Wednesday, May 22, 2013

Language Beyond Words ... Playing for Hospice and the Homebound

“It's not enough to have lived. 
We should be determined to live for something.
May I suggest that it be creating joy for others, 
sharing what we have for the betterment of personkind, 
bringing hope to the lost and love to the lonely.”

~ Leo Buscaglia

I had the pleasure of teaching at the Winston Salem Dulcimer Festival the first weekend in May. It was a fabulous weekend packed with jam sessions, concerts, and a wide variety of classes for players of the dulcimer - both hammered and fretted varieties. From novice to advanced levels, my classes were full of students eager for information and new skills. It was the last session of the day, though, that generated the most interest. It was an enrichment class open to anybody. The topic: "Playing for Hospice and the Homebound." 43 people registered for the class! We had a productive and lively discussion. Everybody had some wisdom to add to the conversation.

Based on the overwhelming attraction to the topic, this is what I know for sure ...  no matter the level of playing experience, many of us feel called to serve and to share the gift of music. It just seems to be the right thing to do. But it can be intimidating. There were a lot of questions and concerns.
  • Who should I play for? Where can I find folks who might benefit from my music?
  • How many tunes do I need to have in my repetoire?
  • What kinds of tunes should I play?
  • I think I'd like to play for Hospice patients but it scares me a little bit.
The first question of who to play for is an easy one once you start thinking about it. When a person's world becomes restricted for any reason, they - along with their caregivers - often appreciate a visit and a musical interlude in their day. It's true that charity begins at "home." Look around your own neighborhood, your own community, your own church. We brainstormed a list of possible venues: 
  • Visit an elderly, ill, or otherwise compromised neighbor in their own home
  • Hook up with the Pastoral Care committee at your church
  • Volunteer to play at assisted living facilities, cancer centers, the VA hospital, senior centers, Ronald McDonald House, or similar. Speak to the activities director or volunteer coordinator. Each place will have their own set of guidelines that visitors must follow.
  • Complete the volunteer training with your local Hospice or similar organization, then provide music as a specialized service to those who want it.
Here's what I think you need to know:

Know yourself
Remember that you are a volunteer, a friend, a neighbor. Know your personal limits. You are never obligated to do anything you feel uncomfortable doing. Ask for help when you need it. Don't overstep your bounds.

A volunteer musician is not a Music Therapist. That job requires a specific educational degree and clinical expertise. You may choose to take your amateur skills up a notch by becoming a Certified Music Practitioner through the Music for Healing & Transition Program. The program requires 75 hours of study and a 45 hour internship.

Know your audience
Be open to the recipient’s condition and response. Adjust the music to the situation. Is your client alert or not alert? Are you providing music for the client or for the caregiver - or both? What’s needed today?  Something upbeat and lively? Something more meditative? Will you be providing "Entertainment" or creating "Ambiance"? Be prepared for either situation.

Know what it's all about
It's NOT about YOU or your music. You are there to serve - to provide what is needed in the moment.

Know that you are making a difference
“Never underestimate the difference YOU can make in the lives of others. Step forward, reach out and help. This week reach to someone that might need a lift”  ~ Pablo

There’s a lot of reward in this work. I truly believe my music has made a difference for people in their day to day life.  But playing for Hospice clients and others has been beneficial to me, too. One valuable side effect: It has taught me to be more flexible and spontaneous in my playing.

The power of music has long been associated with benefits due to the release of stress and the ability to change or enhance moods, and the healing effect of music has been proven in studies. Click here to read more about the healing effects of music.

Trust that you "know" more music than your "official" repertoire suggests
Don’t be afraid to play something you don’t “know." If you can hum a tune you can probably pick it out on the instrument. People like to hear something familiar. On more than one occasion, after playing a complex arrangement of some beautiful traditional tune, I have heard these very words, “That was pretty, but I don’t know what it was.  Do you know (fill in the blank)?”  The request may be for something as mundane as “Row, Row, Row Your Boat” – and I’m not kidding!

If someone asks for a tune and it's somewhere in the recesses of my brain I will attempt to play a basic version. If I'm inspired I might add some simple embellishment. No one has ever complained about a missed or bad note. They’re usually impressed that I “know” almost everything they ask for! Do I play fancy arrangements? No. Do they care? Not at all.

Here are some stories to illustrate…
One summer, one of my lady friends asked me to play “Silent Night”. Had I played that in 7 months time? No. Did I remember my well-thought-out arrangement? Not really. But I played a respectable rendition. She said, “That was so beautiful. I haven’t heard any Christmas music in a long time.” I said, “Neither have I.” From then on, “Silent Night” was on the play list each time I saw her. Christmas and all the associated family traditions were very much on her mind at the end of her life. She died that August.

The spouse of an Alzheimer’s patient had pleasant memories about a family trip to Disney World. He asked for “It’s a Small World”. I had never played it before, but from that day forward I played it for him every time I made a visit. Over time a fairly nice arrangement evolved!

Mixing familiar music with the generally less familiar tunes of the traditional dulcimer repertoire can work just fine. Simply keep in mind that if your client is awake and alert familiar tunes are preferable.

The “unfamiliar” tunes work best when people are too sick to be responsive. They may appear to be asleep, but don’t count on it! An unfamiliar tune, or an improvisation on a chord progression, will allow a person to rest without “clinging” to the music… the mind won’t grab onto the tune. If the person is “resting” play continuously, creating a ‘ground of sound’ within the room. If they really do fall asleep (patients and caregivers alike) consider your job well done! Your listeners have escaped into the music, let go of their worries and anxieties, and have totally relaxed with a relative stranger in the room.

But what about repertoire? Is there a "must know" tune list?
The repertoire you use for these gigs will be a work in progress. It will vary depending on who the listener is and what kind of music you enjoy playing. Keep a list of your own tunes that have been well received. Develop personalized play lists by honoring client requests. Mix the two together for success.

Most of my Hospice/homebound/assisted living-type playing has been geared to the older generation. Elders here in Chatham County, NC like the old hymns. They like tunes that used to be taught in elementary schools. Some people like to sing along.  Here are some examples. This is by no means an exhaustive list!

Amazing Grace (must know tune)
Battle Hymn of the Republic
Be Thou My Vision
Come Thou Fount
How Great Thou Art (#2 hymn, next to "Amazing Grace" in a survey done in 2001)
I’ll Fly Away
Shall We Gather at the River?

Jesu, Joy of Man’s Desiring (people love this)
Ode to Joy (Many people know this as the hymn: Joyful, Joyful)

Americana and Popular Music:
America the Beautiful (and other patriotic tunes)
Arkansas Traveler
Bicycle Built for Two
Happy Birthday
Home on the Range
Irish Washerwoman
Oh, Suzannah (other Stephen Foster tunes)
Polly Wolly Doodle
She’ll Be Coming Around the Mountain
She’s a Grand Old Flag
Somewhere Over the Rainbow
Streets of Laredo
Tennessee Waltz
Turkey in the Straw
Yellow Rose of Texas
You Are My Sunshine

For Veterans:
Air Force - Wild Blue Yonder
Army - The Caisson Song
Marines - The Marine Hymn
Navy - Anchors Aweigh

Etc. Etc. You get the idea.

I would love for you to share the tunes that have made YOUR "must play" list!
Please leave feedback in the comment section of this post.

“May your heart open.
May joy emerge.
May love flow through you.
May you heal and help others.”

~ Charlene Costanzo, The Twelve Gifts for Healing


  1. What a wonderful resource you are, Sue! Great article and VERY helpful!! I had not thought of some of those songs, especially the military stuff! Good to know (and start working on...) Thanks :-)
    Bonnie Nicklaus (from Sandbridge)

    1. Great to hear from you, Bonnie! And glad to be of help. Of course, the population is always changing. What is important to one generation will become obsolete in another. Keep us posted as to what is working for you in your practice!

  2. Thanks, Sue! I needed that encouragement to return to the specialty care facility where I used to play. Jessie Beall

    1. Good news, Jessie! Glad to be your little nudge. I know they'll be happy to have you back.