Article by Matt Gannon, Communications Coordinator & Trainer with Oregon Care Home Consulting & Training.

She walks quietly downstairs with the dogs to start the coffee and let them outside so they can get their fill of the morning air and do what dogs do. She prepares breakfast for our three dogs, two cats, a guinea pig, and a bearded dragon. She dishes their bowls and whispers lovely things to each one, but not before administering insulin to our geriatric and diabetic cat.
​ 
She runs out to the car to start the heater so she doesn't freeze on her way to work.

Now, it is time to prepare our kids' lunches for school, put fresh water in the pets' bowls, and put dog cartoons on TV so the dogs can finish their sleeping on the couch with full bellies in the living room next to the Christmas tree - while listening to Bluey, or some such show, before the rest of us wake. 

​She bundles up in her winter coat, grabs her coffee, and tells herself, "You got this, and you know why you are going to go and grind once again - you know why you are doing this. Deep breath....let's go." She goes out to the bitterly cold morning air and falling rain, and into the car. The house is still asleep, the sun has not yet risen, Christmas lights twinkle in the foggy rain from each home, and she's on her way.​

It's a short drive to the memory care community in our town, where there are elders who live out the remaining chapter of their lives. This is your mom, dad, grandma, grandpa, great-grandma, great-grandpa, neighbor, the people you always saw at church, who may have worked in your schools, built or maintained your streets and bridges, and who played a part in the community and society of your town.

People who lived full lives - who've raised children, grandchildren, and great-grandchildren, served their country and did it all the best way they knew how. And, now, in their later years, fate has delivered - dementia. This has landed them a residence and room at the memory care building and a seat at my wife's tables. These are our elders, and my wife, our children's mom, feeds them.

The time from the alarm waking her to pulling up to the parking lot is barely enough to prepare herself to answer the usual questions: who will show up today to work and who won't? Has that resident I love so much and who tells me she loves my food passed away since I was last there? What condition is my kitchen in and how far back will it set me to have to pick up the pieces of what someone else was supposed to do? Many unknowns, but one thing is known well -  the chances of walking into what "should be" is a rare and mostly non-existent occurrence. 

​No matter, people are depending on her, and the residents need to eat. She tells herself, "You can do this, and no matter what happens, they need me so they can eat, so here I am."​

Fighting back the emotions of facing the hard grind all over again, likely having to do it short-staffed (double the work), she stops for a moment and thinks of some of the brave, bleeding hearts who do work there, have worked there, and the good work and care they provide - her staff who she inspires with her unwavering standards and integrity to do the right thing always (and to wash their damn hands!), even when no one is watching because the residents deserve it. They look up to her and care about her and make it a point to let her know so, and she finds the strength to keep on going and do what needs to be done - she feeds our elders. ​

I worked as a dietary assistant, activities assistant, and certified nursing assistant in memory care for nearly a decade. I then worked as an administrator for memory care for some years. My private caregiving practice also led me to visit and serve my clients in many memory care communities across the Metropolitan area for over two decades. I know memory care and I know dementia care - it is my life's mission and passion to serve our elders who live with dementia.

The doors are locked, they can't get out, and people are losing who they are and what they have as they try to make any type of sense of their day-to-day life in memory care. To say the work can be hard is an understatement. It is not because of the residents who make it hard, they make it all worthwhile in fact. Rather, it is the lack of consistency and longevity of a quality team unit that gets in the way. It is certainly not for everyone. ​​

Taking care of yourself to better take care of others is talked about in this game, but put into action - training, mentoring, and support to see to it everyone can do this - this is not reality. So, instead, you have to save yourself to take care of yourself and you can only depend on yourself to do it, and lean on those who love you, to make sure your self-care is strong and true. And, wherever that leads you is the path you must be walking - even if it means your time in that particular place comes to an end at some point in the future.

When you care deeply about the work it can hurt deeply. It is not hard to care for the people, it is all of the rest of the crap that usually gets in the way. My wife has shown so much more than mere strength. She is a model of a giving heart of service, standing up for what is right, and holding people accountable - all of this to make sure the elders are fed.

What she teaches our children through the work she does is a lesson that is second to none in this world. We love her for it, we are proud of her, she is strong and brave and caring, and willing - all necessary traits the residents need in their support. She has these traits no doubt, and has exemplified this time and time again, day after day, seasons after season, year after year - she feeds our elders. ​

The day is done, and she arrives home to our menagerie, her family, who couldn't be happier to see her, knowing the work she's done, the differences she's made, the fatigue and sometimes heartache she feels, and the quality and taste of all she's put out in the work day to so many.

​How fortunate are we all, that she feeds our elders?​

Article by guest author Alexis Baker, MT-BC, CDP, owner of Bridgetown Music Therapy

As a music therapist, one of the questions I am asked all the time is “What exactly is music therapy?”
 
The formal definition of music therapy as defined by the American Music Therapy Association is:

“The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” (AMTA, 2019)
 
This definition can be broken into two parts:

1. It involves the use of evidence-based music interventions designed to accomplish specific goals based on the needs of an individual or group.
2. All of this happens within a therapeutic relationship, and that person is a credentialed professional music therapist.

 
To break these parts down further, evidence-based interventions are simply music-oriented experiences or activities such as singing, playing an instrument, moving to music, and songwriting, all of which have been studied and shown to be effective in promoting health and improving quality of life.
 
Next, music therapy is always goal oriented. The focus is using music to achieve specific, measurable goals and objectives. A few examples of general goal areas include improving communication abilities, increasing range of motion, reducing stress/anxiety, and promoting social connection. The music therapy process involves assessment, treatment planning, implementation, documentation, and evaluation.
 
Finally, music therapy is based on a therapeutic relationship which implies there’s an established relational bond involving rapport and consistency. This person is a professional board-certified music therapist. As a side note: According to the Certification Board for Music Therapists, there are currently only 10,000 board-certified music therapists in the U.S.
 
Music therapists go through rigorous training to enter the field as a certified and highly-trained professional. They complete a specialized bachelor’s degree in music therapy which is like a double major. Coursework covers a wide variety of areas including music theory, ear training, music history, psychology and human behavior, human anatomy, and therapeutic applications. Music therapists are required to be competent on four instruments: guitar, piano, voice, and percussion. Training also includes 1,200 clinical training hours. Following completion of all coursework and hours, they must take and pass a national board exam to earn the credentials MT-BC (Music Therapist-Board Certified). Recertification is every five years which requires the completion of 100 CMTE (Continuing Music Therapy Education) credits.
 
Music therapists can work with any age, all the way from babies in the womb or preemies in the neonatal intensive care unit (NICU) to older adults and end of life/hospice. Music therapists work in many kinds of settings including adult day programs, childcare programs, long term care, hospitals, schools, rehabilitative facilities, community health centers, hospice care, and private practice. Music therapists serve a wide variety of populations in these settings including but not limited to people with developmental disabilities, physical disabilities, mental health conditions, issues associated with aging, dementia and various other diagnoses, disabilities, or diseases. 

It’s exciting to hear about what music therapy is, but many people struggle to recognize it as a clearly defined practice. They see anything music-related and want to call it ‘music therapy.’ It’s true, music can function therapeutically in a myriad of ways, but the formal practice of music therapy is specific and limited, so let’s talk about what music therapy is not.

To put it simply, music therapy is not music education or music entertainment. It can involve aspects of education and entertainment. It can even sometimes look like education and entertainment, but music therapy is different from these two fields.

Music education is the structured teaching and learning of music theory, practice, and appreciation. It involves more than just learning to play instruments or sing—it encompasses a wide array of skills and knowledge, including reading music, understanding rhythm, harmony, and composition, and exploring music history. Music education fosters creativity and cultural understanding by introducing students to a variety of musical genres and traditions from around the world.
 
At its core, music education helps develop essential cognitive and motor skills. Studies have shown that learning music enhances memory, improves problem-solving abilities, and sharpens attention to detail. It also boosts emotional intelligence by providing an outlet for self-expression and understanding the emotions conveyed through music.
 
For learners of any age, music education often starts with basic concepts like rhythm and melody and gradually progresses to more advanced topics such as composition and performance. In academic settings, it is commonly taught through choir, band, or orchestra programs, allowing students to collaborate and learn teamwork.
 
Beyond the classroom, music education is accessible through private lessons, community programs, and online courses, making it available to people of all ages. Whether someone aspires to become a professional musician or simply wants to enjoy the personal and social benefits of music, education in music nurtures a lifelong appreciation for this art form while enhancing overall personal development.
 
Music education plays a vital role in shaping well-rounded individuals, enriching both their academic and emotional lives.

Music entertainment, on the other hand, is more of a receptive experience. It’s enjoying music for the value of being entertained.
 
Music entertainment is the broad field of performances, events, and productions centered around music as a source of enjoyment for audiences. It encompasses everything from live concerts, festivals, and DJ sets to recorded music, streaming services, and music videos. Whether experienced in person or through media platforms, music entertainment is a universal form of enjoyment that transcends language and cultural barriers.
 
At the heart of music entertainment is the connection between artists and audiences. Musicians and performers create experiences through their music that can evoke emotions, tell stories, or simply provide a fun atmosphere. These performances might be intimate acoustic sets or massive stadium concerts, where production elements such as lighting, sound effects, and visuals further enhance the experience.
 
In today’s digital age, music entertainment has expanded beyond live events to include various digital formats. Streaming platforms like Spotify and YouTube allow people to access vast libraries of music from artists worldwide, while social media enables fans to interact with their favorite musicians directly. Music videos, television shows, and films that feature or are centered around music have become key parts of the entertainment industry.
 
Ultimately, music entertainment is about creating memorable, emotional, and engaging experiences. It serves as a means of relaxation, celebration, and connection, providing joy and excitement for individuals and communities alike. From the casual listener to the devoted fan, music entertainment touches lives by bringing people together through the power of sound.

We are now aware there’s music therapy, music education, and music entertainment. All of these are important, and each serves various purposes. But what if something doesn’t fit the definition of formal music therapy? Or it’s not quite pure music entertainment, or it doesn’t fall under ‘music education’? There is one more term to introduce you to: ‘music engagement’.
 
Engagement is somewhat of a buzzword recently. Music engagement doesn’t have a formal definition, but it does offer a helpful description for things other than pure music therapy, entertainment, and education. Music engagement can incorporate elements of all three of the above. Music engagement is participating in music-based activities for the benefit of participating in music-based activities.
 
As a board-certified music therapist, I’m a huge supporter of music therapy services; however, having been in the field for the past 10+ years, I know that music therapy services can often be expensive and inaccessible. There just aren’t enough music therapists to serve all needs everywhere, especially within senior care. It can also be cost-prohibitive or difficult to access geographically. For example, what about rural areas? This presents several problems for which I wanted to find a solution.
 
I created our virtual music engagement program for many reasons. At the center of it all is my passion and mission in life to use music to make a difference in older adults living with dementia.

Second, this program was created in response to Covid. It started out as an alternative when the pandemic was limiting activities. It can still function in this way. Beyond Covid, however:

• it’s a cost-effective solution to life enrichment through music
• it’s a turn-key activity for busy care home providers and staff
• it’s accessible 24/7 with lots of variety to choose from
• it’s a high-quality alternative when other options simply don’t fit the budget or are inaccessible.

 
Finally, I created it as a music engagement program, for individuals and groups to ENGAGE with music for the purpose and benefits of engaging with music!

For more information about Bridgetown Music Therapy and our virtual music engagement program for care homes, click here.

​How long have you worked in the adult care home business?

The terms wandering and elopement are often used interchangeably; however, they are not exactly the same. Wandering is pacing or aimless walking. This generally takes place inside the home or facility, though it can also take place outside. These are the individuals you see who pace up and down the hallway, seemingly without direction.

Elopement, on the other hand, is the unplanned exiting of the home or facility. It commonly includes “exit-seeking behavior.” This exit-seeking behavior and elopement from the home puts residents at great risk of harm, as Miriam's story tragically illustrated.​

Article by Matt Gannon