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Sunday, June 24, 2012

A Bridge to Betsy's World

                                                                                                        Photo Source

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.  


Bica said...

This story gives me goosebumps - I love that you were able to find this "bridge" for Betsy to traverse.


A wonderful story, I started playing the piano at 2 yrs and had proper lessons at 4 yrs and passed many examinations. I too loved and still do classical music though I always play modern music on my blog.
Wonderful read Doris.


Beth Stilborn said...

Thank you to this testament to the power of music -- and to caring persistence in finding the way to reach a seemingly unreachable individual.

There are tears in my eyes. I will share the link to this post with my facebook friends -- it is so powerful and so uplifting.

Inger said...

This is truly an uplifting post. I had read that music is a way to reach these patients, but I never read anything this powerful and meaningful before. You are not only a wonderful social worker, but a wonderful writer as well. I enjoyed you post about your dad too.

John said...

It is nice to see an idea, shared and used, become a reality that connects you to the patient and the patient to you. Nicely done!

A Plain Observer said...

so you like classical music too, ahhh another colombian connection. I wonder how Betsy reach if she heard a live piano player, if she sat watching a piano player in her nursing home.

Rita said...

Wow! That was beautiful! I'm grinning from ear to ear. :):)

dolorah said...

Brilliant. I'm so glad you were able to elicit a response and know Betsy is still in there. A lovely story.


Mariette VandenMunckhof-Vedder said...

Dearest Doris,

You are a very smart analyst. Not only her passion for piano music but also the fact that she learned it from her mother as a young girl. The earliest memories survive the longest and this proved again true.
Love to you,

Lillie Ammann said...

A wonderful story, Doris, proving that there's often more there than we can tell in Alzheimer's patients.

Anonymous said...

Beautiful, Doris, and very powerful in its message of music being a conduit for memories and how the fingers seem to have memories of their own (as many piano players can undoubtedly testify to). Someday when I am very old, I will tap out sentences on the imaginary keyboard on my bed. Hey, I already do that!

Mimi said...

brilliant! I had despaired of my father getting any pleasure out of life when he was languishing in an ALzheimers home. But every tuesday at 10am a lady with a keyboard came. When she played one of his favorites, he would belt out the words along with her; very well and dramatically. I was stunned. Yes, that's definitely quality of life. Music is a wonderful thing.

Amrita said...

such a beautiful story. Music therapy it was. You are sure a caring person Doris, you went the extra mile to reach out to Betsy

steveroni said...

Sur hope if I get to that point in a home like where you work, someone will bring in a violin--or at least a CD of an artist playing the Brahms, or Beethoven, or Wieniawski violin concertos--or Mozart...Oh!

So many will learn so much and become so helpful to others--at least in their understanding. You are teaching us to find that connection with the mind and soul of a Peep in dementia.

Note: I've got to put you on my sidebar--or I miss these gems of spirituality by you. OK!

Oregon Gifts of Comfort and Joy said...

I am so glad that you kept trying!

Kathy M.

Mary Aalgaard said...

Excellent post. I felt like you could be writing about me when I'm the elderly patient. How brilliant of you to touch her fingertips so that she had the sensory response to the music. I'm going to share this post with my memory advocates group.
Thank you!

Play off the Page

Linda Myers said...

How wonderful of you to explore that bridge.

Hilary Melton-Butcher said...

Hi Doris .. I know my mother realised people's souls beneath the earthly facade when she owned her Care Home - I just wish there was someone like her for the patients up at this Nursing Centre, where she is. I can do things for my mother .. it's others I 'worry' about ..

You are a star - great to read .. cheers Hilary

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