“Henry is restored to himself!”

NPR had an amazing segment on All Things Considered yesterday, April 18th. The online version includes a six minute video demonstrating the power of music for people living with Alzheimer’s disease. I recommend listening to the segment and watching the video. In the video, a nursing home resident is “awakened”’ by music. An observer made the comment that because of music, “Henry is restored to himself.”

Henry, who is featured in this short video, is seen sitting “inert”, restrained, in a wheelchair. He lives in an “Alzheimer’s Unit” of a nursing home. Henry is depressed and non-responsive. Henry’s non-responsiveness reflects a moving into one’s own world, seeking relief from the barren, impersonal institutional environment that one lives in.
As you watch the video, note the environment Henry has lived in for ten years. You see people in wheelchairs lined up along the side of a hallway. Two women placed, one in front of the other, in total solitude in a depersonalized institutional environment. You see lines of people sitting in wheelchairs in a section of a large room, totally unengaged and uninvolved. You will see what is referred to as a “slumper”. This is an all-too-familiar sight in institutional nursing homes: an elder literally slumped in his/her wheelchair, many times with his/her head bent at a 90 degree angle.

Is it any wonder that people “check out” and become slumpers in such barren, impersonal environments? Is it any wonder that absenteeism and staff turnover in such institutions is incredibly high? To quote Steve Shields, these institutional environments are “lethal” to the spirit of residents and of staff. One’s living environment can easily and does lead to depression and withdrawal. There are multiple consequences for such individuals physically, socially and psychologically.

The Picker Institute has, commendably, funded the “Music and Memory” project which will undoubtedly enhance the quality of life for countless nursing home residents. Fortunately, Henry is one of them. If Dan Cohen, Project Director, had not come into Henry’s nursing home, would that institution has ever known that Henry loved music? Luckily, the staff did gain this important information – after Henry had been their resident for ten years!

The good news for nursing home residents today is the requirement for licensed nursing homes to complete a recently revised comprehensive assessment for each resident. That assessment is referred to as MDS 3.0 (Minimum Data Set [of information] version 3.0). This instrument is an excellent tool for getting to really know the resident. All care and services in the nursing home should then flow from that assessment. If Henry were just moving into the nursing home now, under the requirements of MDS 3.0, his daughter and other family members would be interviewed in order to learn much about Henry’s likes, habits, hobbies, preferences, strengths, abilities, needs, etc. Chelly could have told the nursing home staff what she says in the video: Dad “was fun-loving, every occasion he would come out with a song . . . .He was always into music” How sad that Henry had to wait ten years before this vital part of his life and personality was known to the staff and acknowledged by appropriate services.

What about persons who live in unlicensed nursing homes? Many sisters, brothers and priests live in their own convent or seminary headquarters and receive nursing home care there, legally, and without the requirement to be licensed.

There is no obligation – from a legal standpoint – for such centers to utilize the MDS 3.0. However, the staff leadership in these unlicensed communities should look into the advantages of completing an MDS on every brother, sister or priest in their care. There is no better tool available to assure that the staff knows – really knows – the resident.

For those of us who are not (yet) living in a nursing home, it behooves us to look to those we love who are, to those sisters or brothers whom we have known and with whom we have shared community and ministry for decades. It behooves us to advocate for them by making sure the staff does know each individual resident – as an individual – so that care and services appropriately build on that person’s habits, abilities, hobbies, strengths, preferences, habits and needs.

Staff persons who want to do the best they can for each resident will welcome this added information. Staff, in completing the MDS 3.0, will actively seek information from family members and friends, seeing these individuals as strong allies in their service to their residents..