Ep. 029 | Music Therapy & Dementia Part Two
Today, we chat with guest, Kaylee Tilton, a board-certified music therapist, about the popular misconceptions of music therapy in dementia care.
RESOURCES
Positive Approach to Care by Teepa Snow
TRANSCRIPT
Erica: Welcome, friends! You’re listening to The Feeling is Musical — as presented by the Snohomish County Music Project. My name is Erica Lee, and today, we are back, with part 2 of music therapy and dementia, with board-certified music therapist, Kaylee Tilton. Kaylee was born and raised in Edmunds, Washington, and studied music therapy and psychology at Berkley College of Music in Boston. She has been a board-certified music therapist for 5 ½ years, and practicing mainly in the field of memory care.
[Podcast intro music plays]
Erica: Sometimes, there’s some mystery around what music therapy is, particularly in memory care settings. I know that I have fielded a lot of questions from a lot of people we have contracts with in different memory care facilities, or people that are coming to us. What are some of the misconceptions that you are hearing about music therapy in the spaces that you work in?
Kaylee: That I just sing songs.
[Kaylee and Erica chuckle]
Kaylee: That’s the biggest one - that’s the most common one. Um, I think that is because music therapy, from the outside looking in, looks like we’re just having a bunch of fun - and it is really fun, that’s part of why it’s effective. But there’s a lot of therapeutic work that’s going on beneath the surface, and some of it’s really not immediately obvious - some of it is even invisible. So, if you’re just looking in and you see a person singing, you might just think, oh, big deal, they’re singing. But you might not understand the context - that that person usually speaks in what we call word salad, where their words come out all jumbled. You might look at somebody who’s - who’s passing, and I’m playing guitar, and you might think, oh, that’s nice, but the - you know, the person that’s passing isn’t even concious, so what does it matter?
Erica: Mmm —
Kaylee: If you look closely, you might see that their breathing. Pattern has synced up to my guitar. So a lot of these benefits are hard to see - you have to know what you’re looking for - and some of them are invisible if you don’t have the right medical monitoring tools. So, it’s easy to say like, oh, they’re just singing songs - because that’s what it looks like - but there’s so much more there going on beneath the surface.
Erica: Absolutely. And so, what do you do to help educate or advocate for music therapy in your spaces?
Kaylee: Good question. I think there are a few different audiences that need education on - on the efficacy of music therapy, and the misconceptions. So, one of those is the family members. If their loved one is enrolled in one-on-one sessions, I’ll send them a communication each time that I had a session with them - it’s not the same as the session notes, those are protected by HIPAA, but I will send them like, hey, I - I met with you’re mom today - we’re still working on goals of helping her redirect during sun downing hours, and improve the agitation and anxiety that comes with that. So I am really up front about why I am there and the work we’re doing - and how their loved one is doing - so there’s one - one population.
Another really important uh population to really advocate for - or to help them understand - are my bosses —
Erica: Mmm —
Kaylee: Right - the administration of the facility that I’m working for. Because, again, if they have a misconception about what music therapy is, and think, oh, well, she’s just - she’s just singing songs - she’s just playing guitar, then they might think, well why spend money on a music therapist, when I can just get somebody that has music skills —
Erica: Mmhmm —
Kaylee: and is - is not trained in this and isn’t gonna cost as much. I find that the best thing for that population - for the powers that be at your - [chuckles] at your community or your workplace —
[Erica chuckles]
Kaylee: is really giving them the hard data, and explaining how music - and the non-pharmalogical approach of music can really save us money. A lot of times it’s about the bottom line - a lot of times it is about money. And I also think, like, this conversation can be really uncomfortable for people within the profession - but it’s how - it’s how the economy works, and so it’s really important to understand how to have those conversations - and take the value that we understand is being created, and be able to translate that into a value proposition. And it’s really strange, and it feels not so great at first. But that’s the only way that people can access our services.
Erica: Yup. Exactly. Um - im - imagine during the pandemic - in memory care setting is extremely challenging.
Kaylee: Mmm
Erica: Um, and there’s just so much that is happening physically, emotionally, and I’m sure some like procedures are changing - and what is allowed and not allowed, etc.
Kaylee: Yeah.
Erica: SO, in those really difficult circumstances, what inspires you to continue on with your work?
Kaylee: You’re right - it has changed a lot, because keeping our residents physically healthy, um, when you really are faced with the decision, is the utmost importance. And sometimes you do things that keep them physically healthy but have detriments to their emotional health - so that’s where I come in to try to mitigate those impacts - because our residents are in isolation right now. It’s challenging no matter what way you slice it. So um, the reason that I stay in this work, and the reason that I’m really inspired to continue this work, comes down to something really simple - and that’s that I love my residents. I really, truly do. If - if any of your listeners are music therapists, they should be able to say, like without hesitation and really passionately, that they love the people they work with. Because, it is a difficult and demanding job, and you’ll burn out if that’s not your truth. If I’m like frustrated about something - if I have car troubles, or I got into an argument with my partner - it’s really making me have a bad day, holding space and using music with somebody in my workplace - with somebody who has dementia, and making those connections, really helps me put things into perspective about what really matters.
Erica: Mmm. I love that. I think most everybody, in a wide variety of quote unquote helping professions, can run into the risk of burnout - especially with the pandemic. I know I have voiced coming to the point in myself where I can feel burnout coming. But yeah - if you’re not committed to the work that you’re doing - if you don’t find some authentic joy - which is not - to me is not the same thing as finding happiness —
Kaylee: Mmm —
Erica: Then I would maybe reconsider what you’re doing - or like maybe why you’re there. ‘Cause maybe it’s not what you’re doing, but it’s why you showed up in the first place —
Kaylee: Right —
Erica: That it could have been a good reason. But maybe that it’s evolved - you’ve grown - and those are all good things. I don’t I definitely don’t believe that just because you started somewhere, you have to stay there for - quote unquote forever. But taking time to reevaluate that —
Kaylee: Yeah, one hundred percent. One of the other things I love about this population - there’s a million - that you can’t fake it with them. If you are - really inside you’re still carrying something, no matter what you say, they’re picking up on your energy and your nonverbal communication so much more.
Erica: Mmhmm.
Kaylee: Um, so you really have to do some work in mindfulness for the benefit of your clients. They deserve a you that is fully present to them and their needs.
Erica: Yes. Yes yes yes.
Kaylee: Mmm.
Erica: Um, so, in the settings that you’re in, can you tell me how you work interdisciplinary with other professionals - whether they’re creative arts professionals or otherwise?
Kaylee: Yeah. So, 2 parts. Um, I am still working as an employee at a long term care facility - I am working as a music therapist there, that’s my role. But then I also have my private practice and a new business venture that I launched this year. SO, first, in the long-term care setting, I work with the nursing team to help identify residents who would most benefit from one on one music therapy sessions. And this is not just, oh this person really loves music - because who doesn’t - but it’s - it’s this person is isolating, this person is withdrawing, this person has a - a change in condition. So then they’ll call on me for pain management, for behavior modification strategies, and often, those will be planned times when we know that those issues may arise for that resident, like during sun downing. But other times, they just call me on the radio, and they say, hey, um Henry is really agitated right now - before we try to give him some medication, Kaylee, can you come and try to calm him down —
Erica: Mmm —
Kaylee: And see if you can use music to help. So it’s really like a team effort. So that’s kinda how that works in long-term care. Then the other venture that I was kind of alluding to is called Creative Aging Northwest. This is something that I started this year - we started talking about it last year, but we really launched it this year. It’s uh myself, a licensed mental health counselor slash art therapist, and then a - a woman who is - it’s called Positive Approach to Care certified trainer. That’s something that I can delve into a little bit more when we talk about resources, but —
Erica: Sure —
Kaylee: It’s a Teepa Snow program, and she went through like a specific training and class about dementia - and this specific strategy for reaching people with dementia, and making sure that our care and our services are for their benefit, and that we’re truly understanding their communication. So the 3 of us together are hoping that when we open up more - offer some more in-person services with creative arts therapies and activities for folks living with dementia and their care partners.
Erica: Mmhmm.
Kaylee: Right now, in the - in the time of COVID, we’re offering resources, educational webinars, and all of this sort of stuff is online and is virtual. SO we’re trying to kind of reach our community that way.
Erica: Um, particularly when you were talking about the nursing staff - and also within Creative Aging Northwest - it’s so important that we partner with people outside of our profession. And I think it’s also important just to highlight how important relationships are in the work that we’re doing. The relationship between the therapist and the client, the therapist and the family, and the therapist and the nursing staff - or the - like whatever other professionals are in the room. Those people have valuable insights into like what’s happening.
Kaylee: Yeah. And then they become a professional ally for us that understands what music therapy is, how it works, and how it can benefit people - and that’s really wonderful. And then, of course, you - if you’re caring for somebody, you really wanna have strong relationships with every person on that team —
Erica: Mmm —
Kaylee: Who’s also caring for them. That you’re all on the same page working toward the same goal. And, you know, it takes a village - I know it’s cheesy to say —
[Erica laughs]
Kaylee: But like, that’s true.
Erica: Yes, no, absolutely. As a music therapist, what are some ways that families that maybe aren’t at the point that they’re in a long-term facility - or their loved one isn’t in a long-term facility, how can they be using music at home in the very early stages?
Kaylee: So one of the really critical things that they can be doing while they’re at home, and before their loved one is to the point that they need um outside care and a full team, is - usually at that point they’re still able to communicate with you re - pretty clearly. So start to have these conversations, and start to ask them about music that’s really important to them. This is music that’s really meaningful - music from their childhood, music that their mother used to sing. Are those associations with those songs positive are they negative? What songs did they dance to at prom, what was their wedding song, did they sing lullabies to their children? And then, when you experience these songs with your loved one, notice how that makes them react. Are there certain songs that always make them cry? Are there certain songs that make them wanna get up and dance? This is really, really important information, because that background knowledge of why that music is important to them, is so crucial.
But then, beyond that, like just make music part of your routine. Folks who have dementia can have a really hard time with transitions. So like, morning routine, bedtime, meal times, can be really hard to kinda switch from one thing to another. And music can be a really helpful tool for transitioning. SO if you use the same song to transition into bed time or transition into meal time, make that a part of the routine. They begin to associate that song with a switch. And then that makes that routine a lot more smooth.
Erica: Mmm! I wouldn’t have guessed that. That’s a brilliant idea.
Kaylee: It works wonders —
[Erica and Kaylee laugh]
Erica: Um, for people wanting to know more about music therapy in dementia, what resources can you point them to?
Kaylee: Well, I mentioned Teepa Snow earlier. She’s a huge, huge person and name to know in the dementia care community. Her program is called Positive Approach to care. She’s an incredible educator - an incredible advocate. Um, she’s absolutely essential to my practice, and I think her -her education should be standard procedure in the field —
Erica: Mmm —
Kaylee: Um, her website is TeepaSnow.com (t-e-e-p-a-snow dot com). Um, she has resources, from dementia 101, to COVID, to care partners,- everything. So she’s great. Alzheimer’s Association is also a really wonderful - they’ve got lots of resources, and a really wide network of national, international, and local organizations that they partner with to sup - provide support. So that is at alz.org.
And then, I would love to just plug Creative Aging Northwest. SO —
Erica: Please do it. Yes.
Kaylee: Yes, ma’am.
[Erica laughs]
Kaylee: [Chuckling] So, Teepa Snow, her Positive Approach to Care - one of my business partners is a certified trainer in Positive Approach to Care. As I mentioned, the other is a licensed mental health counselor and art therapist. And then, obviously, I’m a board certified music therapist. And we post helpful resources on our social media sites at least 3 times a week. And I really, truly believe in the work that we’re doing, and I think these resources can be really crucial - especially during this time of increased isolation, and increased unrest in society. You can find us at Creative Aging Northwest on any of your social media platforms. I think we’re most active on Facebook, so find us there.
Erica: Absolutely. Um, awesome. So I will put the resources that Kaylee’s talked about - she’s already sent them to me. They’ll be on our website - they’ll be on the episode notes for the podcast. If you want to know more abut the Music Project, our website is S as in Sam, C as in Cat, music project dot org (scmusicproject.org). You can also follow us on social media @SCMusicProject.
We are just starting this conversation about music therapy and dementia slash memory care slash hospice. So stay tuned over the next - I think it’s 5 or 6 weeks. We have a series of different episodes with different people in the memory care community talking about the impact of music therapy um and the way that it works in their different settings. Next week, we specifically have an episode with Marta Street from Brookdale. She’s not a therapist, but is somebody that has really advocated in the Brookdale spaces for music therapy to become part of the life of a resident - and what she sees in the value of that - in the value of paying for a music therapist over just general music entertainment.
If you enjoy the podcast - if you’re receiving any kind of value from the podcast, please subscribe so that you get notifications about when new episodes come out. Leave us a review - direct your friends, your family, you network. We are here to do education/advocacy for music therapy, and for the work music therapists are doing in Washington State, and all across the United States. SO, thank you again, Kaylee, for coming on and chatting with me today. I so appreciate your time and your wisdom and your expertise.
Kaylee: Thank you so much for having me, Erica. This has been a really lovely conversation.
Erica: Mmm.
Kaylee: And um, if you can’t tell, I really enjoy my work —
[Erica laughs]
Kaylee: And I also super enjoy talking about it [laughs].
Erica: [Chuckling] That’s awesome. I - no, I’m so glad we were able to connect. Thank yu, listeners, for listening, and we will talk to you next time.
[Podcast outro music plays]