I work as a music therapist in the stroke and neurology department of a large public hospital. Stroke patients arrive on our ward in the very acute stages of stroke treatment and recovery. Neurology patients may still be in the early stages of diagnosis or be receiving treatment for an ongoing neurological disorder that affects their ability to function in everyday. (Nadia, pictured on the right).
Each morning I attend an allied health multidisciplinary team handover to gain an overview of each patient’s diagnosis and current treatment plan. Some patients I will know already, others may be new on the ward and I will need to meet them and their families and explain how music therapy may be of benefit to them during their admission and in the weeks that follow.
Every patient on my ward will have a different presentation. They vary in age, social circumstances, diagnosis, long term prognosis and ability to talk, walk, understand, and remember. Then there are the psychological effects of illness, hospitalisation and adjusting to life with a different level of functioning.
All these variables and we haven’t even touched on their music history.
Every patient I meet will have their own unique relationship with music. It is my job to create sessions that utilise this relationship in a way that provides a positive therapeutic outcome for each patient. And this may vary each session we have together. Almost all sessions will involve the use of live music – predominantly voice and guitar.
Some stroke patients may have significant difficulty with talking but their ability to sing is unaffected as singing is processed differently to speech. Our sessions together will include singing favourite songs that I tailor in rhythm, speed, and other dynamics to facilitate participation by the patient. Engagement in this way allows them to experience their own voice again, use and maintain strength and function in all the muscles associated with voice production, and help the brain to find new ways to communicate and support vocal recovery.
Music is also a great motivator for movement. Playing and adapting songs to have the right combination of rhythm, cadence, and familiarity and enjoyment can promote movement that supports the ongoing physical rehabilitation work involved in returning movement to the body. I may also sit on one particular side of patient and play live music if they have difficulty orienting to this side after the stroke. This encourages them to orient to the source of the music and helps to overcome the neglect.
Sometimes music therapy sessions may be more about enhancing mood and quality of life. Sessions may be filled with familiar uplifting fun songs that engage other patients and families around them and become a shared group experience. In other sessions the music dynamics may need to be adapted to facilitate relaxation and a sense of peace.
Every day is filled with a unique combination of people, music, medicine and life stories. It really is a job where no day is ever the same as another. And it is always a privilege to play music for people at such an extraordinary moment in their life.