Today I attended the team meeting at Lifepath Hospice for the first time. This is a Hopsice House in-patient facility where people are often not in residence for very long. This past week there were 11 deaths, kind of a record, even in this facility.

The first thing they do each week is review the deaths. It was so good for me to put together the faces with the names and get some closure wiht these people that I had been missing up till now.

After reviewing the deceased we moved on to the living, the existing patients and new arrivals. I was provided with a printout with diagnoses and other pertinent info for each patient as well as briefing on recent history and current conditions with each patient, spoken patiently and comassionately. I was impressed with the level of care on the part of all the staff.

When I finally went to visit patients with music, I was armed for the first time with real knowledge that I could draw on to make my plans for appropriate music and interaction.

My first pt. was purported to be very depressed and very sad especially when his wife was not with him. His wife was present today and I decided, as difficult at it felt, to begin with a slow, chant like, semi-improvisational sounding, piece in a minor key. I later found out that the chaplain on duty thought I had been affected by the meeting and I was playing my own feelings. It was difficult to walk into that room and play music that tried to match the sense of depression of this pt., but introspective music in a minor key can be inspirational as well, and both pt and spouse were engaged.

From here I moved very gradually over 20 or 30 minutes toward steady tempo and some major-minor, a waltz, a song in major, soothing, but uplifting, ending finally with a downright happy tune in a syncopated rhythm. The patient stayed engaged all the way.

Entrainment works!

My next patient was the exact opposite scenario and plan. She had been bouncing between overmedication and agitation. I confirmed her recent conditon with here spouse and decided on a plan to begin with fairly active Baroque music with a regular and insistent beat and motif. Gradually we moved through a waltz, a song, a hymn etc. ending with a soothing, freely rhythmic piece I call "Breathing Song" Even with an overactive family filling the room trying to force-feed this patient she sat with eyes closed and soaked up the music from one end to the other.

It works. Entrainment works. And knowing a thing or two about the patients history and current events helps it work so much better.

Thanks for allowing me to share. And thanks MHTP for the excellent training.

Lloyd J. Goldstein 11/10/04