Highlights from a presentation to healthcare professionals. Music therapy is explained. The group received ideas of ways to use music with the elders they served.
14. +
Alphabet Soup of music therapy
Music Therapist –
Board Certified
Neurologic Music
Therapy
Hospice & Palliative
Care Music Therapy
Certificate
ACMT, CMT or RMT
16. +
A Music Tool Kit
--For use with clients/patients
- For you
17. +
Name That Tune
Version 1 – Conversational flow
of listening, naming, discussing
what song reminds them of,
where they heard it.
Target Behavior: Long-term
memory retrieval
Populations:
Alzheimer’s/dementia,
community, intergenerational
Setting: group or individual
Materials:
Recordings or sheet music
of familiar songs
Tic-tac-toe board if using that
option
Version 2 –Tic-Tac-Toe
competition between
teams/individuals
Version 3 – Give the last phrase
of the song
18. +
Rate this music
Target Behavior: Increase
support, identify preferred
music for various purposes
Populations: Community,
hospice, caregivers, yourself
Setting: small group or
individual
Materials:
Recordings via CDs, MP3s,
Etc.
Rating sheet
Pencil
Consider if need to have a list
of emotions, tasks to pair with
music
Can do as a series of questions
19. +
Sing-along and discussion
Considerations:
Songs people know can vary;
Aging, medications and
diagnosis can affect voice
and alter comfort
Target Behavior: Recall of
familiar songs and past
experiences; self-expression
Populations: Alzheimer’s,
Hospice, Wellness
Setting: Individual interaction to
small group (up to 15)
Materials sheet music or
recordings in sing-able keys ,
lists of songs and discussion
materials
Any tweeters? Please use hashtag so I can see what stood out in this presentationI want you leaving hear feeling empowered to use music in your own life, ready to empower your client/patients to use music, and knowing there is a community of music therapist available to support you, support your clients/patents and to offer services when they are needed. What settings are working in?
Music isn’t owned of use by anyone. Yes, particular songs, compositions are owned but music belongs to all of us. From the infant to the person who is breathing their final breath.Sound and silence, rhythm - duration, pitchMusic can be simple or complex. Let’s do a little experiential (shakers to Lively Latin)Exists within a cultural framework. Framework is changing with our interconnectedness.Do you consider yourself musical? Have you played an instrument? Sang in a group?We all have preferences to music we like. They aren’t the same. Discuss what those present like. Research on childhood preferencesSo if we all own music, we all have individual likes and dislikes with music, why do I think this topic of prescribing music is relevant?
Put #HCLR or @hcldr in and search. Many of the chats are fast and informative, the music and medicine chats get lots of trafficI believe you want the best for your clients/patients and yourselfPart of knowing what is best, is knowing what is available and what it is.
At it’s core MT is a therapeutic relationship using music to support the highest quality of life and to improve their physical, social, communicative, emotional, intellectual, and spiritual health and wellbeing. Evidenced based practice. We engage people in meaningful music experiences that are planned and based up on their assessed needs, interests, and abilities.The ability to read music or play an instrument is not required for people to benefit from music therapy services.Process rather than productDefinitions when you research sites and programs changes.Examples from my work Exercise – Have group to arm exercises to “Hey Good Lookin” Drumming groups in Alz unit “B” in Florida developing skills in interactionExciting time to be a music therapist: “Sing Me Home”, “The Music Never Stops” Gabby Gifford, NICU research
Image is from JennaD on Deviant artDaniel Levitin has done a wonderful job providing a basic understanding (as it exists today) on the brain and music. I highly recommend his book. Other writers Oliver Sacks, and Aniruddh D. Patel – both have been speakers at the American Music Therapy conferences. They, other researchers including music therapist are working on building evidence for what we do as music therapist.
Your information packet has the site: where you can look up hits by year or decade to give you a starter. But this is the popular music. Tuesdays hcldr chat MD spoke of 70 yr old requesting Led Zepplin. Discuss music of cultures. Countries. Site Dad and Betty example of same age totally different tastes/
Common populationsAdults with Alzheimer’s or other dementiaAdults in hospice careAdults in health and wellness programsAdults in intergenerational programsAdditionally seeAdults with Parkinson’sAdults with strokeAdults with psychiatric issues
Cognitive NeedsMaintaining memory retrieval (long and short term), Name and face recognitionMaintain focusResearch has shown music therapy interventions can assist with these. (Brontos & Koger, 2000; Pickett & Moore, 1991; Smith 1986)Disruptive BehaviorYelling, verbal abuse, physical abuse occur with the disease process. May come from issues of being unable to express themselves, not understand, being over stimulated. Research (Bronton & Pickett-Cooper, 1996; Raglio et al. 2008) showed live music therapy interventions can decrease agitation in persons with dementia both during a MT session for for a period of time following the session. (O’Conner et. al., 2009) When an individual’s preferred music is played less agitated behavior is exhibited. MT also seems to have effect on anxiety, irritability, aberrant motor activity (Raglio, et. al, 2008)Emotional NeedsThose diagnosed with Alz can find it devasting especially in the early stages and as they transition into needing care. (Brontons, Koger, & Pickett-Cooper, 1997). A lot of emotions are connected with music. Music can be used to create structure and support socialization. As communication fades, many seem to experience isolation and display symptoms of depression and or apathy. Ashida, 2000 showed that those in residential care who took part in reminiscence based MT groups reduced depressive symptoms over time. A 2007 study by Ziv, Granot, Hai, Dassa, and Haimov (2007) showed that background music participants talked more when passive music than when none.Caregiver Family Needs: Music of the research is by Clair andothers as well as Belgrave. Music therapist structure sessions to include dancing, rhythmic playing of instruments, movement to music, singing and ensemble playing for caregivers and clients. Caregivers reported it added to ways they could positively interact with the loved one, that they felt more connected, and created a sense of satisfaction.Joint engagementPersonal touch/positive physical interactions
The overarching focus of music therapy in hospice care is to enhance quality of life for the patient through the use of live music and personal interaction. The interventions are specific to the client’s needs. Physical needs of pain and symptom management are often addressed with Iso-prinipal – carrying emotion from one state to a more desirable state.Psychosocial needs – music to bring familiarity, structure interactions between individuals, and life review.Spiritual needs of acceptance and reconciliation as well as assisting patients in planning music for their memorial service giving them a sense of control on how they will be rememberedBereavement support can be offered to both the client and their family. Living legacy music and expression of emotions through music making.
In 2005, the AMTA established the standard of practice in this areas as “the specialized use of music to enhance quality of life, maximize well being and potential, and increase self-awareness in individuals seeking music therapy services.”The pursuit of knowledge is key in lifelong learning. Music an be an enjoyable area for learning. Learning to play instruments, about musicPhysical Wellness exercising, moving to musicCognitive wellness involves the combination of various mental skills. Music also involves various mental skills. Emotional Wellness/Psychosocial Well-being – connection with others, expressing emotions in appropriate manner, managing stress
Sages serving younger – Older adults Embed a college age IG videoMy video on next page.
For rehab units, hospitals likely want a music therapist who has studies neurologic music therapy.If client is hospice, look for Hospice & Palliative Care Music Therapy Certificate Designation
Is music therapy a reimbursable service?The American Music Therapy Association now estimates that approximately 20% of music therapists receive third party reimbursement for the services they provide.Music therapy is comparable to other allied health professions like occupational therapy and physical therapy in that individual assessments are provided for each client, service must be found reasonable and necessary for the individual’s illness or injury and interventions include a goal-directed documented treatment plan.MedicareSince 1994, music therapy has been identified as a reimbursable service under benefits for Partial Hospitalization Programs (PHP). Falling under the heading of Activity Therapy, the interventions cannot be purely recreational or diversionary in nature and must be individualized and based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176.Music therapy must be considered an active treatment by meeting the following criteria:Be prescribed by a physician;Be reasonable and necessary for the treatment of the individual’s illness or injury;Be goal directed and based on a documented treatment plan;The goal of treatment cannot be to merely maintain current level of functioning; the individual must exhibit some level of improvement.MedicaidThere are currently a few states that allow payment for music therapy services through use of Medicaid Home and Community Based Care waivers with certain client groups. In some situations, although music therapy may not be specifically listed within regulatory language, due to functional outcomes achieved, music therapy interventions qualify for coverage under existing treatment categories such as community support, rehabilitation, or habilitation services.Private InsuranceThe number of success stories involving third party reimbursement for the provision of music therapy services continues to grow as more clinicians seek this coverage. In response to the increasing demand, the music therapy profession has worked to facilitate the reimbursement process for clients of music therapy services.Companies like Blue Cross Blue Shield, United Healthcare, Cigna, and Aetna have all paid for music therapy services at some time. Success has occurred on a case-by-case basis when the therapist implements steps within the reimbursement process. Like other therapies, music therapy is reimbursable when services are pre-approved and deemed medically or behaviorally necessary to reach the individual patient's treatment goals.
Today, I want to spend the bulk of my time providing you a couple tool kits – one for you and one for your clients/patientsIf you work in a senior living community, adult day care, or provide home care services for elders you should consider purchasing “Music Therapy and Geriatric Populations” which is listed on your reference guide.This book is a great resource to have to assist you, volunteers, musicians in making use of music in appropriate and powerful ways. It also is there as a reference for music therapists.
Version 3: Oh say can you see…home of the brave Take me out to the ball game…at the old ball game Oh give me a home…and the skies are not cloudy all day.
Share rating sheet in packet. Do two or three
Sample: This Land Who wrote this song? What was happening in history when this was written?
#RXMusicTherapyReview resource sheet and books brought with me.“Reminder – Trust yourself. Create the kind of self that you will be happy to live with all your life. Make the most of yourself by fanning the tiny, inner spark of possibility into flames of achievement” (Golda Meir)Ask: What spark of music are you fanning?How can I assist you, your clients in the future?What would you like to see offered in your community?What are your questions?If time, drum circle