{"id":7909,"date":"2017-01-26T14:19:48","date_gmt":"2017-01-26T21:19:48","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=7909"},"modified":"2024-08-15T16:38:24","modified_gmt":"2024-08-15T22:38:24","slug":"palliative-care-gets-creative","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/palliative-care-gets-creative\/","title":{"rendered":"Palliative care gets creative"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>Each time Amy Jones and Angela Wibben enter an inpatient room at University of Colorado Hospital, they do so as caregivers. They are licensed therapists, but they carry surprising resources: yarn, paints, brushes, musical instruments and other objects more familiar to the world of art than the domain of medicine.<\/p>\n<p>Jones and Wibben are, respectively, art and music therapists for a new program at UCH that incorporates the creative arts in palliative care. They began seeing inpatients in late September, melding their creative skills and therapeutic training to meet the emotional and spiritual needs of patients enduring serious medical conditions.<\/p>\n<p>Their work supplements the palliative care provided by clinicians, who work with patients and their caregivers to develop treatment plans that are in keeping with their values and goals, Wibben said.<\/p>\n<p>\u201cPatients can get bombarded with medical information,\u201d she said. \u201cMeanwhile, they are dealing with many ups and downs in their emotions and thoughts. We are there to help them communicate on the non-verbal front.\u201d<\/p>\n<p><strong>Tapping creativity<\/strong><\/p>\n<p>During clinical rounds, Jones and Wibben listen for clues that indicate a palliative care patient might benefit from a creative approach to therapy \u2013 words like pain, coping, anticipatory grief, and anxiety are tell-tale signals. They go to those patients\u2019 rooms to introduce themselves, explain what they do and offer their services.<\/p>\n<figure id=\"attachment_7911\" aria-describedby=\"caption-attachment-7911\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7911 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop.webp\" alt=\"Examples of artwork that Amy Jones uses to stimulate ideas in therapy sessions with palliative care patients.\" width=\"300\" height=\"200\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140627\/EXT_102716_art-composite-Photoshop-200x133.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-7911\" class=\"wp-caption-text\">Examples of artwork that Amy Jones uses to stimulate ideas in therapy sessions with palliative care patients.<\/figcaption><\/figure>\n<p>The two help people acknowledge the realities of their situations while finding the resources to respond on their own, highly personal terms. Many of the tools they carry are at first glance unremarkable: key chains, a tiny microphone and audio recorder, a bag of coins. Yet Jones and Wibben use these, along with art supplies and musical instruments, to help patients express themselves \u2013 not as individuals defined by illness but rather as people with specific memories, talents, accomplishments and histories.<\/p>\n<p>\u201cI go into a patient\u2019s room without expectations and without a set agenda,\u201d Wibben said. \u201cI try to be open to whatever that person needs.\u201d<\/p>\n<p>The field understandably has not received the amount of rigorous research that has been devoted to clinical realms. But a <a href=\"http:\/\/fordham.libguides.com\/Palliative\/IntegrativeTherapies\" target=\"_blank\" rel=\"noopener noreferrer\">growing body of literature<\/a> suggests that art and music therapy \u2013 as well as other alternative and complementary treatments \u2013 can help all patients, including the most seriously ill, improve their quality of life and ability to cope with physical and emotional challenges.<\/p>\n<p>\u201cThis kind of therapy is a huge part of healing that we haven\u2019t fully recognized,\u201d said Jeanie Youngwerth, MD, medical director of UCH\u2019s Palliative Care Service, said. \u201cIt helps patients feel like people again. It\u2019s a way to give them back control and decrease their suffering.\u201d<\/p>\n<p><strong>Family connection<\/strong><\/p>\n<p>For <a href=\"https:\/\/www.cumedicine.us\/providers\/medicine\/jean-kutner\" target=\"_blank\" rel=\"noopener noreferrer\">Jean Kutner, MD, MPSH<\/a>, the hospital\u2019s chief medical officer, the program has a deep personal connection. It honors her mother Natalie, who died in 2014. Trained as a medical social worker, Natalie was also an accomplished visual artist whose work was the subject of a posthumous exhibition at the Fulginiti Pavilion on the Anschutz Medical Campus in 2015.<\/p>\n<p>Kutner said she and her father, Fred, discussed ways to use in-memory donations they had received after Natalie\u2019s death in ways that both reflected her individuality and benefited others. They considered establishing a fund to assist training for medical social workers in palliative care, but ultimately decided on creative arts therapy for palliative care patients.<\/p>\n<p>\u201cAs an artist, she volunteered in community-based settings,\u201d Kutner said. \u201cArt was such a meaningful part of her life.\u201d<\/p>\n<p>After developing a business plan and securing approval from the hospital, the Kutners gathered donations sufficient to fund the first year of the Natalie Kutner Palliative Care Creative Arts Therapy Program. Jones and Wibben each work 20 hours a week.<\/p>\n<p>A specialist in palliative care and leader in developing research in the field, Kutner said she has long recognized that patients grappling with life-changing illness need more than clinical care. \u201cAs clinicians we talk about personal and patient-centered care,\u201d she said. \u201cAmy and Angela are able to tap into the personal with patients in ways that we can\u2019t and are not trained to.\u201d<\/p>\n<p><strong>Palliative process<\/strong><\/p>\n<figure id=\"attachment_7913\" aria-describedby=\"caption-attachment-7913\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7913 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop.webp\" alt=\"Amy Jones (left) and Angela Wibben joined the Palliative Care team at UCH in September.\" width=\"300\" height=\"200\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Jones-and-Wibben-Photoshop-200x133.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-7913\" class=\"wp-caption-text\">Amy Jones (left) and Angela Wibben joined the Palliative Care team at UCH in September.<\/figcaption><\/figure>\n<p>Their qualifications extend far beyond picking up a box of paints or a guitar and spending a free-form hour of idle dabbling. Jones holds a master\u2019s degree in art therapy and is a licensed professional counselor and a registered art therapist. Wibben is a <a href=\"https:\/\/www.cbmt.org\/certificants\/\" target=\"_blank\" rel=\"noopener noreferrer\">board-certified music therapist<\/a> with training in psychology, anatomy and physiology. Both incorporate mindfulness and breathing techniques in their work. Most of all, they listen rather than lecture.<\/p>\n<p>\u201cI try to pick up on cues from the patients about what brings them joy and makes them feel calm and connected,\u201d Jones said.<\/p>\n<p>That approach can follow many paths, she added. There is no predetermined finished work at the end of one of her sessions. \u201cIt\u2019s more about process than product,\u201d she explained.<\/p>\n<p>Jones recalled that one palliative care patient she saw was \u201chyper-aware\u201d of her pain, despite the fact that her providers had controlled it with medications. The patient was anxious because of an intense consciousness of her physical sensations, said Jones, who listened and coaxed from the patient the things she missed because they had given her pleasure. That led to discussions of her family, of being outdoors, and the colors of spring.<\/p>\n<p>After allowing time for those feelings and memories to come forth, Jones mentioned to the patient that she had art materials and asked her what would make her feel good. The patient chose yarn in soft colors that suggested spring and with Jones created a scene with outdoor colors.<\/p>\n<p>The finished piece reflected important pieces of the patient\u2019s life, and Jones had been more facilitator than leader. She also had made \u201ccreating art\u201d something inviting rather than intimidating.<\/p>\n<p>\u201cI rarely bring a blank canvas for people,\u201d she said. \u201cMany times people haven\u2019t created art since childhood. I try to make it accessible.\u201d<\/p>\n<p><strong>The right notes<\/strong><\/p>\n<figure id=\"attachment_7912\" aria-describedby=\"caption-attachment-7912\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7912 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop.webp\" alt=\"Music therapist Angela Wibben uses small coins to spark memories and reflections in patients.\" width=\"300\" height=\"200\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/01\/28140626\/EXT_102716_Wibben-Coins-Photoshop-200x133.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-7912\" class=\"wp-caption-text\">Music therapist Angela Wibben uses small coins to spark memories and reflections in patients.<\/figcaption><\/figure>\n<p>Likewise, Wibben uses music to relax patients and tap into their inner resources. She said she sometimes strums her acoustic guitar to match their breathing rate and slows down the tempo gradually. The power of music to spark memories is a double-edged sword, she added. A song that might have produced powerfully pleasurable emotions in a patient the past \u2013 one played at a wedding or during childhood, for example \u2013 might generate sharp feelings of loss during a hospital stay.<\/p>\n<p>\u201cI\u2019m always watching for facial affect when I play,\u201d Wibben said. \u201cI have to be aware of painful feelings and not take someone to a place they can\u2019t come back from.\u201d<\/p>\n<p>Wibben also incorporates songwriting into her therapy. She uses a bag of small coins imprinted with a single letter as a creative conduit. Patients pick up a coin, feel for the letter and express the \u201cintention\u201d or word that the letter suggests and makes them feel best. With \u201cf\u201d for \u201cfamily,\u201d for example, she might invite the patient to talk about the thoughts the word summons \u2013 children and grandchildren living across the alley who are regular visitors, perhaps.<\/p>\n<p>\u201cI ask them to talk about the space it takes them to,\u201d Wibben said. That might lead to simple song, with Wibben using a \u201ctherapeutic voice\u201d that matches those of the people in the room. A therapy session is not the place to show off her pipes but rather an occasion to join people together in a positive, reflective moment, she explained.<\/p>\n<p><strong>Serious listening<\/strong><\/p>\n<p>The point of introducing creative arts in palliative care isn\u2019t to manufacture sunny optimism. As Kutner put it, \u201cIt\u2019s clear that what they are doing is therapy. It\u2019s not just creating ambience.\u201d The goal, Jones said, is to allow patients and family members to fit days spent with illness into the broader canvas of their lives.<\/p>\n<p>\u201cI try to be open to what they are experiencing,\u201d she said. \u201cWe find ways to reminisce, but also ways to process what they are going through during difficult times.\u201d Art becomes a means of expression that is often \u201cbeyond words,\u201d she added.<\/p>\n<p>It\u2019s not only patients who have benefited from the two therapists\u2019 work in their short time with the Palliative Care program, Youngwerth said.<\/p>\n<p>\u201cAs providers, we are learning so much from how they approach patients and family members,\u201d she said. \u201cWe get to witness an additional dimension of care personalized to each patient.\u201d<\/p>\n<p>In fact, Youngwerth added, an early challenge is managing demand for the services of Jones and Wibben, who for now see only inpatient palliative care patients and are both only half-time.<\/p>\n<p>\u201cWe have already gotten so much feedback from staff who said, \u2018We want this for <em>all<\/em> our patients,\u2019\u201d Youngwerth said.<\/p>\n<hr \/>\n<p><em>To learn more about the Creative Arts Therapy Program and ways to donate to it, contact Cheryl Balchunas at 303-724-6871 or <\/em><a href=\"mailto:Cheryl.Balchunas@ucdenver.edu\"><em>Cheryl.Balchunas@ucdenver.edu<\/em><\/a><em>. <\/em><\/p>\n<p><em>Send donations to the Creative Arts Therapy Program (Fund 0222843), CU Foundation, Mail Stop A065, 13001 E. 17th Place, Aurora, CO 80045 or visit the <\/em><a href=\"https:\/\/giving.cu.edu\/\" target=\"_blank\" rel=\"noopener noreferrer\"><em>CU Foundation website<\/em><\/a><em>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Each time Amy Jones and Angela Wibben enter an inpatient room at University of Colorado Hospital, they do so as caregivers. They are licensed therapists, but they carry surprising resources: yarn, paints, brushes, musical instruments and other objects more familiar to the world of art than the domain of medicine. Jones and Wibben are, respectively, [&hellip;]<\/p>\n","protected":false},"author":2143,"featured_media":7913,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[154,745,263],"class_list":["post-7909","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-palliative-care","tag-rehabilitation-therapy","tag-university-of-colorado-hospital"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.7 (Yoast SEO v27.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Palliative care gets creative - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Each time Amy Jones and Angela Wibben enter an inpatient room at University of Colorado Hospital, they do so as caregivers. They are licensed therapists, but they carry surprising resources: yarn, paints, brushes, musical instruments and other objects more familiar to the world o...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/palliative-care-gets-creative\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Palliative care gets creative\" \/>\n<meta property=\"og:description\" content=\"Each time Amy Jones and Angela Wibben enter an inpatient room at University of Colorado Hospital, they do so as caregivers. They are licensed therapists, but they carry surprising resources: yarn, paints, brushes, musical instruments and other objects more familiar to the world of art than the domain of medicine. 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