A Bridge to Betsy's World

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Betsy was in her own world.  A world we, on the outside, had little idea what was like for her on the inside, in her mind.

Aged in her nineties and diagnosed with end-stage dementia, Betsy’s daily routine in the nursing home was determined by what her caregivers anticipated her needs and wants may be on any given day. 


Betsy had lost her ability to communicate. Her dementia had stolen her words, and even her ability to make eye contact. The staff tried to keep her comfortable while she rested in her bed or her customized wheelchair. Betsy would look into space, sometimes moving her hands randomly, for no apparent reason. 


Betsy needed  assistance with her meals. I observed the aides patiently feeding her, spoonful by spoonful, with pureed food. 
  
I had visited with Betsy several times. I spoke to her, but she never responded, not even with her eyes. I tried sensory stimuli by applying lotion to her hands. I was uncertain if  she  enjoyed the stimulation, the gentile touching, at all. Perhaps I was simply an intruder in her private world.

My interest in Betsy grew stronger. I became more intrigued to bridge our two worlds.

Her family visited often. I was confident that Betsy could sense familiar voices and faces around her, and this would seem to please her. But again, Betsy’s cognitive impairment was so profound that she may have not known who was around. Nonetheless, the family was content with being there for her. They felt it was the right thing to do. And as their social worker, I assured them that was indeed the right thing to do!

“What is Betsy passionate about?” I asked Julie, Betsy’s daughter, during one of her visits. 

“Mother played the piano.” 

“I know she played the piano at church,” I recalled from my social services assessment. “Tell me more.”

“Mother’s interest in the piano comes from her childhood. My grandmother taught her to play the piano,” Julie said, proudly. “My grandmother loved classical music, and so Mother.”

“Did your Mom play the piano throughout her life?”

“That was her life!” Julie exclaimed. “She played at home, at church. She even taught piano lessons for a while.”

Julie had brought a radio to her mother’s room. It was normally tuned to a classical music station. I had no doubt Betsy liked to hear the music. But again, there was no indication of Betsy’s level of enjoyment other than her being calm. 

I continued observing Betsy. I pondered Julie’s statement about her life-long interest in the piano. I realized that Betsy and I had at least one thing in common—we both loved classical music. 

One day, as I was leafing through my CD collection, I came across my favorite classical music pianist: Chopin. Nocturnes were my preferred.  As I mused how divine Chopin’s Nocturnes were to my ears, an idea flashed in my mind. 

Betsy may like Chopin too. 

I brought a CD player and my Chopin’s Nocturnes album to Betsy’s room. She lay in bed, looking aimlessly above her, expressionless, moving her hands randomly, as usual. I plugged in the CD player, and pressed the “play” button.


As the music started to fill the air, she slightly moved her head toward the music coming from the CD player. She seemed calmer, but still expressionless. Another idea came to my mind. I gently reached for Betsy’s hands. I gently started tapping my finger tips against hers in measured time to the piano notes. 

Then something amazing happened.

Betsy’s fingers started dancing upon my hands as if she were playing the piano.


Excitement embraced me. I had somehow connected to Betsy in her world. I knew she was listening and enjoying the music. I knew she was feeling my touch. I knew her tactile memory had not vanished, despite her detrimental Alzheimer’s. 

Betsy, the pianist and classical music lover, was still alive, vibrant. I felt like I uncovered a radiant Betsy from under the facade of an elderly incapacitated lady. I had nothing but respect and admiration for the loving mother, compassionate church fellow, and pianist which lay before me.

And from that day on, Betsy was no longer lost in her own world. We had discovered a language to reach to the treasures in her mind—the language of music.