A Day In the Life of a Hospice Music Therapist

*Hospice is a philosophy of care in which a team of caregivers (doctors, nurses, CNAs, therapists, chaplains, creative arts therapists) collaborate to give comfort to and provide for needs of people who are terminally ill. It can be for people of any age who have a prognosis of less than 6 months to live.*

*Music therapy is the use of musical intervention to achieve non-musical goals (physical, social, emotional, spiritual).*

A typical Monday through Thursday for me.....

8:30 am: Alarm goes off. Colin gets up to make us coffee. I linger for a little while longer, usually joined by Mercedes, one of our two Himalayan cats.

9:00 am: I am getting ready for work and having some coffee with a quick breakfast.

9:30 am: I hit the road. My first drive is always between 30 minutes to 1 1/2 hours away. It is a great thing that I get mileage reimbursement. I have approximately 25 clients that I see weekly. Most of them are in assisted living homes or nursing homes, but I have a few that live in their own homes.

For those of you that live in Wisconsin, I live in Waupaca and have clients in Oshkosh, Appleton, Green Bay, Manitowoc, Fond du Lac, and Beaver Dam, to name a few! These are the general areas I serve.

10:30 am-4:30 pm: I usually see about 6-8 clients per day. There are a few facilities in which I have several clients at, which is nice. Otherwise, I am on the road in between each person I see.

The clients are referred to me by their nurse case managers. To be eligible for music therapy, one does not need to play an instrument or even sing! This is a common misconception. Clients that are good candidates have social, emotional, spiritual, comfort, cognitive, or grief/bereavement needs that can be fulfilled or helped through either active or passive musical intervention by a board-certified music therapist.

If I am seeing a client for the first time, I start out by doing an assessment of the person. This includes their background information, medical diagnosis, mental status, pain level, mood, music background, and observed response to music therapy interventions, etc.

Once I have assessed the clients' needs, I formulate goals that are specific to the client. Examples of goals include: decrease pain to acceptable level, decrease feelings of anxiety, enhance quality of life, increase social interaction, enhance self-expression, increase relaxation, engage in life review-reminiscence, or leave a legacy for life closure.

Then, the fun part for me is coming up with musical activities that will help the clients reach their goals. Examples include: song-writing, improvisation on instruments, singing to favorite songs, movement to music, lyric analysis of songs, relaxation through listening to me play the harp, reminiscence, respiratory entrainment, or life review.

I almost always bring my guitar and songbooks, and sometimes bring percussion instruments, my harp, a keyboard, cds, bubbles, or anything else seasonal or fun!

Throughout sessions, there is always a lot of socialization (if the client is able). Often, my clients are 'starving' for somebody to listen to them. Somebody to tell stories to or to tell them stories. Somebody to discuss music with!

It can be difficult being a therapist to those that are suffering from disease progression. It is often heart-breaking going through death with my patients. But the joy received and given is worth the aches. I have learned many life lessons from my hospice clients. It is a privilege and honor to work with them. I have one who has a history of song-writing (and tells stories of being a hobo!), and another who played harmonica at the Grand Ole Opry! He has met Loretta Lynn, among other country stars of his day. I have some that are sweet souls and grandmotherly.

After I see the client, I fill out paperwork- an assessment, progress note, or narrative note of my client.

4:30 pm: I drive home. All the miles I drive gives me much needed time for reflection. On my sessions, on processing my emotions, or on how I can better meet the needs of my clients. I always listen to KLove on the radio. It gives me rest and inspiration.

5:30 pm: I arrive home. Time to fill out my time sheet and fax it to my company, along with copies of all my paperwork on my clients from the day. Biweekly I fill out my own invoices and fax them out.

6:00-9:00 pm: Shower and try to unwind. Go on blogger. Read. Cook dinner.

9:00 pm: Colin arrives home from work. We eat dinner together. Discuss our days. Almost daily I ask Colin if he is feeling one or two babies. Girl/s or one of each. Is he excited? Are we ready? We read together. Sometimes watch Survivor, American Idol, The Amazing Race, or Biggest Loser together online. We don't have cable, so our television watching is limited to these shows when they are in-season. But that is fine with us!

11:00 pm-Midnight: Say our prayers and dream like crazy fall asleep.

On Thursday morning, I add in two hour-long groups at another facility I contract out to. The groups are with people that have developmental disabilities (Down syndrome, mental retardation, etc.). We do a lot of sing-a-longs, instrumental improvisation, and social and motor skills work.

If you have any questions for me about music therapy or hospice or anything whatsoever, please ask! There is so much more to tell.

It is interesting to imagine what my day will be like when we have our baby/ies. So completely different, but so completely fulfilling.