How did I use music therapy to foster connections between residents, and between residents and others in a rest home and hospital environment

<p>Abstract This study is submitted in part fulfilment of a Master of Music Therapy degree through Victoria University of Wellington (VUW). Group and individual music therapy sessions were undertaken within a rest home and hospital environment in response to the rest home managers request to bring residents out of isolation and increase socialisation. Facility notes, plans and observations, meeting notes, and reflective and reflexive journaling were written during a six-month period from February to July 2019. This clinical data was then used, with informed consent, to investigate how music therapy was used to foster connections between residents, and between residents and others within the rest home and hospital environment. Findings from Secondary Analysis of the data showed the overarching category of rapport led to the interplay of four main themes: interdisciplinary collaboration and teamwork, therapeutic approaches, physical and musical resources, and environmental conditions. The Community Music Therapy (CoMT) ethos supported the flexible work within the context to achieve the manager’s goals resulting in increased connection between residents, and residents and others. The use of reflexivity enabled the development of richer therapeutic relationships and helped align the researcher’s community musician skills to those of a community music therapist. Further studies which focus on rapport, connection and relationships, in music therapy with older people, are needed.</p>

How did I use music therapy to foster connections between residents, and between residents and others in a rest home and hospital environment

<p>Abstract This study is submitted in part fulfilment of a Master of Music Therapy degree through Victoria University of Wellington (VUW). Group and individual music therapy sessions were undertaken within a rest home and hospital environment in response to the rest home managers request to bring residents out of isolation and increase socialisation. Facility notes, plans and observations, meeting notes, and reflective and reflexive journaling were written during a six-month period from February to July 2019. This clinical data was then used, with informed consent, to investigate how music therapy was used to foster connections between residents, and between residents and others within the rest home and hospital environment. Findings from Secondary Analysis of the data showed the overarching category of rapport led to the interplay of four main themes: interdisciplinary collaboration and teamwork, therapeutic approaches, physical and musical resources, and environmental conditions. The Community Music Therapy (CoMT) ethos supported the flexible work within the context to achieve the manager’s goals resulting in increased connection between residents, and residents and others. The use of reflexivity enabled the development of richer therapeutic relationships and helped align the researcher’s community musician skills to those of a community music therapist. Further studies which focus on rapport, connection and relationships, in music therapy with older people, are needed.</p>

The protection of consumers in rest homes - time for a change?

<p>This dissertation examines the statutory protection of elderly consumers in rest homes and makes several proposals of how to improve their protection. The dissertation compares New Zealand’s legislation with the existing rest home related legislation in Australia and Germany to improve New Zealand’s regulations. At first, the dissertation characterises elderly consumers as a consumer group with special vulnerabilities. According to the dissertation several reasons can be identified, which justify regulatory intervention in favour of the elderly. Secondly, the dissertation gives an overview of the relevant rest home legislation in New Zealand, Australia and Germany. In the later chapters the dissertation examines the existing information obligations, and the statutory protection of elderly consumers during the implementation and at the time of the termination of a rest home contract. The author argues that many of the existing consumer protection measures are not specifically tailored for consumers in rest homes and, therefore, do not ensure comprehensive protection. Furthermore, the author identifies several gaps in protection and proposes to introduce targeted new protection measures to close these gaps. Subsequently, the dissertation considers the access to justice for elderly consumers. The author states that the existing system offers some advantages but is far from being perfect. He speaks in favour of establishing a new Commissioner who is responsible for the issues of elderly consumers and the enhancement of their legal position. Lastly and on the basis of the previous outcomes, the author recommends creating a new piece of legislation specifically tailored for the protection of elderly consumers in rest homes to implement all the proposed changes. In the author’s opinion a new Act could build on the existing consumer protection measures but should also improve them to ensure the best protection possible. The author also outlines how a code of practice should be put in place, which sets out minimum requirements.</p>

The protection of consumers in rest homes - time for a change?

<p>This dissertation examines the statutory protection of elderly consumers in rest homes and makes several proposals of how to improve their protection. The dissertation compares New Zealand’s legislation with the existing rest home related legislation in Australia and Germany to improve New Zealand’s regulations. At first, the dissertation characterises elderly consumers as a consumer group with special vulnerabilities. According to the dissertation several reasons can be identified, which justify regulatory intervention in favour of the elderly. Secondly, the dissertation gives an overview of the relevant rest home legislation in New Zealand, Australia and Germany. In the later chapters the dissertation examines the existing information obligations, and the statutory protection of elderly consumers during the implementation and at the time of the termination of a rest home contract. The author argues that many of the existing consumer protection measures are not specifically tailored for consumers in rest homes and, therefore, do not ensure comprehensive protection. Furthermore, the author identifies several gaps in protection and proposes to introduce targeted new protection measures to close these gaps. Subsequently, the dissertation considers the access to justice for elderly consumers. The author states that the existing system offers some advantages but is far from being perfect. He speaks in favour of establishing a new Commissioner who is responsible for the issues of elderly consumers and the enhancement of their legal position. Lastly and on the basis of the previous outcomes, the author recommends creating a new piece of legislation specifically tailored for the protection of elderly consumers in rest homes to implement all the proposed changes. In the author’s opinion a new Act could build on the existing consumer protection measures but should also improve them to ensure the best protection possible. The author also outlines how a code of practice should be put in place, which sets out minimum requirements.</p>

Are community music therapy principles relevant to my work with large groups of older adults in a residential care facility?

<p>This research focuses on my student practicum placement at a residential care home offering rest home, hospital and specialist dementia care for older people. A significant part of my work at the home was facilitating large, open groups, as ensuring the maximum number of residents could participate in music therapy each week was a priority for the facility. Due to my background in community music, which included work in care homes, I was interested in whether community music therapy principles would have relevance in this context. I wanted to improve my practice and add value to my work and in doing so I also hoped to contribute to the wider conversation around the distinction between community music and community music therapy, and how these two disciplines can enhance and support each other. Using an interpretivist framework I engaged in action research, an orientation towards the research process which focuses on real-world change. I conducted three action cycles, collecting data for each cycle over a period of approximately six weeks. I then used thematic analysis to examine this data. My main data source was my practice notes, which included reflections and ideas for improvement. I also drew on the community music therapy literature to develop my practice. Based on emerging themes, I generated actions I could take in the next cycle to advance and improve my practice. I found that large group music therapy sessions can provide the opportunity for participants, both staff and residents, to experience a shared social space which enables moments of connection and promotes inclusion, creativity, self-determination, and expanded identities. This suggests that the groups had therapeutic value for the participants. I discuss identified differences between my community music and music therapy practice, including the possibilities for individual work and use of music therapy theory. I believe that community music therapy principles were relevant to this work and in particular taking an ecological perspective was significant. Further research into community music therapy in residential care settings is recommended.</p>

Are community music therapy principles relevant to my work with large groups of older adults in a residential care facility?

<p>This research focuses on my student practicum placement at a residential care home offering rest home, hospital and specialist dementia care for older people. A significant part of my work at the home was facilitating large, open groups, as ensuring the maximum number of residents could participate in music therapy each week was a priority for the facility. Due to my background in community music, which included work in care homes, I was interested in whether community music therapy principles would have relevance in this context. I wanted to improve my practice and add value to my work and in doing so I also hoped to contribute to the wider conversation around the distinction between community music and community music therapy, and how these two disciplines can enhance and support each other. Using an interpretivist framework I engaged in action research, an orientation towards the research process which focuses on real-world change. I conducted three action cycles, collecting data for each cycle over a period of approximately six weeks. I then used thematic analysis to examine this data. My main data source was my practice notes, which included reflections and ideas for improvement. I also drew on the community music therapy literature to develop my practice. Based on emerging themes, I generated actions I could take in the next cycle to advance and improve my practice. I found that large group music therapy sessions can provide the opportunity for participants, both staff and residents, to experience a shared social space which enables moments of connection and promotes inclusion, creativity, self-determination, and expanded identities. This suggests that the groups had therapeutic value for the participants. I discuss identified differences between my community music and music therapy practice, including the possibilities for individual work and use of music therapy theory. I believe that community music therapy principles were relevant to this work and in particular taking an ecological perspective was significant. Further research into community music therapy in residential care settings is recommended.</p>

Hear to Care: The role of caregivers in the spiritual care of residents in New Zealand Rest Homes

<p>This thesis argues that caregivers are exposed to the spiritual needs of rest home residents much more than might have previously been recognised, and that they are a more important part of the matrix of spiritual care than has been understood or acknowledged. By employing a qualitative research methodology, staff, residents and management at two rest homes in the greater Wellington region were interviewed to address the question: to what extent and in what ways is spiritual care a part of the caregiver role in New Zealand rest homes? The research explores current understandings and perceptions of the caregivers' role in attending to the spiritual needs of the residents by addressing a key set of related questions that arise from consideration of the rest home milieu. The research indicates that the move into a rest home is a turning point in the life of the residents. The changes involved in this transition may lead to a spiritual search for meaning, and to questioning that arises from a sense of being in transition from life to death. In the course of daily work, caregivers, as members of the team that provides holistic care, therefore relate to residents who are experiencing various spiritual challenges associated with rest home life and the vulnerability of ageing. Caregivers' confidence to respond to residents' spiritual needs was explored. The thesis suggests that there would be value in extending caregiver training to strengthen their capacity to recognise and respond to spiritual issues when they occur in the course of their work. Such training is seen as important if provision of care in rest homes for the aged population in New Zealand is to be truly holistic.</p>

Hear to Care: The role of caregivers in the spiritual care of residents in New Zealand Rest Homes

<p>This thesis argues that caregivers are exposed to the spiritual needs of rest home residents much more than might have previously been recognised, and that they are a more important part of the matrix of spiritual care than has been understood or acknowledged. By employing a qualitative research methodology, staff, residents and management at two rest homes in the greater Wellington region were interviewed to address the question: to what extent and in what ways is spiritual care a part of the caregiver role in New Zealand rest homes? The research explores current understandings and perceptions of the caregivers' role in attending to the spiritual needs of the residents by addressing a key set of related questions that arise from consideration of the rest home milieu. The research indicates that the move into a rest home is a turning point in the life of the residents. The changes involved in this transition may lead to a spiritual search for meaning, and to questioning that arises from a sense of being in transition from life to death. In the course of daily work, caregivers, as members of the team that provides holistic care, therefore relate to residents who are experiencing various spiritual challenges associated with rest home life and the vulnerability of ageing. Caregivers' confidence to respond to residents' spiritual needs was explored. The thesis suggests that there would be value in extending caregiver training to strengthen their capacity to recognise and respond to spiritual issues when they occur in the course of their work. Such training is seen as important if provision of care in rest homes for the aged population in New Zealand is to be truly holistic.</p>

“Let my Spirit Always Sing”: a Descriptive Study of How Four Elderly Rest Home Residents View Spirituality and Spiritual Care at the End of Life

<p>Over the last twenty years spiritual care has become recognised increasingly as an important component of holistic care, care that nurtures the spirit as well as addressing the person’s physical and psychosociocultural needs. This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. From this group of people I recruited four Rest Home residents who were prepared to talk to me about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi’s analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants’ satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured.Recommendations are made for improving the spiritual dimension of care, and for further research. Similar research, for example, should be carried out in different residential care settings, especially in the “for profit” sector. Research should also be undertaken to gauge the awareness care staff have of residents’ wishes for spiritual care in the perideath period.</p>

“Let my Spirit Always Sing”: a Descriptive Study of How Four Elderly Rest Home Residents View Spirituality and Spiritual Care at the End of Life

<p>Over the last twenty years spiritual care has become recognised increasingly as an important component of holistic care, care that nurtures the spirit as well as addressing the person’s physical and psychosociocultural needs. This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. From this group of people I recruited four Rest Home residents who were prepared to talk to me about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi’s analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants’ satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured.Recommendations are made for improving the spiritual dimension of care, and for further research. Similar research, for example, should be carried out in different residential care settings, especially in the “for profit” sector. Research should also be undertaken to gauge the awareness care staff have of residents’ wishes for spiritual care in the perideath period.</p>