The Power of Song: A Short Essay

Her name was Edith and she was a Presbyterian to the core.  She loved her church and her family and she especially loved her God. I met Edith towards the end of her life.  She was a resident at a nursing home where I started my career in healthcare as a certified nursing assistant. When we met, she was already in the later stages of dementia.  She needed help with a great many things, not because she couldn’t get around, but because she no longer understood what the toilet was used for and why she needed to eat food.  She did know how to make a bed (there were none better made in the entire building) and she loved to talk.  She was constantly talking. Unfortunately for the staff, she only spoke in a sort of jumbled gibberish.  I could catch certain words sometimes, but most of it was nonsensical. There was a delicacy with which we all worked with Mable; we had to watch out for her temper.  If she got angry, she was liable to haul out and punch someone. We spent our shifts gently guiding her through the day to keep her safe and clean and well fed. It was no easy task, but still it was manageable. 

Mable and I bonded when one day I decided to sing a hymn while I was giving her care. Within seconds of hearing the first verse, Mable stopped jabbering. She suddenly became very calm. She looked at me and she really listened. In that moment I felt as though I could truly communicate with Mable.  The words I said didn’t always have meaning to her but the song did. From that day forward I would always sing to her. I would guide her through getting washed up and ready for the day with a gentle touch and a song on my tongue. It felt good. I was connecting with her. The hymns would sooth her soul (as well as mine). One day she even tried to sing along. I delighted in these times. They were so very rewarding.

One week Mable seemed to be in a very special mood; she was refusing to do anything.  She wouldn’t change her clothes, she would let us wash her and she absolutely wouldn’t wear shoes. One of two things usually occurs when someone refuses care.  Either the aide or nurse finds a creative way to still administer the care or they take it as an excuse to stop trying.  Unfortunately, in my experience, the latter happens more often than the former.  So when I arrived at work one evening and heard from a nurse that Mable had been refusing care all day, I knew I had my job cut out for me. 

I went into her room to get her ready for bed. She wouldn’t do a single thing for me; she wouldn’t even move.  I tried everything in my repertoire and then some. No tactic worked, no gimmick tricked her, no request was heard. I sang all the old hymns I knew but to no avail. She would not be moved and she would certainly not be changed. I was so frustrated. I thought I had the magic touch with her. It was then that my CNA training came back to me.  I remembered discussing how to deal with people who are being difficult. If your patient is safe, it is ok to walk away and try to give care later. I gave her 15 minutes.  When I went back in, I was pleasantly surprised to find Mable up and about. She was making her bed.  It was a very simple segue from making the bed to turning down the bed, getting washed up to getting changed into her pajamas, and then into bed for the night. I was thrilled.  

Giving the best care possible is about meeting the needs of the patient in that moment.  Sometimes that means giving someone space so that when you come back to give care, they are in a better mental state.  Not all my patients throughout my career as a nurse will not be like Mable, but working with her and learning how to meet her needs has taught me a lot. Patient care can be tricky, difficult, and frustrating, but when you take the time to truly meet a patient’s needs, it can also be incredibly rewarding.