By Jennifer W. Paquette, DMin, BCC
It was the season of Advent and several hundred people packed into the Chapel of Providence Mount St. Vincent to hear the choristers from St. James Cathedral in Seattle. The choir began with a familiar Christmas hymn, and I watched as a woman in the audience joined in for all five verses, her voice melodious and pleasing. Her arms glided through the air, a breath in advance of every change in tempo, as though she were the conductor. I was stunned. I was new to “the Mount” yet knew this woman to be far along in her journey with dementia. She rarely spoke more than a monosyllable, and I experienced her as lethargic and flat in our encounters. On this afternoon, she sat on the end of the pew two rows opposite me and was transformed before my eyes. Through the music, she became engaged, alive, energetic, and fully in sync with the melody. There was a sweetness, a lightness, an enchantment about her that I had never experienced. She sang without a sheet of music to inform her, yet the music evoked a memory where remembrance otherwise evaded her. I did not understand the impact of music in dementia, but I knew I was witnessing something extraordinary. Clearly, music reached deep into the spirit. I vowed that day to understand this phenomenon and to invite a variety of musical talents to teach me how we could use music to touch the spirit, enabling joy and life for the residents.
I soon discovered Oliver Sacks, the physician well known for studying neurological disorders and the impact of music on the mind. His book Musicophilia: Tales of Music and the Brain was the subject of the 2009 PBS special titled “Musical Minds.” What his work taught me is that music has the capacity to engage the emotions, the imagination, even the creativity of the demented mind, whether watching or participating in the musical event. Indeed, the identity of the person is restored, even if only for a few moments, a vital and loving gift to an individual aware of the mind slipping away. This impact may be more profoundly evident where music has been an integral part of the pre-dementia experience, and so it was for this resident who had sung in a choir and was its sometimes director at an earlier time.
The French theologian Louis-Marie Chauvet once wrote, “We situate ourselves in the world in a way to find an identity that makes sense.” For the person with dementia, the evolving identity has no congruency with the past when the mind is increasingly unable to remember. In the context of a musical past, the only past that can be recalled, identity is restored along with hope. When the past is present the future is possible. For those moments, life is joyous.
A powerful affirmation of this concept took place in a YouTube video from two years ago.1 An elderly man with significant dementia had slipped into inertia. The staff desired to enliven his days through the use of an iPod and music he might enjoy. After listening to the music, the man was asked, “What does the music do to you?” He responded, “It gives me the feeling of love!” Then later, he added, “The Lord came to me and made me holy.” After all, it is our identity that we take before God. Everything else is inconsequential.
To be clear, music has been an integral component of the Mount experience for many years. Yet, its introduction as a conduit into the spirituality of the individual is quite new. We continually rethink our approach to its application. Our chapel is large, a size typical of an older Seattle church. We continue to invite high quality musical talent to perform in the chapel. Yet, we look for more intimate and interactive ways for music to lead us into the individual’s spirituality. We’ve taken the radical step of moving some of our Masses and other worship services, along with the music, out of the chapel and into the more intimate settings of the communal areas. The residents can see, hear, and touch one another, and engage in new ways through the music. One Mount community of residents has a weekly “Play and Praise,” where music and their collective voices, otherwise more often mute, share in thanksgiving for God’s goodness.
The art teacher at the Mount opened my eyes to added possibilities to bring the spirit alive. Several times each week she teaches classes to Mount residents who have dementia, never thinking specifically about how the spirit could be engaged, yet aware that it was happening. She showed me a “pepper” created by a resident. Surely it was a “pepper” to the artist, though it didn’t look like one to me. Nonetheless, the quality of the artwork, the refinement, and the delicacy of the colors were compelling coming from an individual who exhibited low cognitive ability. It was a portrait of reality for her. It had flowed from a place within of delicate beauty and grace.
Together the art teacher and I explored ways that we might tap into this inner depth of emotion and identity. She helped me to understand that asking the individual to paint a specific religious image, such as an angel or a cross, would likely be frustrating as we hold those images from our life experiences, often now closed to the mind with dementia. But what we could do is lead a discussion of religious concepts, have the “artists” evoke the meaning, and then ask each to draw his or her vision of the concept. For example, what does “hope” look like? Or “holiness?” This work is in its infancy, but we are hopeful that we can touch a deep, perhaps unexplored, center of the individual spirit. As the old man from the YouTube video said of that center, “The Lord came to me and made me holy.” We expect to find holiness.
Jennifer W. Paquette is director of spiritual care at Providence Mount St. Vincent in Seattle, WA.