Occasionally in my work with private clients and older adults, I’ll experience a phase when it seems like everyone is “declining.” At least, that’s what they call it. After all, it is a common understanding that dementia is a degenerative disease. How could anyone cure a degenerative disease? Sounds pretty impossible.

There is a difference between healing and curing. Music therapy helps to heal. The way I see it, to be healed (even if only for a second) is to experience pleasure, peace, sense of relief, joy, epiphany, alignment, and/or faith. Healing can be measurable and observable, especially if demonstrated physically. Perhaps healing can lead up to a cure, but that’s not the point necessarily. That’s not always the goal. Healing is in-the-moment.

I got goosebumps galore when I read this powerful story about The Difference Between Curing and Healing, written by an MD.

The challenge in treating Alzheimer’s and dementia is accepting the fact that the goal of music therapy treatment is not always to rehabilitate or help the client completely regain functionality. Sometimes it is difficult to accept the less concrete goals of improving quality of life and creating meaningful moments when a sudden change occurs.

Perhaps the client’s face becomes noticeably slimmer. Perhaps the client no longer walks or talks. Perhaps the client no longer recognizes you or family members. Perhaps the client no longer looks at you.

If we can use music therapy to slow down degeneration or even regain a bit of functionality, then that is wonderful and fantastic! But the essence of my work with people who have Alzheimer’s and dementia is…


To open up a space where life is experienced in the fullest sense,

as it plays out in the moment,

and I serve as the facilitator to help make it easy.

Fortunately, remembering the essence of the work allows me to stay grounded and take action when something changes suddenly with my clients. Here’s what I do when I notice cognitive decline, loss of physical mobility, depression, or sudden change in any aspect of my client’s health:

1. Communicate with the team. If you notice any signs of decline, unusual temperament, different affect, and/or sudden change in behaviors, then let the team members know. Team members include other healthcare professionals, caregivers, social workers, and staff people.

2. Drop the guilt. Guilt is a major burnout enabler. If any guilt comes through for me, I feel it, acknowledge it, then test whether or not I’m ready to let it go. Guilt is normal to feel, so it doesn’t make sense to feel guilty for feeling guilty. But as soon as I realize how unproductive guilt is, it peels off like a banana. I think Tim Ringgold would agree. (See video below.)

3. Start fresh and new. Your client is now your new client, in whatever form he or she may take right after the change. This is a new starting point. A new baseline. In my mind, I’ll go through the entire scenario of introducing myself to the new, changed client. I still know personal information (family life, background, music preference, inclination towards specific movements, gestures, mannerisms, etc.), but I place that information into a new frame. The new client may come with a whole new set of daily living requirements.

Funny thing is that when I drop expectations of the new client to act like the old client, I can drop guilt like a bad habit.

Have you ever had someone in your life go through a sudden, noticeable change? How do you respond? What do you do?

If you liked this post, then you will love these:
Alzheimer’s Communication: Validation Versus Approval
Tribute to My Grandpa
5 Reasons for Music Therapy and Drumming at Independent Living Communities
Humbled and Thankful

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