much is that Doggie in the Window.
    1. Chris shared with us the lyrics and chords for I Love You A Bushel and a Peck and The Whale. 
  4. Other topics of interest 
    1. Peggy is presenting on a panel at the Generations 2019 Conference April 16 on A Continuum of Music in Healthcare from Music Listening to Music Therapy. The music Therapy track runs all day long and anyone can register and attend that track for a fee. If you want to attend just the panel presentation from 9:15 am to 10:30 email Peggy and you can attend that session only,  free as her guest. 

Peggy will be hosting our next UTHN meeting at her house in Orem April 24 (date and location to be confirmed later)

The UTHN is a professional development network of practicing Therapeutic Musicians living in Northern Utah. All members have graduated or are currently enrolled in a Therapeutic Music Certification program approved by the National Standards Board of Therapeutic Musicians (NSBTM) Or Music Thanatologists. Visitors to our monthly meetings are always welcome. Please contact me if you would like more information about this organization.

Digital Medicine and Music for Treatment of Chronic Diseases

The Osher Lifelong Learning Institute at the University of Utah offers a rich and evolving array of courses, lectures, and special activities for people who are 50 years of age and older. On 12/13/17 I was fortunate to be attending an Osher LLI  Lunch and Learn. The keynote speaker was Dr. Greg Bulaj of the Medicinal Chemistry Department at the University of Utah. I was especially interested in his talk and had reserved a space well in advance as I expected the lecture to be pertinent to Therapeutic Harp work.

It was titled: Digital Medicine and Music for Epilepsy, Pain, Depression, and Cancer: How Mobile Apps and the Internet Deliver Non-pharmacological Therapies for Chronic Disorders.

Dr. Bulaj has been conducting research combining drug therapies with music and digital apps to improve the outcome for patients.  As he began his lecture he informed us that one of the biggest healthcare challenges today is the fact that patients do not take their prescribed medications either at all, or sporadically, or incorrectly.  According to research in the area of Medication Non-adherence, 50% of people with chronic diseases to not take their medications as prescribed. This can result in increased mortality and morbidity rates, reduced quality of life and shortened lifespans.  The reasons for non-adherence vary including medications being too expensive, regimens too difficult to follow, patient denial of disease and need for treatment, discontinuing medication due to patients feeling well, and unpleasant medication side effects.

In the case of epilepsy, if meds are taken incorrectly seizure activity increases.

Mobile Medical Apps

Medical Mobile Apps are considered medical devices and require FDA approval and clearance.  Examples include:

Epicadence:  mobile software for the treatment of epileptic seizures (under development)

Blue Star: prescription digital intervention to treat Diabetes Type II. In clinical trials it was shown to be just as effective as medication. It is an FDA cleared mobile medical app and delivers behavioral self-management content.

Pear Therapeutics: mobile app to treat substance abuse (FDA cleared prescription digital therapeutic)

MusicGlove used to treat stroke and traumatic brain injury, and Cerebral Palsy.

Project EVO videogame by Akili Interactive treats ADHD and Autism.

NeuroRacer videogame to treat and monitor cognitive decline.

Pain RelieVR: Virtual Reality device and software to manage pain.

ReMission: videogame for pediatric cancer patients.

Intellicare:  A suite of apps for the mobile phone to treat depression  and anxiety from the molecular level to the behavioral level. ‘A novel suite of 13 speedy mini-apps called IntelliCare significantly reduced depression and anxiety in study participants, who used the apps on their smartphones up to four times a day. The reductions of 50 percent in anxiety and depression are comparable to results expected in clinical practice using psychotherapy or with antidepressant medication.” https://www.sciencedaily.com/releases/2017/01/170105123102.htm

Cancer 

Patient Empowerment Exercise Video game, called PE Game, for pediatric oncology patients. Similar to Wii.

Combination therapy for cancer patients includes cancer drugs and the PE Game.  Builds strength and improves positive attitude which can improve the immune system. The mobile game is loaded on a tablet and improves physical and mental empowerment and becomes an exercise device for patients.

Depression:

Packaging music into music streaming software to be used as a medical treatment.  See published research paper below:

www.frontiersin.org/articles/10.3389/fpubh.2016.00217/full

See UpMusing.net for use of music in treatment of depression and pain.  upmusing.net/

Pain

Music and Physical Exercise are very effective in treating pain. Recommended treatment for chronic low back pain now is physical exercise, tai chi, or yoga. If no relief from this regimen after several months, then physicians may prescribe meds.

Fish oil (omega 3) can also be useful for pain management in combination with other modalities.

Epilepsy

Mozart Sonata K448 has been shown to reduce seizure activity in humans and rodents if performed per the original composition.  10 min/day seems to be an adequate amount of time for listening to be effective. It can also improve sleep and reduces stress. OK to listen to the music while sleeping.

http://www.frontiersin.org/articles/10.3389/fneur.2014.00126/full

If music is packaged in a mobile app, and approved by the FDA as a medical device, it can be reimbursable by third party payers

Dr. Bulaj’s final thoughts and comments:

“Alone we can do so little. Together we can do so much.”  Helen Keller.

Digital Medicine may be efficacious as a preventive treatment because this is where behavior changes can most influence the disease outcome.

Challenges to Acceptance:

  • Cyber security fears
  • Power requirements
  • Patients willingness to be actively engaged in their own therapy

—————————————————————————————————–

After an enlightening discussion with Dr. Bulaj earlier this week he sent the following links for additional information related to his projects including harnessing medicinal properties of Mozart music for people with epilepsy.

    1. This article describes a rationale for integrating Mozart music with digital/mobile technology and antiseizure medications: www.frontiersin.org/articles/10.3389/fneur.2014.00126/full
  • This is a link to our digital therapeutics startup – Epicadence Public Benefit Corporation  –  epicadence.com/ –  focused on developing Mozart-music based digital therapy for epilepsy.

For more information contact Greg Bulaj at bulaj@pharm.utah.edu
My thanks to Dr. Bulaj for his suggestions and edits to this posting for clarity and accuracy of his presentation.

When Music Alone is Not Quite Enough

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.

Healing Practices Anyone Can Do

I was asked to present some Self-healing practices at our most recent Utah Therapeutic Harp Network (UTHN)  gathering (a sacred circle). I have taken so many workshops and classes on the following list but can not claim any expertise. I’ve tried them all  and to some extent they are all useful and easy to do. We did some of the exercises at our meeting and I think everybody felt more open and less stressed at the end. I know I did. Then, of course, we ate a fabulous lunch prepared by our awesome hostess, Peggy. Felt like a day at the spa.

What makes all of these practices most beneficial is habit. They should be practiced  on a daily basis, not just when you’re depressed or stressed, in order to build resilience. Yeah, right. Do what I say, not what I do. Youtube video references are included for more in-depth explanations and demonstrations. I tried to find the best for you.

Self-Healing Practices to Stay Healthy and Creative

1. MUSIC: Listen, play, sing and tone your chakras
If you’re feeling overwhelmed by a stressful situation, try taking a break and listening to relaxing music. Playing calm music has a positive effect on the brain and body, can lower blood pressure, and reduce cortisol, a hormone linked to stress. (Did I really need to remind a roomful of Therapeutic Musicians this?) Ocean or nature sounds have similar relaxing effects as music. So does singing and it improves your oxygenation levels if you do it right.
Exercise: Tone your Chakras. As you sing the vowel sounds, hold the place where that chakra resides in the body and see if you can feel the vibration there.  https://www.youtube.com/watch?v=F8kwc1lkiAQ      every video has different vowel sounds.  If the following don’t work for you, try another one.

Root chakra:  uh sound (C)
Sacral chakra: uuuu (like Moo) (D)
Solar chakra: long o  (like low)  (E)
Heart chakra: Ahhhhhhhhh (F)
Throat Chakra: long I (like lie) (G)
3rd Eye chakra: long A  (like hay)  (A)
Crown chakra: long E (like she)   (B)

2. Call a friend (another UTHN member)
When you’re feeling stressed, take a break to call a supportive friend and talk about your problems. Good relationships with friends and loved ones are important to any healthy lifestyle, and they’re especially important when you’re under a lot of stress.

3. Talk yourself through it  (EFT)
Sometimes calling a friend is not an option. If this is the case, talking calmly to yourself can be the next best thing. Don’t worry about seeming crazy — just tell yourself why you’re stressed out, what you have to do to complete the task at hand, and most importantly, that everything will be okay. Remind yourself of all the challenges in life you have already overcome successfully. Or try the
Emotional Freedom Technique technique https://www.youtube.com/watch?v=XyHxuTG6jRk  with self talk and tapping.

4. Eat Right
Stress levels and a proper diet are closely related. When we’re overwhelmed, we often forget to eat well and resort to using sugary, fatty snack foods as a pick-me-up. Try to avoid sugary snacks and plan ahead. Fruits and vegetables are always good, and fish with high levels of omega-3 fatty acids have been shown to reduce the symptoms of stress. A tuna sandwich really is brain food.
Drink Green tea rather than caffeinated drinks A large dose of caffeine causes a short-term spike in blood pressure. It may also cause your hypothalamic-pituitary-adrenal axis to go into overdrive. Instead of coffee or energy drinks, try green tea. It has less than half the caffeine of coffee and contains healthy antioxidants, as well as theanine, an amino acid that has a calming effect on the nervous system.

5. Laugh it off—yoga laughing
Laughter releases endorphins that improve mood and decrease levels of the stress-causing hormones cortisol and adrenaline. Laughing tricks your nervous system into making you happy.
Can’t think of anything funny? Go to Youtube and look for Monty Python, Robin Williams, Carol Burnett or whoever has made you laugh in the past.
Fake it. Just start belly laughing. This will be enough for your body to respond biochemically. And you will soon be laughing for real at how silly you sound.  Did you know there are Laughing Yoga clubs all over the planet?
https://www.youtube.com/watch?v=5hf2umYCKr8

6. Exercise (even for a minute) Qi Gong and Qi Self Care
Exercise doesn’t necessarily mean power lifting at the gym or training for a marathon. A short walk around the clinic or neighborhood, or simply standing up to stretch during a break at work can offer immediate relief in a stressful situation. Getting your blood moving releases endorphins and can improve your mood almost instantaneously.
Open the Meridians with tapping and movement
https://www.youtube.com/watch?v=FjQJYAk97ns

7. Sleep better (banana tea)
Everyone knows stress can cause you to lose sleep. Unfortunately, lack of sleep is also a key cause of stress. This vicious cycle causes the brain and body to get out of whack and only gets worse with time. If sleep is a problem, try turning the TV off earlier, dim the lights, and give yourself time to relax before going to bed. It may be the most effective stress buster on our list. Kristen shared a recipe for insomnia, make banana tea: cut off the ends of a ripe banana and boil it for 10 minutes. Drink the water as tea with some cinnamon. : https://www.davidwolfe.com/banana-cinnamon-tea-deep-sleep/

 

8. Breathe deep and think of things you are grateful for
For centuries, Buddhist monks have been conscious of deliberate breathing during meditation. This is also the foundation of HeartMath’s formula for improving Heart Rate Variability and increasing resilience. Sit up in your chair with your feet flat on the floor and hands on top of your knees. Breathe in and out slowly and deeply, concentrating on your lungs as they expand fully in your chest. While shallow breathing causes stress, deep breathing oxygenates your blood, helps center your body, and clears your mind. While you’re breathing, focus your mind on the things in your life you are grateful for. 3-5 minutes every day, longer if you don’t think you have time to do this.   https://www.youtube.com/watch?v=d4QtkV3UgDY    and  a guided meditation:

9. Morning Pages,  The Artist’s Date, Sacred Circles: Purpose: to declutter your brain and banish blocks to creativity and living a full and abundant life. All of this is from the book, The Artist’s Way by Julia Cameron. If you read this 20 years ago, like me, read it again. I got so  much  more out of it the second time.
Morning pages: Every morning before anything else, sit and fill 3 pages of handwritten stream of consciousness. Do not review it, do not edit it. Just brain dump onto the paper. https://www.youtube.com/watch?v=oxtEo4yCOh4
Artists Date: Make a date with yourself to do something that you really enjoy, honoring yourself and what it is you do that makes you unique on a regular basis. What is fun? Can you do it alone? Do it. Is there someone who would enjoy doing it with you not just out of obligation? Invite them.
Forming a Sacred Circle—”Success occurs in clusters and is born in generosity. Let us form constellations of believing mirrors and move into our powers.” J. Cameron. This is what  UTHN is, our sacred circle.

Namaste!

My 2017 Harp Focused Summer Vacation

I returned recently from the International Harp Therapy Program workshop in Cedar Falls, Iowa and the follow up  experiential workshop on Resonant Tone in Albert Lea, Minnesota. While I wasn’t looking forward to traveling to the mid-west in August from all I had been warned about: sweltering heat, oppressive humidity and bugs; none of that proved to be the case, at least while I was there. The weather was agreeable, even cool and rainy and the bugs stayed home.  It is always inspirational and validating to come together with the IHTP tribe of Therapeutic Harpists, including new students, former teachers, experienced practitioners, and old friends.  We speak the same language and have shared experiences. While all presentations at this weekend conference were valuable and informative, my favorite takeaway from this session was the Aromatherapy Workshop. I use aromatherapy with patients by dabbing it on my wrists.  The movement of my arms while playing harp sitting close to the bedside then sends it subtly into the room. My favorite blend is from Young Living Farms called Forgiveness. It includes sesame seed, melissa, geranium, frankincense, sandalwood, coriander, angelica root, lavender, bergamot, lemon, ylang ylang, jasmine, Helichrysum italicum oil, Roman chamomile, and rose.

“Forgiveness™ contains an aroma that supports the ability to forgive yourself and others while letting go of negative emotions.”(https://www.youngliving.com/en_US/products/forgiveness-essential-oil)

It is useful when people are at the end of life and can’t seem to let go because of anger, bitterness, resentment, guilt and fear.  And I love the smell.

Pamela, my new IHTP sister, friend, and roommate for both workshops, acquired a room spray of Frankincense to help us sleep and ground us while we were there from Rodney Schwan, which she liberally spritzed every night before bedtime. It seemed to do the trick. Rodney is a Massage Therapist and Aromatherapist who works in the field of palliative care.  The knowledge and personal experience he shared about using various scents in palliative care use was extremely valuable and which I intend to include more of in my own practice.  

On Saturday night, Gaylord Stauffer, Cedar Falls host, harpist and gardener extraordinaire, invited us all to his home. The following pictures are from his incredible gardenscape, where we were able to wander and wonder at our leisure while our friends played harp and sang into the evening.  Good food, good company, and incredible creative landscape artistry created a magical environment for us all to refresh and relax.

 

 

 

Albert Lea and ESM Workshop

“ESM – Experiential Specialty Module – The Experiential Specialty Module requires in-person attendance for all students. This is a week long Module. The ESM is scheduled at venues in many countries, and you can take it anywhere it is offered. This allows the program to be quite flexible and moderately paced for all students. The Experiential module (which is an extension of Unit 4) enables the student to be ‘recommended for Hospice work,’ as opposed to those who only take the theoretical Unit 4 about Resonance.”  (http://harptherapycampus.com/campus-2/faqs/).

Diane, Pamela, Sharon, Heidi

There were four of us in this training:

From  left to right: Diane from Idaho, Pamela from New York, Sharon from Edmonton, CA, and me. Included is Sharon’s Stony End harp which we all got to play one evening in the hotel lobby for our own amusement and that of the hotel staff and guests while it poured rain outside.

Being such a small group with 2 fabulous instructors: Christina Tourin and Judith Hitt, allowed us to really go deep into the training which was so appreciated by us all.

Having gone through the theoretical ESM training seven years ago, much was review for me but the experiential resonant tone was practice-changing for me.

The concept of resonant tone is based on the fact that we all vibrate, and that which vibrates, produces sound. As Therapeutic Harp Practitioners, we must be centered, focused and attentive to our patients and their surroundings, integrate that information and meet the patient where they are at within that moment vibrationally, emotionally, and mentally. Any vocalizations produced by the patient provide a clue as to their resonant tone which we try to match with our musical selections.  Items in the room provide clues to their interests and personality and whatever they are willing to share with us in that space also helps. Being open to all of this and completely focused on the patient allows intuition to assist with the choices. Some of my colleagues refer to this as “the voice”, “Creator”, spirit guides”  “universal intelligence” and “pure coincidence”.  Whatever the source  for an idea that comes to us to play a particular tune or improvisational mode for a patient that is absolutely perfect, it will come to us if we are open to it,  paying attention, and grounded in our intention to do the best we can for the person we are with.

Watching the response of the patient to our musical selections, key, rhythm, genre, allows for opportunities to change and select a more appropriate choice to connect with the patient as needed.

At the end of the week we gave a performance for the residents of the facility which had provided  a beautiful space for us all week. Then we traveled to a different facility where we were allowed to shadow Christina and Rachel Christianson, IHTP graduate, amazing harpist, and local host for our training, as they provided Therapeutic Harp music for selected patients.   They used harp, voice, conversation, shared experiences to establish that special connection for the patient and their families within a limited amount of time.  There is no way to glean the benefits of this level of training without being present and experiencing it first hand.

At Rachel and Dave’s house Tina and Rachel jamming on the Heartland harps

 

 

 

 

Another dinner party, this time hosted by Rachel and Dave Christiansen of Albert Lea, MN at their lovely home on the lake.  From L to R: Tina, Judith, Pamela, Sharon and Diane.

I have been able to develop a new depth to my own practice of bedside playing for hospice patients because of what I learned in both of these workshops. It was well worth the time and money to participate, expand my skills and work outside my comfort zone with such incredibly talented and dedicated professionals.

 

 

 

 

 

 

Playing for the Dead

Sometimes I don’t arrive in time to play for the actively dying patients before they pass.  If the mortuary has not come yet, I may sit with the body in a low-lit room and play for the newly departed. My personal belief is that the newly dead remain in the former space for a short period of time. Like birth, the end of life transition from mortal to spiritual being can be traumatic and confusing, initially. I imagine the abrupt cessation of pain, gravity, and fear when the spirit finally releases the physical shell, combined with the impending launch into the light of unconditional love with the soul family and Creator, may cause some momentary resistance, at least for some.  So, I play for that spirit who may remain, encouraging it to take flight.  I play for the hospice staff and family members who remain in the room grieving their loss.  I play for the facility staff who clean and prepare the body for the mortuary to pick up and are mourning, as they complete this final service for a patient they have come to know and love.  This is a sacred space and time and I feel a responsibility to hold and preserve  that sacredness for just a bit longer with music if I can.

Rudy was a patient who was loved by everyone he met throughout his life. He came to America as a poor Russian immigrant when the Soviet bloc collapsed in the 1980s and he could leave Mother Russia. He brought his family with him including his wife and several small children and was a man who made friends wherever he went. According to one son, Rudy never forgot his old acquaintances while continuing to make new friends his entire life.  How he remembered all those people, their names, the details about their families and lives was a mystery to everyone, including Rudy’s own family.

Rudy’s final days were spent on hospice in an assisted care facility he had been living in for a while. Even before Rudy was admitted to hospice, I knew him. He had met me when I came to play for our hospice patients at the facility and we had spoken in the lobby while I tuned the harp and he was waiting for his daughter to come and visit.

When I first entered Rudy’s  room with the harp, he looked up and smiled. “Well, I guess it must be my time, the angel has come for me, now”, he said.  He remembered who I was from our prior brief meeting. I told him I hoped we would have many therapeutic music sessions together.  He just shrugged, leaned back in his wheelchair, closed his eyes and let the music envelop him.  We did get to have many sessions together but not as many as either of us would have liked. I remember him always smiling and welcoming me into his room even as his diminished health steadily declined.

I was unable to be there with him while he was actively dying but I was told he was surrounded by his loving family and friends. By the time I arrived at the facility to play for him, Rudy had passed and his family had left so I sat in his room with his body and played some of his favorite songs.  Soon the Nursing staff came in to prepare Rudy’s body for the mortuary.  I asked them if I could stay and continue playing while they worked.  The two Aides agreed although my request seem to surprise them. Both were tearful while they lovingly bathed Rudy and covered his body.  Rudy’s  departure would leave a large hole in the world for all the people whose lives he had touched.

When the mortuary came for Rudy, his body was carefully transferred to the gurney and his face covered with a drape.  A rose was placed on his body and the processional to the waiting van began with the hospice nurse, the 2 mortuary staff people, and the gurney with Rudy. The nursing assistants and I walked behind out to the waiting car. I believe Rudy’s spirit had already departed by then. I played only for his memory and for the people he had left behind to comfort us all in our grief.

I had been alerted through encrypted email that one of my favorite VA patients had passed after a long time on hospice. I had gotten to know Joe well during our sessions together as he did not suffer from dementia and loved music.  Usually welcoming and greeting me with a big smile, the last time I visited he asked me to leave as he just wanted to sleep. I knew he wouldn’t be with us much longer.

The next time I saw him, he had passed. He was still in his facility bed and room and his family wanted to provide a memorial for him there and dispense with a funeral service. They planned a bigger family and friend memorial much later in his home. Joe would be cremated. A rose was placed on his body and I sat next to the bed as far back as I could get in very tight quarters to accommodate family who wanted to say “Farewell” and touch him.  As they slowly filed in, I played hymns and music he had enjoyed.  Although no program had been formally planned, at one point a son began telling stories about his dad from a happier time.  In addition to being a kind, generous, adventurous man who loved the outdoors and his family, he had also been a Gin and Tonic drinker. Neat, no ice.  As the family stories began to unfold of trips to Moab and Lake Powell and skiing, there was equal laughter and tears. Everybody, including teenage grandchildren at the time, had been encouraged by Joe to join him in his favorite drink.  As they told it, mostly gin, little tonic, warm and disgusting but they drank with him anyway to please him.  And to honor him, an adult grandchild pulled out of his pocket a flask of gin and a small bottle of tonic water.  Paper cups were gathered and a toast was drunk to Joe, beloved husband, father, grandfather and friend. After everyone was done speaking I  played some more and stayed until the mortuary arrive.   I finished with You Raise Me Up, Wind Beneath My Wings, and Somewhere Over the Rainbow.  I waited outside the room while the mortuary transferred Joe to their guerney, draped his body with the American flag and began the processional out to the waiting van.

At this VA long term care facility, the dead are acknowledged and honored. As they are slowly moved out in a great processional with the nurse, chaplain and family following the departed, over the loudspeaker everyone in the building is informed of their passing, their military service and a recording of Taps is played. All who can, stand and either salute or place their hand over their heart until the veteran moves out the door.  All work and conversation that is not essential stops. It is a very moving experience just to be part of this loving and final tribute to people who selflessly served their country.