22 February 2015, Our Services
In the first part of the article, we found out more about music therapy from music intervention trainer Serena Lo. This week, one of our Star PALS mums shares her family’s experience.
Twelve-year-old Esther, who has been living with arthrogryposis since birth, depends heavily on her parents and domestic helper. Although her condition prevents her from speaking or moving, the bubbly girl communicates with heart-melting smiles and giggles.
Children under our paediatric programme, Star PALS, are given the opportunity to try music therapy with Serena, music intervention trainer. Esther and her family have gone through the sessions, and are enjoying it thoroughly.
We caught up with Mdm Chng, Esther’s mother and primary caregiver, to find out more.
HCA: How did you first get to know about music therapy?
Nurse Serene Wong is our primary nurse, and she noticed that Esther tended to smile and laugh when the nurses sang to her. She thought that Esther might benefit from the music therapy sessions with Serena.
HCA: What made you decide to proceed with the session?
Basically, in a parent’s heart, we always hope to do our best for our children. Honestly, we would try anything if we knew it has a chance of helping her.
Besides this, we’ve always known that Esther responds well to things she can hear, laughing when she listens to music and even conversations. I’ve also heard from her teachers in the Rainbow Centre that she enjoys music there as well.
HCA: What happened during the session?
I didn’t know what to expect at first. Then I saw how professional and systematic Serena was, unpacking all the things she had with her – the keyboard, and all the percussion instruments – I immediately began to record the session.
She started with a greeting song, where we sang ‘Say Hello’. She then introduced us to the all the different instruments she brought along, letting us hear the different sounds they produced.
Serena didn’t just play the instruments for Esther, but helped Esther feel the instrument, and “play” the instrument by holding her hand and moving it to use the instruments.
Throughout, Serena asked us to play along to the music and help Esther with the playing too so she could join in. We sang many different songs, and nearing the end Serena taught us to do the simple massage and Esther’s usual exercises to the music.
HCA: Were there any parts of the session that was specially planned for Esther?
Definitely! She asked us what Esther likes. When she found out that Esther laughs at repetitive sounds, she included songs like ‘Old Macdonald’, which Esther really enjoyed. She learned that Esther took a taxi to school, and changed the lyrics in ‘The Wheels of the Bus Goes Round and Round’ to ‘Esther Sits In A Yellow Taxi’. When she sang, ‘Weah! Weah! Weah!’ like a crying baby as part of the song, Esther really loved it!
HCA: How did Esther respond?
We were so surprised at how happy she was during the session! We had never seen her so stimulated and responsive. She was laughing and smiling throughout the session.
I felt so glad that I recorded the sessions. Sometimes, I play back the tape recording, or show Esther the video, and she gets as excited as she did during the session.
HCA: Was there a difference between letting Esther listen to normal music, and the music therapy process?
Yes. She was definitely a lot more stimulated during the session. I think the difference is that she usually listens passively, but Serena got her to take an active role this time by playing the instruments with us, and making the actions like us kissing her, or even her kissing us. I could see her thinking and processing the lyrics in the song.
HCA: How do you see music therapy factoring into Esther’s care moving forward?
Personally, I’m hoping to see more responses from Esther, and hoping it can even affect her range of motion. We’re looking forward to the next session already!
This February, Star PALS kick-started the Star PALS Empowerment Series to equip caregivers with useful skills that could help them in their journey.
The Star PALS Empowerment Series is targeted at the parents of the children under the Star PALS Programme. Composed of workshops by qualified speakers on a variety of subjects, the series is slated to be a bimonthly affair.
“A vital part of paediatric palliative care is supporting the patients’ loved ones,” said Ang Siang Ping, Medical Social Worker with Star PALS. “The Star PALS Empowerment Series will include all sorts of courses that we hope can help these caregivers reconnect with themselves.”
Medi Minder assignments were arranged in conjunction to the session to allow parents to take the time off caring for their children with peace of mind.
The very first session in this series was entitled, “When the going gets tough…coping strategies”, and was led by trainer Imelda Sutisna, Managing Principal Consultant & Master Trainer of JOURNEY Training & Consultancy, who specialises in imparting proven thinking processes to developing capabilities. Imelda has a wealth of experience in psychology and training and development.
By 9am, the HCA Auditorium was transformed into a cosy and welcoming environment with rugs, cushions and snack trays awaiting the parents. Two ladies from the British Association also joined in, very generously preparing an inviting spread of quiche, cake, and scones for refreshments.
When the participants were finally settled comfortably on the rugs and chatting with each other, Imelda began the session with a needs assessment. Working in teams, the parents discussed what sort of courses and sessions would be useful for them – from information on therapy aids like aromatherapy and hydrotherapy, to grooming techniques for the children, to more practical information such as generating passive income.
After this, Imelda moved into relationships – in the theme of Valentine’s Day, which coincided with the workshop. She asked the parents to share with each other the ways they support and strengthen their own relationships. Together, they brainstormed ways to improve their relationships,
Finally, they moved the discussion to brainstorming for ways to make the everyday fun and enjoyable for the whole family.
It became apparent that the parents had many ideas and experiences to share, and many important perspectives for each other to consider. Finally, the session had to come to an end before Imelda could continue on to the topics of adversity. She concluded with a final slide on the ‘Marriage Box’:
“Marriage at the start is an empty box. You must put something in before you can take anything out. A couple must learn the art and form the habit of giving, loving, serving, praising – keeping the box full.”‘
The participants most enjoyed learning from other like-minded individuals who had a deep understanding of the challenges they all faced. Although a majority of the parents weren’t acquainted before the session began, they were chatting like old friends and exchanging contacts by the end of the session.
“I’m glad that these parents are given the opportunity today to meet each other,” shared Imelda. ”I’m glad they also had a chance to get a break – some of our participants today seemed rather downcast and tired when they first came in. I also hope they’ll form a supportive network between each other.”
Star PALS would like to thank Imelda and her team of volunteers, as well as the British Association, for making the session a success.
05 January 2015, Our Services
Children under the Star PALS programme at HCA Hospice Care are provided with several sessions with music intervention trainer Serena Lo. What’s music therapy? We find out more from Serena.
HCA: What’s the theory behind music therapy? What makes music an effective way to help an individual?
Neurologic Music Therapy is defined as the therapeutic application of music to cognitive, sensory, and motor dysfunctions. In scientifically-based research, it’s been shown that music can stimulate multiple parts of the brain at one time, and even reconnect them. Through various techniques, music therapists make use of different kinds of music and its components to help patients in different ways – like in speech, gross and fine motor skills, and social skills.
Besides this, everyone knows how music can soothe the body, soul, and spirit. I see music as a vehicle, a language, and a tool, that can convey messages of love and emotion, and facilitate reconciliation and healing in relationships.
HCA: How do you tailor the therapy sessions for our Star PALS patients?
In Olive Tree Developmental Center, where I work with children with special needs, I compose songs and teach phonics, numbers, and reading through rhythm and music. Sometimes, I incorporate dance, movement, speech and drama when it’s appropriate to the challenge of the child.
The patients at Star PALS, however, are often bed-ridden with much more serious conditions. We need to be very observant of the parts of their body that can move and respond to beat and rhythm – it could be a foot, or even a finger. We then use a small drum or small percussion instrument so he or she can participate. I encourage caregivers to sing or play recorded music, massaging or performing their usual physiotherapy with the music.
I also use the sessions as a platform to bring the whole family together as a band. The more sounds from different instruments, the more the child’s brain is stimulated. Often, siblings may feel neglect or jealousy. It’s also a good opportunity to give them some attention, and rope them in as musicians to help. Sound is energy. When it is done with love and joy, it can do wonders to bond the family, bring comfort, and restore relationships.
HCA: Give us a rundown of what you’d normally line up for a one-hour session.
We begin with a greeting song, and songs of assurance for the patient, which we personalise by changing lyrics. I find out what are the child’s favourite songs, sometimes modifying lyrics to address the family’s needs and alleviate the tension the family is going through. Sometimes I compose new songs to encourage the child. I also ask the child if they would like me to sing to their family, to communicate their love on their behalf.
Throughout the sessions, I encourage family members to join in with percussion instruments, to sing along, and to gently tap or massage the child with the music. Caregivers can also help their child play the musical instrument by moving their hands and feet if the child is unable to do so themselves. It’s also great for parents to take videos of the session so their child can see their own face and the faces of their parents, and feel the music and joy any time.
I often end the session with a debrief, observation, and feedback from the child’s parents. I share links and information on music therapy and the latest research. I teach them how to perform the therapy and intervention, and encourage them to do it as often as they can. I believe in empowering these families with the ability to bring this joy into their child’s life.
HCA: Would you be able to share a particularly memorable moment with one of our Star PALS patients?
I recall fondly sessions with Sandra (not her real name), and her family. Although she couldn’t normally move her hand, she would respond and try to lift her hand to touch the drums, laughing. Her condition deteriorated rapidly and she became unconscious. One day, I visited her at the ICU with my keyboard, and began singing to her. She started tearing and gripped my hand tightly.
I asked her mother what she wanted to communicate to her, and put these feelings into words. Her mother then sang this song to her in tears.
I’ve kept in touch with Sandra’s family, even after she passed on, and have been glad to hear that their family is doing well!
HCA: What challenges do you face?
Sometimes, parents do not see how music therapy can improve their child’s condition. After a couple of sessions, though, most would begin to see the joy their child experiences.
HCA: What’s your own background, and how did you get involved in music therapy?
Since young, I’ve had plenty of exposure to music through my parents. I have a background in piano, and as a church musician. Together with my husband, Philip, I was involved in music ministry, youth work, pastoral work, and counselling. I’ve also been teaching students, including those with special needs, piano. I recently did a Public Performance Diploma in Teaching Pianoforte to Physically & Intellectually Challenged pupils.
Four years ago at a music therapy symposium, I met Dr Deforia Lane, who recommended that I attend the 28th Advanced Neurologic Music Therapy programme with the Colorado State University. I’ve never looked back since.
It was very painful and traumatic for my family and me when my own husband died suddenly in 1998. My three children will still very young at that point.
My family was blessed and fortunate to have the support and love of family members, pastors, and friends from church to help us cope in the earlier years, for which I am very grateful. I am especially grateful for the faithfulness and help of my children’s Godpa. I am, most of all, thankful to God for seeing us through. Money and status can never buy love and time. Everyone will die one day – it’s not when or how we die that counts, but how we live our lives. Every moment and every life is precious.
God is love. As a recipient of God’s unconditional love and grace myself, it has been an honour and privilege to now be able to let love and restoration flow through my music and my work.
Enjoy singing, dancing, and making music!