66 Projects

Dreading the Drama

Harper went to work like she normally would any other Monday morning. And, like normal, she went to her desk to check emails before her boss came in to give her instructions for the day’s tasks. A couple minutes later, her boss walked in, and Harper went to meet her at her desk in the back. Everything was as normal for the first few minutes, but suddenly, Harper began to feel off.

The last thing she remembered hearing clearly was, “How did imaging go yesterday?”. Then, Harper felt as if she had just entered a soundproof sauna. Beads of sweat began to form on her forehead, and the normally bustling office suddenly became silent. She watched as her boss’s mouth moved, forming words, but not a single sound was reaching her ears. What is happening? But before Harper could think of a logical answer, she became much more concerned with the feeling of a volcano that was about to erupt in her stomach. Her stomach churned as more and more saliva bubbled up and into her mouth. Harper felt as though the volcano inside her was about to erupt, so she interrupted her inaudible boss, “I don’t feel very good; I’m going to run to the bathroom.” She turned to go as her boss’s lips moved forming words Harper still couldn’t hear – all that she understood was a slow nod accompanied by eyebrows furrowed in concern. Harper only made it a few steps towards the door before her legs began to shake like leaves in a sudden gust of wind. She grabbed for the wall for support, but the gust became a cyclone, and Harper fell to the floor in a heap.

Now, Harper sat in a room that smelled of rubbing alcohol as her mother stared at her like she was an injured puppy. She recalled the conversation that brought her there:

“Mom, it’s nothing!”

“How is it nothing, Harper? It keeps happening!”

“They’re not going to find anything wrong with me, and then they’re gonna think I’m being dramatic. That’s so embarrassing!”

“I don’t care if it’s embarrassing. I’d rather have them check it out than something terrible happen to you.”

“Mom, please just – ”

“No, you’re going to the doctor.”

As they sat there in silence waiting for the doctor to come in, Harper thought of all the other times she had sat in this same position. One specific encounter kept entering her head. It happened about a year ago when she had hit a volleyball wrong in gym class, and the couple days following, she wasn’t able to straighten her finger. So, she went to the doctor to have it looked at, but the doctor just dismissed her saying it was only jammed a little. Harper left that appointment feeling judged and embarrassed. Now, as a pre-med student, Harper often thought about her future patients and how she hoped to never make them feel the way she did that day.

Knock, knock. The door opened, and a smiling woman in a white lab coat peeked in. As the doctor sat in her wheely chair, she exchanged niceties with Harper and her mother. Then she went through the routine questions – what’s your name, what’s your birthday, are you currently taking any medications? Eventually, she asked the question Harper dreaded most, “So, Harper, why are you here today?”. Harper drew in a deep breath before she began explaining how she kept experiencing random episodes of fainting.

“How often does this occur?”

“Um, like once every couple months, I think,” Harper lied, knowing it was much closer to once a month, if not twice.

“Okay, and what symptoms do you experience before you faint?”

Harper lied again, diminishing the severity of what she felt right before she fainted. Maybe, if I downplay everything, she won’t think I’m a drama queen. The doctor stood as she reached for her stethoscope. Just as Harper had expected, the doctor was going to listen to a few deep breaths before she told Harper that it’s nothing to worry about. As the doctor listened to Harper’s heart, Harper’s face flushed thinking that she had already been labeled as dramatic. But as Harper watched the doctor work, she unexpectedly saw uneasiness in her eyes and a stiffness in her shoulders. The doctor finished her examination, and to Harper’s surprise she said, “So, I’m going to order you an ECG for later today. Will you be able to make that?” Harper nodded silently as she saw her mom’s body tense in the chair in the corner.

After the ECG, Harper and her mother were told that the doctor would call with results in a couple hours. The hours between the doctor appointment and when the phone finally rang were mostly silent. It was 5pm when the phone rang. Before she answered, Harper’s mom put the call on speaker so Harper could hear.

“Hello?”

“Hi, this is Doctor Green calling with Harper’s ECG results.”

“Okay…”

“Is Harper nearby? I want you both to hear this.”

Harper’s mom clutched her chest, “Yes, she’s here.”

“So, after looking at the ECG test results, it looks like Harper has a heart arrhythmia which means she has an irregular heartbeat. I want to schedule an appointment, so we can discuss treatment.”

Looking back, Harper remembered being in complete shock after she heard that news. A heart arrhythmia? She had learned about this condition in her classes, and Harper knew that heart arrhythmias were no joke. She remembered going through all of the possible outcomes of an untreated heart arrhythmia in her head. Stroke, heart failure, cardiac arrest. Sudden and unexpected death.

At the follow-up appointment, Harper was prescribed a medication to help regulate her heartbeat, and for the next few months she would have regular check-ups to monitor her progress, but in the end, she would be fine. It was only after if this appointment when she realized that things could have gone very differently.

After she got home from the doctor’s office with her dad, the first thing Harper did was give her mom a hug, and said, “Thank you for being a drama queen.”

I started making music when I began piano lessons as a child – when I was in fourth or fifth grade. Originally, this was not something that I really wanted to do, but my parents thought it was important that all of their children were well-rounded, signing us up for everything including piano lessons, sports, boy/girl scouts, and more. So, my two siblings and I began piano lessons, but I took lessons longer than both of them – partly because I started to love it, and partly because it got me out of having to join the school band.

I make music by playing the piano. When I was younger, I would sometimes record myself playing and even sometimes have my younger sister join in by singing the lyrics that accompanied the piece I was playing. Now, I just play for fun and for the nostalgia of it.

The music I make usually comes from a score. I always go back to playing songs that I got good at playing when I was young. Some of my favorite pieces to play are “Amazing Grace”, “Mr. Bojangles”, and “Greatest Love of All”. I also really enjoy playing pieces from Disney movies such as “A Whole New World” from Aladdin and “Colors of the Wind” from Pocahontas. In some cases when I don’t like the way a song ends, I will try to write my own ending for it.

I usually make music either when I’m alone or when family is around. When I was younger and taking piano lessons, I would practice with my siblings. My dad would listen as I practiced and make sure to let me know if I had played a wrong note. My mom just liked to listen to me play. My grandma loved when I played, and anytime she came over, she would ask me to play for her. One Christmas when my whole family was at my house, my grandma asked if I could play some Christmas carols for her, so I did. My whole family ended up listening and giving requests as I played.

When I was making music when I was younger, I was focused on improving my skills so I could go to my next piano lesson and show my teacher that I had been practicing. Sometimes it felt like a chore; sometimes it could feel stressful. But now that I just do it for the fun of it – for my own fulfillment – it makes me feel at peace. When I’m at home and playing the piano, I don’t have any worries. I’m back in my childhood home – I don’t have to worry about school, and grades, and jobs. I’m playing songs that I love – that bring me back to my childhood. Sitting down on the piano bench releases the tension I seem to always hold in my body. The nostalgia takes over, and I am a kid again. No worries, just me and my music.

Melodies for Memory: A Music Therapy Training Program for Nurses to Support Dementia Care

Caring for dementia patients presents significant challenges, particularly in managing behavioral and psychological symptoms such as agitation, aggression, and anxiety. Music therapy has emerged as a powerful, non-pharmacological approach to addressing these symptoms, yet its implementation in nursing homes remains limited due to a lack of trained staff. My grandma lived in a nursing home for the last few years of her life, and I know that there were days when her anxiety made taking care of her a lot harder. She passed a few months ago – right around the time when we were learning about music therapy in class. Now, I look back at her time in the nursing home and wonder if it could have been better for her had I known about music therapy earlier. Would it have made her happier? Would it have made caring for her easier?

Nurses face many difficulties when caring for dementia patients. Music therapy has been shown to help patients with dementia, but nurses are rarely trained in music therapy. How is the health of dementia patients affected when nurses are able to administer music therapy?

Research highlights the efficacy of music therapy in mitigating behavioral and psychological symptoms of dementia (BPSD), suggesting it as a promising intervention for improving patient well-being. Gerdner (2000) emphasizes that music therapy in nursing homes reduces agitation, aggression, and verbally disruptive behaviors while enhancing food consumption; however, more studies are needed to assess its implementation by trained nursing home staff. Building on this, Raglio et al. (2008) demonstrated that sixteen weeks of music therapy significantly improved BPSD and neuropsychiatric inventory (NPI) scores, alongside increased active participation. Similarly, Svansdottir and Snaedal (2006) found reductions in anxiety, aggression, and activity disturbances, though the effects were short-lived, lasting less than four weeks.

Live music appears particularly impactful. Holmes et al. (2006) found that live-interaction music effectively alleviated apathy and fostered immediate positive engagement in dementia patients, outperforming pre-recorded music, which showed limited but non-harmful effects. These findings collectively suggest that music therapy, especially live or interactive formats, holds significant potential to address BPSD, though questions remain about sustaining its benefits over time and optimizing its delivery by caregivers.

Despite its demonstrated effectiveness, a significant gap persists in the implementation of music therapy within nursing homes, largely due to a lack of trained staff. Because of the gap in the implementation of music therapy within nursing homes, there is also a significant gap in the understanding and research of the long-term benefits of consistent music therapy.

To address this issue, I propose the implementation of music therapy training into the nursing curriculum or the development of a specialized music therapy certification for nurses. By equipping nurses with the skills necessary to administer music therapy, we can ensure that this beneficial intervention is readily available in nursing homes, fostering consistent, patient-centered care.

The proposed implementation would focus on creating a workforce of nurses proficient in music therapy, capable of addressing the emotional and psychological needs of dementia patients. Music therapy evokes a range of emotions in participants, and trained nurses would be well-equipped to guide patients through these experiences, creating a therapeutic and supportive environment. This intervention aims to bridge the gap in current care practices and elevate the standard of dementia care by providing an accessible and sustainable solution.

Several challenges may arise during the implementation of this initiative. First, gaining acceptance and buy-in from nursing schools could prove difficult, as these institutions may resist adding new courses to an already rigorous curriculum. Similarly, nursing home administrators might hesitate to prioritize music therapy training over other pressing medical needs. To overcome these challenges, it will be essential to emphasize the long-term benefits of music therapy, such as reduced reliance on pharmacological treatments and improved patient satisfaction.

Funding represents another significant barrier. Developing and implementing a music therapy course or certification program will require financial resources for hiring qualified instructors, purchasing materials, and covering administrative expenses. Securing grants from government agencies or private healthcare organizations could provide the financial support needed.

Awareness and recruitment pose additional challenges. Nurses and nursing students may not immediately recognize the value of pursuing music therapy training. Targeted efforts to raise awareness about the benefits of music therapy, both for patients and professionals, will be critical. Finally, integrating music therapy into existing workflows in nursing homes may require adjustments to policies and schedules, necessitating a collaborative approach with administrators and staff.

To implement this initiative, several key resources will be required. Financial support will be essential to develop the curriculum and offer scholarships or incentives for nurses to participate. Collaboration with universities, nursing schools, and professional organizations will help design and accredit the program, ensuring its credibility and effectiveness. Nursing schools and healthcare facilities will need to provide spaces for practical training and clinical application of music therapy techniques. Additionally, qualified instructors with expertise in music therapy and dementia care will be necessary to lead the training programs.

The primary audiences for this initiative are nursing schools, nurses and nursing students, healthcare administrators, and caregivers. Nursing school faculty and administrators will play a key role in adopting the music therapy course or certification program. Nurses and nursing students represent the target group for enrollment, as they will directly implement music therapy in clinical settings. Healthcare administrators must recognize the value of having trained music therapy professionals on staff, while caregivers and families will benefit from increased awareness of music therapy’s availability and advantages.

This project aims to benefit multiple stakeholders. Dementia patients stand to gain the most, as they will experience reduced anxiety, agitation, and apathy, leading to an improved quality of life. Nursing homes will also benefit through enhanced patient satisfaction, better management of BPSD, and potentially reduced reliance on pharmacological interventions. For the nursing profession, music therapy training will provide nurses with a valuable skillset, making them more versatile and effective caregivers. Additionally, this initiative addresses a gap in the integration of non-pharmacological therapies in dementia care, setting a precedent for similar innovations in other areas of healthcare.

The program could begin modestly with pilot courses at select nursing schools or community colleges. If successful, it could be scaled to become a standard component of nursing education, supported by ongoing research into its effectiveness. Establishing partnerships with healthcare institutions and policymakers will be key to ensuring the program’s sustainability. By fostering these collaborations, this initiative has the potential to become an integral and enduring part of dementia care, providing long-term benefits for patients, caregivers, and the healthcare system as a whole.

In summary, caring for dementia patients requires innovative and compassionate approaches to address the challenges posed by behavioral and psychological symptoms. Music therapy has demonstrated its potential as a powerful non-pharmacological intervention, yet its implementation remains underutilized due to a lack of trained staff. This initiative, which proposes integrating music therapy training into the nursing curriculum or developing a certification program for nurses, seeks to bridge this gap.

By equipping nurses with music therapy skills, we aim to provide consistent, patient-centered care that enhances the well-being of dementia patients, reduces the reliance on pharmacological treatments, and supports caregivers. Anticipated outcomes include improved quality of life for patients, increased satisfaction for families and caregivers, and a more holistic approach to dementia care within nursing homes.

Though challenges such as funding, curriculum integration, and institutional buy-in must be addressed, targeted efforts to raise awareness and build partnerships can overcome these barriers. By starting with pilot programs and scaling up based on success, this initiative has the potential to transform dementia care, honoring the dignity of patients like my grandma while empowering nurses to deliver compassionate, effective support.

References

Gerdner, L. A. (2005, January 10). Music, art, and recreational therapies in the treatment of behavioral and psychological symptoms of dementia: International psychogeriatrics. Cambridge Core. https://doi.org/10.1017/s1041610200007286

Raglio, A., et al. (2008, April). Efficacy of music therapy in the treatment of behavioral… : Alzheimer disease & associated disorders. LWW. https://doi.org/10.1097/wad.0b013e3181630b6f

Holmes, C., Knights, A., Dean, C., Hodkinson, S., & Hopkins, V. (2006, June 29). Keep music live: Music and the alleviation of apathy in dementia subjects: International psychogeriatrics. Cambridge Core. https://doi.org/10.1017/s1041610206003887

Svansdottir, H. B., & Snaedal, J. (2006, April 18). Music therapy in moderate and severe dementia of alzheimer’s type: A case–control study: International psychogeriatrics. Cambridge Core. https://doi.org/10.1017/s1041610206003206

ChatGPT was used for spelling and grammatical errors in my completed paper.

Research Rabbit was used to find similar primary sources to one I had already found.