Poker game for older adults

This music activity is a variation on poker that is probably best for groups of adults or geriatric patients. Of course, unlike the real game, there is no betting or cash prize at the end.

Materials needed for preparation:
Standard 52-card deck with the jokers removed
Permanent marker
Poster board
Velcro strips
Winning hands pdf

Prep-work:
1) On each playing card, write a song that is appropriate to your group of patients. It doesn't matter whether you prefer to write on the front or back of it, just don't write where the velcro strips are going to be attached.
2) Attach velcro strips to the center of the back of the card. When the card is stuck to the poster board, the number and suit of the card should face toward the patient. I prefer to attach the softer side of the velcro to the cards because the patients will be grabbing these and it is easier to the touch.
3) Draw a line down the center of the poster board and label the left side "Team A" and the right side "Team B."
4) Under each team side, attach five velcro pieces in a vertical line. Leave enough room for the height of a playing card between each strip. Remember that you are attaching whatever side of the velcro piece is OPPOSITE to that attached to the card. You should have 10 velcro pieces on your board altogether.
5) Attach the Winning Poker Hands pdf print-out to the back of the board as a reminder to you which hand wins. On the sheet, the possibilities are listed in rank order, with the highest hand (best combination) to the lowest hand (worst combination).

Materials needed in session:
Pre-made poster board
Pre-made playing cards
Bag/basket to place the cards in
Guitar
Sheet music, if necessary

Procedure:
1) Briefly explain the poker game. No need to get technical, just help them understand that each card a patient draws has a song printed on it that the whole group will sing.
2) Split the group into two teams. Decide which team goes first.
3) Offer a patient the bag full of cards. Instruct them to reach in and grab one without peeking.
4) Read the song printed on the card aloud. To increase cognitive functioning, have the patients guess the song or artist by offering clues.
5) Stick the song on the board under that team's name.
6) Sing the song printed on the card.
7) Next move to the second team. Repeat steps 3-6, alternating teams until all 10 velcro pieces on the board are filled.
8) Have a conversation about who won the game (refer to the Winning hands print-out). Discuss how the patients enjoyed the experience of playing this game.

This game is great for increasing cognitive functioning and social interaction. After each song, you might talk with the patients about past memories or song meanings.

Post-Friday Friday Five: Helpful tips, ideas, and resources

I made a few discoveries in this past week or two that were important in my music therapy-life. Of course, I want to share the things that helped me in hopes that they may help you!

P.S. This was intended as a Friday Five, but as it is in the music therapy world, we are constantly adapting to unexpected changes in plans.

1) Play Ball! music activity for geriatric clients. I was fortunate to come across this activity on Rachelle Norman's blog while looking for ideas for a session. I used it the next day and it went over beautifully!
2) Dry erase/wet erase white board trick. I found this genius songwriting tip on Michelle Erfurt's website. And if this trick wasn't brilliant enough already, Kat Fulton commented that smeared white board marker can be cured with nail polish remover.
3) Wikifonia lead sheets. Wikipedia, WikiHow, WikiAnswers, WikiBooks... now Wikifonia? Possibly the greatest Wiki ever created, this site provides sheet music for a long list of songs. In fact, this was the only place that I could find free chords for the Pennsylvania Polka. I don't know much about this site just yet, but I imagine some songs (like oldies) are easier to find than others. If you know more about Wikifonia, feel free to comment!
4) Online music games. To incorporate these in sessions, you'll have to be creative. But i believe there is a lot of potential for some of these games. Browse music games at sites like musicgames.us, PBS Kids, and Nickelodeon.
5) Preschool songs and activities. This site provides links to a number of ideas for development-related activities. Some examples include learning the days of the week, vowels, and creating a rain storm.

Hopefully you find these helpful! If anyone has more helpful tips and discoveries to add, I invite you to comment.

Friday five: singing traditional hymns versus gospel

I loved my experience in hospice. I'm not one that knew much about spiritual music when I went in, but I sure know a lot about it now. In fact, I really love some of the songs my patients enjoyed. One of the biggest challenges in hospice was understanding how to sing in a style that was authentic to the music your patient preferred. Here, I discuss singing in a traditional church style versus singing in a gospel style (which can be difficult to master).

Traditional hymns use a classical, church-singing voice. Everything you see on the sheet music is taken very literally.
1. No note embellishments. Straight-forward melody line. Limited vocal range.
2. Solemn, majestic tempo.
3. Use a very smooth voice, sing notes cleanly and exactly as they are on the page.
4. Play rhythm as it is written.
5. When playing guitar, finger pick or use a straight strum.

There are many different styles of gospel music, so I will speak very generally.
1. Notes can be embellished, repeated, etcetera, etcetera. Do almost whatever you want to make the melody "flashy." Uses a wide vocal range.
2. Songs are animated and enthusiastic!
3. Again, you are free to do almost anything you want with the melody. Add some "whoa's" and "oh yeah's" anywhere you see fit. Repeat, repeat, repeat words from the melody when you can. Many families that listen to gospel even create their own verses that are unique to that family. Learn them or create some of your own. Good opportunity for song-writing, p.s.!
4. Rhythms can be lengthened, shortened, widened, flattened, etcetera, etcetera.
5. Use mostly down-strums on the guitar.

Theses examples are extremes: either very traditional, or very gospel-like. Remember that different religions can be anything in-between. The best thing you can do is listen as your patients sing along. Take clues from them as to how they prefer to hear their spiritual music sung.

An activity that will be a lifesaver

Today at the BHC, I had a plan prepared for one of the units. I spent the morning putting it together, copying songs to a playlist on the computer. With 15 minutes to go-time, I plugged in the iPod only to find that the computer would not recognize the stupid machine. Not only that, but the iPod screen completely froze! And yes, we have another iPod but no, for complicated reasons we cannot play video from it.

What is one to do with an iPod full of music and no time to plan?

Music trivia! Music trivia for mental alertness, cognitive stimulation, and mood elevation.

Materials:
iPod and speakers
White board
Dry/erase markers

Task Analysis:
1) Split your group into two teams. Have them come up with a team name.
2) Decide who goes first (the team who has a person with the closest birthday goes first, for example).
3) Play a song for that team. Teams get one point for artist, one point for song title. You can throw in fun points here and there, like a point for dancing the Cupid Shuffle or a point for naming the movie that Eye Of the Tiger is famous for.
4) Repeat step 3, alternating between teams. If a team is at a loss for artist or title, you can allow the other team to "steal" their point.
5) Towards the end of the session, make it a "free for all." Anyone can guess at any time. Warning: you have to pay close attention to who guesses correctly first. It is hard when a few people shout it out at once.

I do not blindly choose songs either. There are two reasons that I can think of to rig the game this way. (A) I want to set the patient up for success. If they are slow to answer and points are popping up from everyone but that patient, play something you think they will know right off the bat. (B) I want to shape a person's mood. Today a patient came into session late. She planted herself right in front of me with arms crossed and started yelling at the staff. Well, my next song was Michael Jackson, something I really thought she'd enjoy. By the end of the hour she was dancing like crazy, smiling and laughing! It is awesome to see changes like that happen in front of you.

Friday Five: Staying age appropriate with older adults

Older adults are not like preschool children, so why do so many people talk to them as such? Bent over, face close, hands clasped, gaping smile, voice raised an octave and, "Evelyn, it's time for music, yay! Would you like music? How about some music!" I wrote the other day that older adults absolutely love when you talk enthusiastically with them. But I'm sure that they do not appreciate anyone talking down at them, trying to get them excited for something as if they are offering them a treat for good behavior.

Below are some tips on staying age appropriate with older adults. Forget the "sweeties" and "honeys," but don't be offended when they turn around and use these words with you.

1) Consider your volume. Of course, we often have to talk a lot louder than normal to compensate for any hearing loss. I have had to work a lot at this because I normally speak softly. However, don't assume right away that you'll need to put so much power into your voice that it vibrates your entire chest. I suggest starting at a normal volume (for me, that is a little louder than I am comfortable with), then take some quick cues from your clients as to how you should adjust it. When you see them squinting, tilting an ear towards you, or furrowing their brow as though they are concentrating a little too hard on what you're saying, take a hint that you may have to speak up a bit. Also, continue to remind yourself to speak consistently at that volume. If they have to ask, "Pardon me?" again and again, they may begin to feel discouraged and frustrated with making conversation.

2) Watch your tone of voice. It was something mom always told us, and I will say it again. Not for the same reason, of course. Watch your tone to make sure it doesn't start creeping up the register. We will talk to babies and dogs in this voice, but it is not okay to talk this way to an individual who has lived long and accomplished much.

3) Let them make choices. A lot of adults in hospice or nursing homes may feel like they have had all their freedom taken from them. They often don't get choices in what they wear, what they eat, etc. Create opportunities to offer them choices. Should we play "Let Me Call You Sweetheart" or "Danny Boy"? Also, if they get up to leave, there is usually not much you can or should do to keep them in session. They are adults, and you can't beg them to stay, or raise your voice, or block them off at the entrance. You can however, offer them an opportunity to join again when they feel like ready.

4) Keep conversation. Show genuine interest in your client. Talk with them on subjects they care about. I wrote a post the other day called Keeping Conversation When It Counts. Use this for topic ideas: family, travel, hobbies, memories, etc.

5) Play preferred music. You've heard this a hundred times, I'm sure. Learn as much as you can about your older adult's choice of music. If you know nothing about your client or group, you can take a smart guess at their music preference. People tend to like the music they listened to in their twenties and early thirties. Take their age, calculate when they were this old, then begin with whatever was popular at that time. Also consider gender, religion, and ethnicity. If it comes down to it, it does not hurt to ask. In fact, they may see you asking as a sign of complete respect.

Keeping conversation when it counts

Some of my happiest music therapy moments come from working with older adults in hospice and intergenerational choir. They absolutely glow when you smile and talk with them enthusiastically. But it can be hard to keep a conversation at times. As I returned each week to see my patient in hospice, it was hard to tell if she remembered who I was or what we've talked about before. I was also hesitant to approach certain topics because I didn't know how to segue from one thing into the next. I found it most helpful to know ahead of time some conversation starters. Here is a list of just a few:

1) Career. What did they do with their life, did they keep more than one job, where did they work, what did they enjoy about it?
2) Hometowns. Where were they born, did they spend much time there, did they live any other places, what was their favorite home, what was their house like, did they have good neighbors?
3) Travel. Where have they traveled, what was their most memorable trip, who did they go with, how long did they stay, what would they suggest someone see if they were going to travel to that place, do they have any stories they could share?
4) Family. Spouse, children, grandchildren, names, ages, their education, their careers, where do they live, how often do they visit, pets?
5) Hobbies. What is your favorite activity, how much time do you get to spend doing this, what would you like to learn, do you share this hobby with anyone else?
6) Current events. Have you heard about (blank), what do you think about that, what do you think we should do about it?
7) Things around the room. Decorations, jewelry, clothes, pictures, personal items.
8) Weather.
9) Religion. Be careful to respect their religion and don't offend. Don't share much of your own beliefs, especially if you disagree with theirs. Do show interest. Where do they go to worship, do they participate in choir, are they involved in any other way?
10) Friends. Where did they meet, what interests do they share, how long have they been friends, do they have kids/grandkids? You can basically ask everything above all over again in relation to their friends.
11) Future. What are they looking forward to doing today, do they have exciting plans in the near future, do they have family visiting soon?
12) Holidays. What are they doing to celebrate, do they have any good memories about that holiday past, what is their favorite holiday, what do they enjoy most about that holiday?
13) Memories. Wedding, birthdays, holidays, major events?
14) Other interests. Music, food, movies, television shows, books, games, sports etc.?