Pebbles cascaded melodiously as Lanette Lutz lifted the rain stick.
“I love that,” she laughed over the sound.
Dawn Broadwell reached over and helped Lutz tilt the dried cactus branch higher. The older woman’s eyes lit up as the sound grew stronger.
She and Broadwell talked about how it took two people to lift the heavy rain stick higher.
“What’s the lesson in that?” Broadwell asked.
“We have to rely on other people,” Lutz replied.
Throughout the 30-minute music therapy session, Broadwell would repeat the question as the pair played with the rain stick and two xylophones.
Broadwell and Lutz discussed rhythm, scales, notes and lyrics. But the conversation’s unspoken refrain centered around life and death.
Lutz laughed as she ran a mallet over the keys of a black and white xylophone. Days before, she’d been deeply depressed, but music therapy sessions salve her despair, she said.
“This will last me two or three days, this upbeat,” Lutz said. “And, boy, I’ve been needing it. I’ve been way in the valley—way, way, way. So this has helped a lot.”
Like many of the patients who receive services from Mary Washington Hospice, Lutz didn’t know what to expect when doctors said they could no longer treat her congestive heart failure. The 68-year-old reluctantly contacted the hospice agency in December.
“When you hear the word ‘hospice,’ it’s a death sentence,” Lutz said. “And that’s the first thing I thought of, ‘Oh, you know, I’m going to go home and die,’ and I said that to my doctors and my daughters. But it’s a way of living, as well. Once you pull yourself up by the panty strings and you realize you’ve got things still to do, it’s not over ... The fat lady hasn’t sung yet.”
A hospice nurse convinced Lutz to try one of the service’s expressive therapies—patients can choose to receive massage, art and music therapy. About 40 percent of Mary Washington Hospice’s patients take advantage of the therapies, which are offered free of charge, said Ashland Evans, manager of hospice and palliative medicine for Mary Washington Healthcare.
Early this year, Broadwell began bringing her bag of musical instruments to the Stafford County home where Lutz lives with her daughter, son-in-law and granddaughter.
Broadwell and Lutz developed a relationship during the monthly sessions.
At the end of the most recent one, Lutz hugged Broadwell.
“Oh, baby, I thoroughly enjoyed it,” she said. “You know how much I love you.”
“Well, I love you, too,” Broadwell said. “And I love doing music therapy with you.”
HOSPICE IS ABOUT LIVING
Broadwell is one of three part-time therapists employed by Mary Washington Hospice. They travel the Fredericksburg area offering music, art and massage therapies to help patients in their final months.
To qualify for hospice care, a doctor has to believe a patient has six months or less to live. For that reason, many see hospice as a death agency. But it’s really about living, said massage therapist Randy Shipp.
“Everybody’s focus is to make the patient comfortable, whatever that may be, and happy,” he said. “So actually, we’re not helping people die, we’re helping people live.”
RELIEF THROUGH MASSAGE
For William Barrack, the massage therapy has offered pain relief and greater mobility. Barrack doesn’t often get out of his bed these days, as lung cancer leaves him weak.
At the most recent session, Shipp first asked Barrack how he felt after the last massage.
“I wasn’t sick after you left,” Barrack said faintly. “I wasn’t sore or nothing.”
But his leg was hurting again, he said.
“OK, we’ll do some energy work on that leg,” Shipp said.
He provides a combination of traditional massage and energy therapy, an offshoot of the Reiki therapy Shipp learned in massage school.
He didn’t use the Japanese energy technique until working with hospice patients. One writhed in agony, unable to bear the slightest touch. Shipp reached his hands over the man’s shoulder, massaging an invisible energy force. The man soon felt relief, said Shipp, who has offered the service since.
While many people are skeptical about massaging invisible energy, Shipp’s patients have been receptive.
“When you get close to the end of life, you start to understand things that other people just don’t understand,” Shipp said. “I think it’s a beautiful part of life, personally.”
Shipp donned lilac latex gloves as Barrack lifted his white T–shirt to reveal a frail, pale back. An oxygen near the bed machine sighed as Shipp applied massage lotion and began rubbing Barrack’s back.
The elderly man closed his eyes and groaned as the massage began.
“That feels good,” he said.
For nearly an hour, Shipp kneaded Barrack’s muscles, at times sweating from the effort. Barrack asked about the weather and talked about his hopes of riding in his truck later in the week.
Shipp’s massages relieve Barrack’s pain and help him get out of bed more often.
By the end of the session, Barrack was exhausted, lying on bed and barely able to talk. But he lifted his thumb in the air toward Shipp and said, “He’ll make you feel better!”
INSIGHT THROUGH ART
Patricia Jackson didn’t feel like being creative during her most recent art therapy session.
The 71-year-old Fredericksburg resident enjoys sessions with art therapist Nora Dinu, and recently made a mask that she wanted to decorate.
But Jackson hadn’t been feeling well, and listlessly picked through the colorful feathers Dinu had brought to adorn the mask.
Jackson felt more like chatting about her earlier life in California and her thoughts about the upcoming presidential election—“maybe Oprah could be president.”
Decked out in a sparkly peach cardigan and a festive hair band, Jackson looked ready for a party. She had been excited to meet Dinu in the dining area of the Hughes Home, an assisted living facility in the city.
“I look forward to seeing her,” Jackson said. “It does me good.”
She didn’t explore art much before becoming a hospice patient about six months ago. But she’s enjoyed making the mask and creating a picture with colored pencils and magazine cutouts.
Jackson spoke about the idea of masks, the mystical idea of the third eye, and the vibration of thoughts.
“The whole idea of art therapy is to gain more insight into ourselves,” Dinu said.
Patients lead the therapies—sometimes they’re too tired for music or art, or they just feel like talking. And that’s OK.
“Nothing is set in stone,” Dinu said. “The schedule is loose.”
For days when patients don’t feel like creating, Dinu brings a cigar box filled with sensory treasures: a smooth stone egg, a rough piece of felt, a bumpy rubber ball, a collection of seashells. The treasures stimulate the senses gently, providing a bit of therapy even on days when patients can’t do projects, Dinu said.
All three of the expressive therapies offered at Mary Washington Hospice stimulate senses, and that’s one of the benefits to the therapies, said Terri McCormack, community liaison for Mary Washington Hospice.
“It also builds rapport with the patient and their family,” she said. “It helps them recognize their own feelings and their attitudes on what they’re going through. And it enhances the quality of their life. It provides them a feeling of being whole, even when they’re limited.”
CALM THROUGH MUSIC
Music therapy helps Michael Coughlin overcome some of the limits illness has imposed.
During a recent session with Broadwell, Coughlin leaned on his walker as he shuffled into the kitchen of the Comfort Keepers LifeSelect home he shares with other seniors in Fredericksburg.
Broadwell looked at Coughlin’s feet and said, “Let’s sing your song.”
Coughlin’s blue eyes lit up and he smiled as he started singing softly with Broadwell,
“Take me out to the ball game,
“Take me out with the crowd,
“Buy me some peanuts and Cracker Jack.”
He began to lift his feet off the ground, moving them to the song’s rhythm.
During various sessions, Broadwell used song to remind Coughlin to keep using his body, even though Parkinson’s disease has slowed his steps.
“Use the rhythm to anticipate the next beat,” Broadwell said.
She brought a large djembe drum to help Coughlin keep the rhythm. Together, they tapped out the song, changing the words to root for Coughlin’s Red Sox.
When Broadwell first met Coughlin, she suggested writing a song about his life story.
“I’ll tell you about the love of my life,” Coughlin said.
So the pair wrote “When Marilyn’s Eyes Are Smiling,” renaming the popular Irish tune for Coughlin’s wife of 50 years.
The song carries meaning for Coughlin, who danced to the melody with his daughter at her wedding.
Music therapy often works like that, connecting various parts of a person’s life as they face the end, said Evans, the hospice manager.
The therapy also brings Coughlin moments of happiness, Marilyn said.
“That’s what it’s about,” Broadwell said. “To improve quality of life, to help them see there’s still joy as they continue to live.”