Since March 12, 2020, I have been playing music and singing via my phone with residents at the Panorama Convalescent and Rehabilitation Center (C&R) in Olympia Washington. I started the day after this skilled nursing facility (nursing home) closed their doors to all visitors to protect the residents from COVID-19. The Panorama C&R is just 70 miles from the first US outbreak of this deadly virus in another nursing home in Kirkland Washington where so many deaths have occurred. These folks are among the most vulnerable.
I have been doing one-to-one work at the C&R for a few years now, and I have loved these “private concerts” as one resident dubbed them. In the two weeks that I have shifted abruptly to working from my living room and a screen, I have learned some tips I want to pass on if your loved one is also in a facility where you cannot visit him or her. Most of the residents at the Panorama C&R do not have their own cell phones, so the administration must help facilitate this process.
No, videochatting is not as good as a visit in person. But it’s still pretty awesome that we have this technology during such a difficult time. Please try to use it–I promise, your loved one will appreciate it so much. Nursing homes may not be open to visitors for months yet, so finding a way to connect is critical for their well-being. Yes, you can make an ordinary phone call, but videochatting is simply better, especially for your loved one who misses seeing you. I hope these are helpful.
#1 Create Agreement with the Facility
There are technical issues to be solved, but they are all solvable. If your loved one is in a facility, the administration should be able to find a way for you to see and hear each other. Be polite but persistent, keep asking until they come up with a plan. By now (March 28, 2020), many facilities in my area are finding ways to connect residents with loved ones and a screen.
#2 You CAN figure it out!
If you have never videoconferenced yourself and are intimidated by the idea of learning a new technical skill, just know that you can do it. My 91-year-old mother figured out Zoom. Mom is really patient and diligent, so pull out some of those qualities in yourself. Get help from a younger relative to talk you through it.
#3 You will probably need help from the staff.
If you are already connected with your loved one through apps on your phones such as FaceTime, that is great–use them as often as possible! But many residents in nursing homes do not have their own cell phones.
Especially if your loved one has dementia or if he or she is too elderly to figure out the technology, you will need staff assistance. Remember to be patient and kind with the staff. They are overwhelmed and frightened themselves at this time. They have to try to provide this kind of valuable service to each resident, all who have anxious family members. Remember, staffers are in danger themselves by working in a health care facility. Don’t make their lives harder by dumping your fears and feelings of frustration on them.
#4: Pizza helps everything.
Speaking of staff, if you haven’t lost your income and can afford it, buy them a pizza. It lets them know that you appreciate the extra care they are bringing to your loved one when you cannot be there. The staff at nursing homes are relatively low-paid workers, so a free lunch is more than a token gesture. Do it every week if you can!
#5: Which program/technology?
I have found that FaceTime with an I-phone on my end and an I-pad on their end to get the best results. The signal stays clear, and the resident has a large enough screen to enjoy the experience. It is likely the same with other cell phone video chat technology. Cell phones use the cell phone networks rather than the internet and it seems to work better (so far).
But those options may not be available. You will have to see what the facility is using. When I have used my computer rather than phone, Zoom seems to work a bit better than Skype in my limited experiments. There are many other programs I have not tried.
#6: Keep on the sunny side.
Try to be in as good a space as possible before you start the call. We’re all freaked out right now, so take a deep breath and “smile though your heart is aching,” as the old song goes. Sometimes when we pretend to be happy, we actually can generate happiness. It is also healing for you to focus your attention on giving rather than fear.
#7: Love the camera!
If you have videoconferenced before, you know that the only way the other person feels like you are looking into her eyes is for you to look into the camera. That means that most of the time you don’t look at her on your screen. You can glance down here and there, but keep your focus diligently on the small dot of your camera. You have to pretend to be looking into the eyes of your loved one, which is a bit weird and a bit hard to do for long.
Note: this discipline is not important or expected in business meetings, but it is critical for your loved one to have a good experience, and to feel connected.
8: Really? No bingo, no happy hour?
Ask your loved one how he is feeling, to begin with. Listen, emphasize. She is probably pretty bummed out about the situation, and she may be angry too. Your loved one cannot see you, and he also cannot see his friends in the facility. The dining room is closed and everyone must eat their meals alone in their rooms. They can’t play bingo, see musical events, go to worship services or participate in any number of daily activities that connect them with others and break up the monotony that is in the best of times part of living in a nursing home.
Tell her it’s so good to see her…remembering to keep that smile on your face. Don’t worry if it feels fake, SMILE! It will feel 100% real when she smiles back and your heart turns over. You can tell him that you are sad you can’t be there, but so happy that you can see him and hear his voice.
9. Way better than nothing
With almost all people that I had met with before the Great Separation, the musical calls are helpful and bring good vibes and comfort, laughs and smiles. It has honestly surprised me how uplifting these sessions have turned out to be.
Even more surprising, I have had rich and lovely connections with elders I have never met, especially those without dementia. So don’t be discouraged by thinking this technology cannot be the same as seeing your loved one in person. No, it is not the same, but in truth it is far, far“better than nothing.”
10: Facetime/Skyping with dementia residents.
Some with more advanced dementia may not be able to comprehend what is happening or respond to you. Everyone is different, so you can only try. But do try more than once if it seems hard to connect.
One man who always twinkled and smiled when I saw him in person seemed to think I was just the TV when we FaceTimed. He stared at the screen and would not respond no matter what I said or did. Then we tried it on another day and I got some smiles with the tunes.
Many others with early or moderate dementia might be confused by what is happening, but can easily get to a place of enjoying it and conversing, singing and laughing and joking, just as if you were there.
11: Send a hug.
If it is appropriate, give “virtual hugs” by hugging your own shoulders and saying, “I’m hugging you right now!” Just yesterday I did this with a woman named Alice who lives in the memory care unit. Alice gave a huge smile, hugged her own shoulders and said, “I can feel it!” Blowing kisses is fun too.
12. I love your sweater!
Talk about what you can see and invite them to see your space. I always say, “welcome to my living room!” Sometimes I take the camera around and give them a tour of my house, or show them what it looks like outside. For folks who have never used Facetime or Skype, this can be really fun.
13. The beauty of a human face.
After consulting with staff, I have so far been putting the camera on just my face. I may in the future change the angle so they can see the guitar, depending on the person. Some people really like to study a guitar player. (My dad would have been one of those!) But there is nothing like a beloved face, as close up as possible, to cheer up your loved one.
14. Set the stage.
Pay attention to the lighting. (There are plenty of tips out there in the past few weeks about this, check them out too.) Take the time to work on this as if you were a professional! Your loved one is worth it, and they will unconsciously feel the difference and respond more if it looks pleasing. A diffused light on your face works best, avoid super bright spots and shadows. Spend some time finding or making a good background. Something with a simple texture is great. I have cedar walls and a barn ceiling, that works well.
15. Gussy up!
Get out of your PJs! Wear bright colors and take the time to feel good about how you look, putting on makeup or styling your hair, wearing a hat or a favorite scarf. Put on a happy face as if you were taking your loved one out to a special lunch. I guarantee it will be uplifting for your loved one to see you looking good.
16. Music to their ears.
Best to be in a room that has furniture or other sound-catchers so you don’t sound hollow or echo-y. We live in a recording studio, so it’s easy for me. Try to troubleshoot the acoustics with a friend before the videochat. Again—sound quality is a detail most of us don’t consciously realize affects our perception, but please trust me on this: good acoustics make for good connections. Think of some of the news interviews you have seen over the past few weeks in someone’s laundry room that just sound terrible. It’s hard to keep paying attention.
17. Consider sharing music.
I chat with the residents a bit to establish rapport, but my main focus is to choose songs that are appropriate for the moment and sing them—all looking at that camera, all with a smile, moving as much as possible. If you sing, you can try this too. You also might try playing recorded music they love, and suggesting they sing with it. (However, see #18 below.) Just make sure that the sound source is close enough to your microphone if you try this. Singing is a helluva lot easier than trying to talk when using these programs, and more calming and reassuring for your loved one. It gets you off the negatives and into some joyful moments.
18: Double negative reality inversion.
There is a huge problem with the delay of sound when using videoconferencing when you try to sing together. If your loved one wants to sing with you, someone on that end will need to turn off the microphone during the singing, and turn it back on during the talking. You won’t hear your loved one during the song, but there won’t be a delay problem on either end.
This is an unsolvable problem using cell phones or the internet. With folks that just want to listen to the music, it’s easier.
19: The digital touch is not the human touch.
While this kind of connection really is far “better than nothing,” if you follow all these tips it may feel better for your loved one than for you. I have found myself to be totally drained after two hours of working this way with folks.
I couldn’t understand it at first. I finally realized it is because I don’t have the soul nourishment of looking into their eyes and connecting. I don’t have the physical nourishment of holding their hands. That real and human feedback is missing for me now, even though I know that I am helping them.
This is why it is so important to look into the camera when talking or singing to them—your loved one will get more of a feeling of connection. But your feeling of connection will be somewhat sacrificed. I had no idea how important those simple human connections were until I shifted from working in person to working via screen. So be sure to do what you need to do to care for yourself.
20. Bye for now!
Make sure you tell your loved one that you love him and miss him, using the language that works best for your relationship. Tell her you’ll see her again as soon as you can. Suggest some little positive future action, such as saying hello to a favorite nurse from you, or telling another family member about a story you shared.