White walls, cold temperatures, screaming neighbors and people constantly running around.  Where is this magical place?  A nursing facility.  All are very unique, yet it is still difficult to find peace within these walls.  There are constant beeps and bells.  There’s always a nurse or certified nursing aide rushing in and out just trying to provide the best care for the resident.  A roommate or neighbor down the hall is screaming as they are confused and wanting to go home.  Still no peace.  Don’t think that hospitals are exempt from this peace-less feeling.  The sterile environment.  The trauma.  The fear.  Nope, no peace there either.

As a board-certified music therapist in the hospice setting, I venture to these buildings daily.  Most of the time, peace is cast on the outside of the building and even on the faces of some of the staff and residents, but is it really within?  How can the people obtain a piece of peace?  How can there be peace within the walls?  Two words.  Music therapy.

A recent case of mine included a hospice patient at a nursing facility who had been agitated the day before and facing the end of life.  The daughter was present and the patient was relatively calm when I arrived; however, when nurses came into the room and turned the patient, poked and prodded, talked loudly, opened and closed the door and left the door wide open when there were loud residents and staff in the hallway, my patient became agitated again.  Of course, the staff was doing their job, so I can’t fault them for that, but there was no peace.  How can this patient of mine regain the peace she once experienced?

As the environment remained peace-less, I realized that the music I was providing was the peace.  A piece of peace.  I wanted the patient to receive the whole “pie” or full circle of peace when all she needed was a small piece.  I focused on the patient, matched the patient’s movements and breathing and we were in sync with each other   I began to mold her breaths and movements by slowing the tempo of the music and taking deep breaths myself ( In music therapy land, we call that the iso-principle and entrainment).  The patient’s breathing slowed and even deepened.  As her eyes closed, the daughter rubbed the patient’s head and cried. Everything slowed and nearly stopped at that moment.  Peace was here.  There was a release of emotions from the daughter and a release of anxiety from the patient.  I hardly noticed the nurses rushing around.  The sound of the screaming residents became faint.  We achieved peace.  That’s what we all searched for.  It seems like if you want peace you can create it no matter where you are.  Music can provide an opportunity for peace to enter the space and surround the circumstance.  It can even overcome the circumstance.

Peace doesn’t always look that way, however.  Let’s set the scene again.  In an Intensive Care Unit (ICU) at a hospital; sterile, white, beeping, nurses in and out. This time, an extubation or the removal of life support was taking place.  Family surrounded the patient’s bedside.  The patient was in bed and awake, but unresponsive.  The patient’s daughter released blood curdling screams as she anticipated losing her mother after the tubes were removed.  There was no peace.  How could there be?  Emotions ran rampant.  Fear suffocated the room.  Luckily, the family agreed to utilizing music therapy services during the extubation.  I began to utilize live preferred music to create a familiar environment in such an unfamiliar place with an unfamiliar circumstance.  As the session progressed, one family member began to sing and then another and then another.  The fear that suffocated the room slowly released its grip as the family began to breathe or release.  Eventually, the entire room was filled with music.  Even the daughter’s screams shifted to singing.  Once the tube was removed from the patient, she breathed on her own for a few minutes and then passed away peacefully.  Peace was achieved.  The family continued to fill the room with singing.  We all wanted peace but weren’t sure what it would look like or how much we could attain.  It started as a small piece of peace and eventually grew into the entire pie or circle.

You see, everyone’s piece of peace looks different.  It may be small, it may be huge; however, there is one common ingredient: music.  In one case, the music decreased the sounds to quiet the environment which was peaceful to that particular patient and family.  In the other case, the music increased the sounds to fill the environment which was peaceful to that particular patient and family.

To achieve a piece of peace with your patients, families, friends or self, I encourage you to grab a piece of music, art, nature or whatever else gives you peace.  Maybe you will find you need more, or less or perhaps it is the right amount.  No matter what environment or circumstance, if you reach out for that piece of peace, you can achieve it.  I think to successfully grasp that piece of peace a release has to take place as noted in both cases.  In the first, the daughter released tears and the patient released breaths.  In the second case, the family released singing into the room.  The music allowed them to comfortably let go of what stole their peace.  Once their comfort levels increased, their peace was within reach.  Remember, your peace may not look like someone else’s or what you think it should look like.  Once you get your piece of peace, don’t let it go.  Hold on to it for as long as you can.  And if a person or circumstance enters your space and disturbs the peace, honor that moment of peace you had and reach for it again.  A piece of peace may be silence, listening to music, singing, smiling, hand holding or embracing.  There’s really no right or wrong way to achieve peace.  Of course, I believe the best way, is through music by a board-certified music therapist, but to keep the peace, I won’t tell you what to do!

What does your piece of peace look like?

Peace,

Msberrica