A woman carrying a guitar quietly slips into a room, sits down gently and starts playing.
The person lying in the hospice room will die soon, and she accepts that. The priority for hospice workers is keep her comfortable.
Daveana Schieler begins to sing Jim Croce's “Time in a bottle.” For the first time in maybe 10 days, the person in the bed settles down and pays attention. For the next hour, she is calm and even smiles as Schieler plays and sings “Happy Together,” “Rainbow Connection,” “Moon River” and other soothing standards.
There's even a nurse standing outside the room, enjoying the music and the chance to decompress.
“Sometimes, have you ever listened to somebody sing and you get goosebumps?” nurse Jenny Ford said. “They hit that sweet spot that just gets you? That's how I was feeling with the music therapist. It's like a lullaby.”
It can be said that those who work with hospice patients are angels, but the music therapists sing like ones.
Schieler worked as a bank accountant before realizing her career growth was limited and began searching for a different profession. She discovered music therapy, and at the time, Indiana Purdue University Fort Wayne was the only public Indiana university to offer such a degree.
For six years, Schieler, 33, has worked in hospitals, group homes and private residences, sharing her gifts mainly with the autistic, those with disabilities, addicts and the dying, helping them with symptoms like anxiety, pain and depression. It's not just playing music or performing, it's connecting personally with patients and sometimes families. There's a clinical reason for everything, every song and every way she sings.
“It's being able to walk into a situation and assess what's going on and knowing how music works and how to use music in the right way that's going to benefit the person in the room who needs it,” Schieler said. “In hospice, every day we are working with people who are dying and making sure what we are doing is effective quickly. We may not get another chance to help someone. It's a skill, not just going in singing songs or being a bedside singer who is playing someone's favorite tunes. It's very purposeful.”
Schieler works 25 hours a week, mostly with Stillwater Hospice as a contractor from Fort Wayne to Berne, serving five people per day for usually between 45 minutes to an hour, but more if necessary. It depends on the situation, for which she has learned to understand and develop instincts. Any more time than that and it takes too much out of her in terms of concentration, emotion and empathy and requires a longer self-care recovery period.
Though they may not have a full-time position and work for many different agencies, music therapists can earn between $30,000 and $60,000 annually. Part of their education includes a six-month internship after completing four years of classes, a certification board exam and license reapplication every five years. And it can be stressful as it's not uncommon for music therapists to help patients as they transition into death.
Schieler and Stillwater's Music Therapy Coordinator Emily Borkholder are working on master's degrees. Practitioners often realize they need further schooling and training to be more effective.
“It takes a special personality and a calling to work in hospice, especially,” Borkholder said. “There's so much joy in it, though. Music therapy is definitely misunderstood because people don't know what it is. Sometimes with hospice, too. I've offered my services, and people think, 'We're not here for music.' They really question it, and then once they have some experience with it, we are often invited back.”
It's valid, science-proven and researched therapy – as breathing and heart rates slow and brain activity increases – but few people have heard of it. Until seeing and experiencing music therapy in person, few have any idea of the potential impact.
Though music therapy is reimbursed through Medicaid for serving those with disabilities (at a rate that hasn't increased in 20 years), it is not reimbursed for use in hospice, which is paid for through private funding, donations and grants. But if a grant is not renewed, the job disappears, though not the work. There are not enough music therapists to see everyone that could benefit or who have been referred by medical personnel.
“Anybody that we work with, we try to meet them exactly where they are and provide that compassionate care to treat them like they are people and they matter and they still matter until they take that last breath,” said Stillwater Director of Support Services Mary Willems-Akers. “That is a primary goal of what we do, to kind of journey alongside them and help them however we can.”
Before Schieler finishes playing her last song, the person in the bed has drifted off to her first peaceful sleep in a week. Quietly picking up her equipment and her jacket, Schieler slips out the door.