If you were asked to list types of medical specialties, you’d likely be able to come up with a dozen or more, from anesthesiology to midwifery to urology. It’s our guess that music therapy would not be on that list, unless you happen to know Moreen Burkart, a Board-Certified Music Therapist (MT-BC) on staff with the Visiting Nurse Association of the Treasure Coast.
What is music therapy? We’ll get the official definition out of the way – the website of the American Music Therapy Association says it’s “an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.” It has been a reimbursable service under Medicare since 1994.
If you talk to Burkart, as we were fortunate to do at a recent discussion held at Vero’s Center for Spiritual Care, you’ll be able to go way beyond the definition and understand the power of music therapy to improve the quality of life for the VNA’s hospice patients.
“We use music to achieve clinical and emotional goals, such as reducing pain and anxiety, decreasing feelings of isolation, and allowing for emotional expression.” says Burkart. A typical session is 30 to 45 minutes long, conducted by Burkart wherever the patient resides – whether it’s at home or in a facility.
Burkart says her fellow VNA staff members are great advocates for her music therapy services, especially the social workers. “They pave the way by explaining to patients what it is and what it isn’t. There’s no musical talent needed to benefit from this type of therapy. They just have to like music.” (Fortunately, this is a really low bar – studies have shown that music is at least somewhat important to more than 90 percent of the population.)
While patients don’t need to have a musical gift, the music therapist sure does. To receive the MT-BC designation, they must hold a bachelor’s degree, or higher, in music therapy from a college or university approved by the American Music Therapy Association. In addition, they must complete 1,200 hours of clinical training and show competence in the areas of voice, piano, guitar and percussion.
In addition to helping achieve the patient’s clinical goals, music therapy also allows the hospice patient – if they are so inclined – to create a musical gift as a legacy for their family. Burkart told us about a man who changed the words to “Twinkle Twinkle Little Star” and created CDs so that his grandchildren could hear his voice and his message of love after he was gone. Another man, who loved his family dearly but had trouble saying the words, was able to do so in song; his recording was played at his funeral.
Burkart’s passion for her work and devotion to her patients was evident throughout the discussion. She spoke of how she tailors her approach to the individual’s in-the-moment needs. For one patient, she played a reverie harp, a small, egg-shaped instrument made of wood that can be cradled in the player’s arms. “The strings are tuned to make one harmonious chord,” Burkart says. “It has a heavenly sound.” Another patient said she missed the sounds of the ocean, so on her next visit Burkart brought an ocean drum, a percussion instrument which produces soothing ocean-like sounds, and can even create the sound of crashing waves.
Music therapy may have benefits that last far beyond the session. Burkart says, “Music activates every single region of the brain. A person who can’t speak may still be able to sing, as song is retrieved from a different part of the brain. And this retrieval can lead to the creation of new neural pathways.”
Burkart has seen more than 230 patients in her tenure at the VNA, which dates back to early 2015, and she typically carries a caseload of 30-35 patients. Amazingly, she is the only MT-BC in Indian River County, although there are about 300 in Florida and more than 6,000 nationwide.
Burkart shared tips for caregivers who want to provide a safe and beneficial music experience for their loved ones with Alzheimer’s or dementia, including:
• Create a space that is conducive to promoting relaxation and attention.
• Play music (live or recorded) from the person’s teenage years and early 20s, as that’s when most musical memories are formed.
• Watch for negative physical responses – music can be overstimulating or trigger bad memories.
• Be aware of the volume of the music and match it to your loved one’s needs.
• Remember that music that may be relaxing to you may not be relaxing to your loved one.
• If the person loves nature, recordings with nature sounds can be beneficial.
• Encourage reminiscing and sharing of memories, and leave space to listen.
While the music is playing, there are things the caregiver can consider doing (based on the person’s health and needs): encourage singing, talk about the songs being played, hold or massage their hand – and perhaps even dance.
The 2014 documentary “Alive Inside: A Story of Music & Memory” follows social worker Dan Cohen as he uses music to unlock memory in nursing-home patients with Alzheimer’s disease. (The film is available on Netflix and Amazon.)
In his book “Musicophilia,” the late neurologist and author Oliver Sacks explains the deep reach of music therapy for individuals with problems such as Alzheimer’s disease and related dementias: “While music can affect all of us – calm us, animate us, comfort us, thrill us, or serve to organize and synchronize us at work or play – it may be especially powerful and have great therapeutic potential for patients with a variety of neurological conditions. Such people may respond powerfully and specifically to music (and, sometimes, to little else).”
The Center for Spiritual Care (www.centerforspiritualcare.org) is a non-profit organization led by co-founder and Executive Director Carol Ludwig. Among other endeavors, it provides individual and group spiritual direction to people seeking deeper meaning in their lives and relationships. The Center’s main number is 772-567-1233.
For more information about VNA home health and hospice services, including music therapy, call 772-567-5551 or visit www.vnatc.com. Caregivers can contact the VNA for more guidance about providing safe and beneficial music experiences for their loved ones.
