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Source: (consider it) Thread: Leading worship in an assisted living home
Al Eluia

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# 864

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For the past year or so my wife has been playing the organ for a brief Sunday afternoon service at an assisted living facility near us. (Her father spent the last year-and-a-half of his life there.) They have varied speakers come in to lead worship, but the resident who schedules the speakers has memory issues so sometimes there's no speaker. This Sunday Mrs. Eluia asked me if I'd lead worship if there was no speaker, so I prepared something. As it turned out, there was no speaker.

I feel like it went well. I have been involved in liturgical leadership in my (TEC) church for a long time, but this was my first time doing it in a non-Episcopal context. This was the order we followed, loosely based on the structure of Morning/Evening Prayer:

Opening hymn
The collect of the day
The psalm
Another hymn
The Gospel
Some remarks I'd prepared on the Gospel
Another hymn
The Lord's Prayer
I asked for any prayer concerns and prayed extempore for those for whom prayer had been requested
We finished with another hymn followed by the hymn "God be with you till we meet again," which has become their standard dismissal.

I'd appreciate any tips/insights from any of you who have led worship in nursing/retirement/assisted living homes. Mrs. Eluia did suggest I talk a little louder for the benefit of the hard-of-hearing. As far as homilies, what considerations might I keep in mind in tailoring the message to this audience?

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gog
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Main question I'd as is how coherent are the folks you are leading.

At one home I go to they are very coherent (this been a mid week service) so they get most of what I delivered on the Sunday.

At another they are a mixed bunch (Sunday afternoon), and they get Sunday service lite. Something like what you've outlined and short reflection on the reading.

At the third, they are not quiet as with it, so get the lite version of what has happened.

The main thing I find is to treat them as people and work to the level they can take things at.

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Amanda B. Reckondwythe

Dressed for Church
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I think the service you outlined above sounds lovely. Maybe a few too many hymns, though, for the old folks to warble through. I'd have an opening and closing hymn only, and maybe a Doxology after the psalm, and move the Lord's Prayer to after the intercessions, but otherwise it looks good.

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"I take prayer too seriously to use it as an excuse for avoiding work and responsibility." -- The Revd Martin Luther King Jr.

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Al Eluia

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quote:
Originally posted by Amanda B. Reckondwythe:
I think the service you outlined above sounds lovely. Maybe a few too many hymns, though, for the old folks to warble through. I'd have an opening and closing hymn only, and maybe a Doxology after the psalm, and move the Lord's Prayer to after the intercessions, but otherwise it looks good.

This is a group that likes to sing (although a couple of the hymns we picked out were pitched a bit high for me!). I like your suggestion of a doxology and moving the Lord's Prayer. We use an evangelical hymnal that doesn't have canticles, but they should know the Old 100th.

To reply to gog, a couple of the ladies have memory issues but not quite what would qualify as dementia.

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Nick Tamen

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# 15164

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quote:
Originally posted by Amanda B. Reckondwythe:
I think the service you outlined above sounds lovely. Maybe a few too many hymns, though, for the old folks to warble through. I'd have an opening and closing hymn only, and maybe a Doxology after the psalm, and move the Lord's Prayer to after the intercessions, but otherwise it looks good.

My experience is that for these groups, the more singing—of familiar hymns—the better. It creates a connection that few other things can. The groups like this I've known an interacted with prefer to cut just about everything else before they cut the singing. YMMV, of course.

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The first thing God says to Moses is, "Take off your shoes." We are on holy ground. Hard to believe, but the truest thing I know. — Anne Lamott

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Baptist Trainfan
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# 15128

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I do a regular service in two Sheltered Housing places. Most of the residents are coherent. I usually do:

Opening hymn
Prayer
Bible reading
Message
Hymn
Confession/intercessions, ending with Lord's Prayer
Hymn
Grace/blessing.

Of course this is basically a cut-down or rearranged version of a "standard" nonconformist service. It lasts between 25-30 minutes. Then we have tea and biscuits! The hymns are traditional.

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Gee D
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I'd keep the hymns, sticking to old favourites with the older music. It's amazing how well they stay in the memories of those whose minds otherwise are not as good as they once were.

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Not every Anglican in Sydney is Sydney Anglican

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John Holding

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Just remember that the people who first rejected the exclusive use of trad hymns are now in their late 60s and early 70s. We're the people who liked the folk style new music and Graham Kendrick.

At my age (70) I suppose I could be one of those people in the home, and if you dare unleash the trad version of the Lord's Prayer on me, or try to make me sing what currently pass for golden oldies in the hymn world, I will find another way to satisfy my spiritual needs.

John

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Al Eluia

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# 864

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quote:
Originally posted by John Holding:
. . . if you dare unleash the trad version of the Lord's Prayer on me, or try to make me sing what currently pass for golden oldies in the hymn world, I will find another way to satisfy my spiritual needs.

Funny you should mention the Lord's Prayer. When we got to that I intended to say the trad version but got mixed up because we say the modern version at church. I don't know what came out of my mouth, but I'm sure the Lord honored the intent.
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Amanda B. Reckondwythe

Dressed for Church
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quote:
Originally posted by John Holding:
The people who first rejected the exclusive use of trad hymns are now in their late 60s and early 70s. We're the people who liked the folk style new music and Graham Kendrick.

Good Lord, has it really come to this?

BTW -- I'm 71 and rejected the concept of mass as hootenanny right from the start. "Give me that old time religion, it's good enough for me."

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"I take prayer too seriously to use it as an excuse for avoiding work and responsibility." -- The Revd Martin Luther King Jr.

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Galloping Granny
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# 13814

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quote:
Originally posted by Al Eluia:
quote:
Originally posted by John Holding:
. . . if you dare unleash the trad version of the Lord's Prayer on me, or try to make me sing what currently pass for golden oldies in the hymn world, I will find another way to satisfy my spiritual needs.

Funny you should mention the Lord's Prayer. When we got to that I intended to say the trad version but got mixed up because we say the modern version at church. I don't know what came out of my mouth, but I'm sure the Lord honored the intent.
I've been caught like that in an ordinary church service – in the city we've used the modern version for decades, so I have to take a printed copy at Matarangi.
The continuing care home that I go to there (not to lead the worship, just as support for the friend who does it) has a (familiar!) bible reading, some simple observations following from it, a prayer and the Lord's prayer, and 3 or 4 of the hymns they sang as kids. Not in that order. I know some of them are pretty confused, and this is what they enjoy.

GG

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Nick Tamen

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# 15164

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quote:
Originally posted by Al Eluia:
quote:
Originally posted by John Holding:
. . . if you dare unleash the trad version of the Lord's Prayer on me, or try to make me sing what currently pass for golden oldies in the hymn world, I will find another way to satisfy my spiritual needs.

Funny you should mention the Lord's Prayer. When we got to that I intended to say the trad version but got mixed up because we say the modern version at church. I don't know what came out of my mouth, but I'm sure the Lord honored the intent.
I've heard worship leaders in contexts like this invite those gathered to say the Lord's Prayer in whatever words are familiar and comfortable to them. Sure, those of us saying "debtors" will need to wait a second for those saying "those who trespass/sin against us" to catch up. But it usually works just fine.

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mdijon
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quote:
Originally posted by John Holding:
The people who first rejected the exclusive use of trad hymns are now in their late 60s and early 70s. We're the people who liked the folk style new music and Graham Kendrick.

quote:
Originally posted by Amanda B. Reckondwythe:
Good Lord, has it really come to this?

BTW -- I'm 71 and rejected the concept of mass as hootenanny right from the start. "Give me that old time religion, it's good enough for me."

You mean this?

There's all sorts of traditions and old time means something different for different places and ages.

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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon

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gog
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Just having come fro taking a service in a residential home reminded my self of a couple of other pointers.

1) Read the hymn in full, this gets it into peoples mind, and those with sight issues can join in as they have just had a memory jog of the words.

2) While going for older hymns, I tend to also go for simple tunes (or ones that don't break into harmony parts), as it helps to get and keep the singing going

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Al Eluia

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Thanks! These are all good comments. I may actually be willing to lead the service again.

Re gog's comment above: the hymnal this group uses (copies of which were provided by a local church) is pretty good as far as familiar, singable hymns. I'm thankful for that.

BTW there was one speaker a while back whose talk recapped the entire book of Job. The service is usually half an hour but in that case it dragged on for nearly an hour. Not doin' that!

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Mamacita

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Is there a church in your area that uses Godly Play for its children's Christian Formation? There is a growing body of experience of using Godly Play with older adults and even with folks who have dementia. If you can connect to that somehow, having someone occasionally do a Godly Play story in place of the homily/comments could be enriching.

[ 22. June 2016, 15:21: Message edited by: Mamacita ]

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Do not be daunted by the enormity of the world’s grief. Do justly, now. Love mercy, now. Walk humbly, now. You are not obligated to complete the work, but neither are you free to abandon it.

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Al Eluia

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quote:
Originally posted by Mamacita:
Is there a church in your area that uses Godly Play for its children's Christian Formation? There is a growing body of experience of using Godly Play with older adults and even with folks who have dementia. If you can connect to that somehow, having someone occasionally do a Godly Play story in place of the homily/comments could be enriching.

Interesting idea. We actually use GP with the kids at our church.

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mark_in_manchester

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I've enjoyed this thread - I'm 45, but personally I'd much rather 'All creatures that on earth do dwell', 'Come down oh love divine', 'Tell me the old old story' or even 'will your anchor hold...' than much else. What hope do I have in 30 year's time that anyone sentient will know how to humour me!

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(so good, I wanted to see it after my posts and not only after those of shipmate JBohn from whom I stole it)

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Cathscats
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I take care home worship in a place where dementia is rife - most have some degree of it in various forms. I tend to base my service, which includes two readings and tow prayers and three hymns, around either what I have done/ will be doing for a children's address in church or around what I do at assembly in the primary school. In other words, simple and lots of visuals. We also have the hymns, mainly old faithfuls, printed in very large size on individual sheets of paper to give out and take in again immediately after we have sung - this is easier than looking up and holding a hymn book, and by taking them in it stops wondering what they are from further distracting our already confused congregation. We always say the Lord's Prayer. And at the end the pianist plays Scottish airs and we either have a sing song or do a wee dance! Church should be joyful.....

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"...damp hands and theological doubts - the two always seem to go together..." (O. Douglas, "The Setons")

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Graven Image
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Keep it short and simple without talking down to people.

One service I did we always had the Lord's Prayer and the 23rd psalm because all could remember the words. Even those who would nod off for most of the service would chime in for those 2 parts.

I also liked to leave them with something, a paper book mark or such so they had a reminder of being with us. They would tell me they gave it to a family member who visited, or showed it to someone. Give them something to talk about.

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leo
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A colleague of mine asked what I would do if, giving communion, someone spits a half-swallowed consecrated host across the room.

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Leorning Cniht
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quote:
Originally posted by leo:
A colleague of mine asked what I would do if, giving communion, someone spits a half-swallowed consecrated host across the room.

Take off and nuke the site from orbit. It's the only way to be sure.
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leo
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It was a serious question- what do catholics think should be done?

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kingsfold

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Bury it?
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Al Eluia

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quote:
Originally posted by kingsfold:
Bury it?

I'd think that would be the correct answer unless one consumes it.

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Leorning Cniht
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# 17564

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I think the serious answer is to wrap the contaminated host and take it back to the church, place it in water until it dissolves, and pour the result down the piscina (or whatever you usually do.)
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Forthview
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From the Catholic POV the Host should be placed in water and left until it completely dissolves and is then poured down the sacrarium.

In a way I now understand the Presbyterian idea of throwing unused communion bread to the birds. It does indeed return the Sacrament to the earth.

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Anselmina
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Al Eluia
your order of service looks just about right, to me. Perhaps for some groups of people, depending on ability, one might have to be a bit flexible, deciding on the moment whether or not to do everything one has planned, or to do prayers in a different way, eg. But it looks really nice what you've done already.

I used to share such a worship time with a Methodist woman, who because she played the accompaniment for the music chose all the hymns. She used to choose all these lovely old Methodist choruses and hymns, which even I hadn't heard of, despite a wide experience of cross-denominational singing. And as our usual constituency of worshipper was Catholic and Anglican the music response was not always great! We had to negotiate a bit on what was 'popular', as in likely to be well known across the board. A task harder than it looks!

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Spike

Mostly Harmless
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quote:
Originally posted by leo:
A colleague of mine asked what I would do if, giving communion, someone spits a half-swallowed consecrated host across the room.

I've known it happen. I usually wrap it in tissue then bury it in the churchyard

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"May you get to heaven before the devil knows you're dead" - Irish blessing

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Moo

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quote:
Originally posted by Al Eluia
Mrs. Eluia did suggest I talk a little louder for the benefit of the hard-of-hearing.

Speaking loudly won't necessarily help that much. It is much more important to speak distinctly. I have hearing problems, and one of my greatest difficulties is figuring out where one word ends and the next one begins. It helps when people speak more slowly.

Some preachers speak distinctly during much of the sermon, but speak some phrases very quickly. This leaves me guessing.

A young woman at our church was ordained deacon recently and read the gospel at the next Sunday service. I think that's the first time I understood every word. She had a voice that 'carried' very well and she enunciated clearly. I can't tell you how much I enjoyed it.

Moo

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See you later, alligator.

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Al Eluia

Inquisitor
# 864

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quote:
Originally posted by Moo:
[QUOTE]Speaking loudly won't necessarily help that much. It is much more important to speak distinctly.

Great point. I think I may have gotten mumbly at one or two points. In future I will make it a point to speak distinctly, as you say. I've been told I have a fairly stentorian voice. [Smile]

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Lothlorien
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# 4927

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quote:
Originally posted by Al Eluia:
quote:
Originally posted by Moo:
[QUOTE]Speaking loudly won't necessarily help that much. It is much more important to speak distinctly.

Great point. I think I may have gotten mumbly at one or two points. In future I will make it a point to speak distinctly, as you say. I've been told I have a fairly stentorian voice. [Smile]
Backing Moo up here, strongly. Clear speech is essential and I have problems with strong accents too.

[ 03. July 2016, 02:21: Message edited by: Lothlorien ]

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ThunderBunk

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I've also been told that a beard gets in the way horribly for any who lipreads, whether consciously or unconsciously. In honour of which I always trim my moustache if I'm going to read in church. The part below the lips doesn't get in the way because it grows away from the lips, but the moustache can blur the outline so I trim everything to a clear line.

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Belle Ringer
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# 13379

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Two unrelated thoughts.

1. When my parents were very old, they usually looked disengaged when they were actually paying close attention. Facial expressions take energy, there wasn't the energy. Also the mind was slower but still intelligent.

Some people have some dementia, (some have boredom and depression that give the impression of mild dementia), but there's more interest and awareness going on than the visual clues may suggest.

2. People I know who do music in old folks homes tell of people with alzheimers who haven't spoken a coherent word or shown awareness of surroundings in a year singing along to a familiar hymn and accurately tapping the rhythm.

Healthy people who are lifetime stutterers or who struggle with speech because of a stroke can usually sing the words just fine. (Been there, first thing my neurologist said was "sing" to communicate clearly and to help heal the injured brain.)

Music is deeply important to brain function and memory and communication.

All of which suggests lots of music and some words, not lots of words with just a brief hymn verse or two. I don't mean turn it into a sing-along instead of a church program, but don't skimp on hymns to get more time for more spoken words.

[ 03. July 2016, 14:46: Message edited by: Belle Ringer ]

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Pomona
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I know Godly Play can be used well for people with dementia, but on the whole I am not a fan of using children's materials for old people. Old people are not children; they will likely have had sex, been married, had children of their own, had a career, fought in major wars. Given the ageing Boomer population, it's likely that more and more people in assisted living homes will have been part of the sexual revolution and civil rights movements. I don't think it's appropriate to reuse a children's address for someone who went on the March on Washington. Obviously such children's addresses may be absolutely wonderful and not dumbed-down, but it is not at all the same audience - eg David and Bathsheba will have little relevance to children, but may well have lots of relevance to older people who will have at least lived though major public marital scandals. I think one can use more creative and less verbal ways of delivering a sermon without it being the same as a children's address.

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Consider the work of God: Who is able to straighten what he has bent? [Ecclesiastes 7:13]

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Graven Image
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I remember going into a care home to visit a lady who had a stroke and could not talk. She kept pointing at the wall and making sounds of distress. Not sure what was wrong I tried to figure it out. Did she want the window open and such? Finally I pointed to a cut out of a Disney princess on her wall. She grew very excited. When I asked if she wanted me to take it down she seemed please so I took it down and she calmed down. This lady who had been a teacher and a writer did not need a childish picture on her wall to stare at all day long. I second the no vote for Godly play.
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Piglet
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quote:
Originally posted by Belle Ringer:
... Healthy people who are lifetime stutterers or who struggle with speech because of a stroke can usually sing the words just fine
...

When we were in Belfast, one of the retired Canons at the cathedral suffered a stroke. The assistant organist went to visit him in hospital, and as soon as he saw him, Canon J. started to sing the priest's part of the Rose Responses. The organist responded with the choral part, and it was one of the ways he got his speech back.

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alto n a soprano who can read music

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Jengie jon

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Also for lip readers, or those who rely on lip movement to hear.

Look up, not down at your book

Stand facing the main source of light if you can but have any projector screen in a dark corner.

Jengie

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"To violate a persons ability to distinguish fact from fantasy is the epistemological equivalent of rape." Noretta Koertge

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Mamacita

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quote:
Originally posted by Pomona:
I know Godly Play can be used well for people with dementia, but on the whole I am not a fan of using children's materials for old people. Old people are not children; they will likely have had sex, been married, had children of their own, had a career, fought in major wars. Given the ageing Boomer population, it's likely that more and more people in assisted living homes will have been part of the sexual revolution and civil rights movements. I don't think it's appropriate to reuse a children's address for someone who went on the March on Washington. Obviously such children's addresses may be absolutely wonderful and not dumbed-down, but it is not at all the same audience - eg David and Bathsheba will have little relevance to children, but may well have lots of relevance to older people who will have at least lived though major public marital scandals. I think one can use more creative and less verbal ways of delivering a sermon without it being the same as a children's address.

Pomona, perhaps I misunderstand your post, but I would like to clarify that Godly Play is nothing like a "children's address." I don't want to derail the thread by going into a long defense of it, so I will simply leave these two links for anyone who might want to do further research:


The Godly Play Foundation - the basic website for anyone interested or curious

Article about a program of using Godly Play with the elderly - the last 2/3 of the article goes into some detail about how the Godly Play method of biblical storytelling has sparked memory recovery in older adults. I would suggest this speaks to your concern that older adults' life experiences would be dismissed or disregarded. On the contrary, their life experiences are being evoked, recovered, and honored.

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Do not be daunted by the enormity of the world’s grief. Do justly, now. Love mercy, now. Walk humbly, now. You are not obligated to complete the work, but neither are you free to abandon it.

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Belle Ringer
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Went to the weekly episcopal service at assisted living.

Started with one hymn (2 verses) accompanied by piano, from then on no music.

Collect and a couple other prayers, three long readings (OT, NT, Gospel) prefaced by a long introduction to the OT reading, a sermon (she said based on the preacher's most recent sermon - not sure what "based on" means, it seemed as long as any sermon in that church but maybe it wasn't), Lords prayer twice - the old version used in that church's formal service plus the "Welsh" version ("life giver" etc) used in the "informal" service, communion, prayers of the people, closing prayer.

I was surprised at doing lords prayer twice, one right after the other (in two versions). ETA - or is that the creed in modern language? by them i was too bored to pay attention.

Other than opening hymn, no music. Also they took out most responses - like, prayers of the people was read straight through, not pause every short paragraph for a response.

These are mentally competent people with physical inability to live alone.

I have no idea if the residents like it exactly this way (some Episcopalians prefer a said service), or if they would prefer fewer words and more music. (The group was 4 residents, 4 volunteers, and me visiting by invitation)

The monthly Methodist service at assisted living (about a dozen residents attend) uses 3 or 4 hymns, during the event asks residents for suggestions what hymn they would like next; but Methodists are proud of a tradition of lots of singing and I guess don't have a tradition of a said service.

(I think a couple of the "conservative churches show up at least monthly. And a woman leads a sing-along weekly of religious songs, all PSA theology.)

Interesting point upthread that today's people in their 70s-90s are not singing the songs we gray haired associate with our own grandparents. I've been to nursing home sing-alongs where the leader is passing out words for "bicycle built for two" to people who relate to swing era and 50s music, not turn of the last century. Church music choices and styles evolve too, even if you leave out CCM.

[ 09. July 2016, 04:07: Message edited by: Belle Ringer ]

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Belle Ringer
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P.S. Chatted with assisted living preacher today. She said only one hymn "because they cant sing."

I don't know if she means they can't sound good singing, or they can't find the familiar tune, or they don't want to sing because its too much work, or they've been told older voices sound bad and they shouldn't try, or what.

(One man said to me he can't sing but he wishes he could.)

I have noticed before people truly cant carry a tune sound much better and are more willing to join in for bouncy songs than quiet slow songs.

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Graven Image
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I found having a list of only 9 hymns and choosing three each visit helped as people grew use to singing they sang with more confidence.
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Karl: Liberal Backslider
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quote:
Originally posted by Belle Ringer:

Interesting point upthread that today's people in their 70s-90s are not singing the songs we gray haired associate with our own grandparents. I've been to nursing home sing-alongs where the leader is passing out words for "bicycle built for two" to people who relate to swing era and 50s music, not turn of the last century. Church music choices and styles evolve too, even if you leave out CCM.

This is a common problem. We (speaking as a pretty average aged person - 48 since you ask) remember the old people of our youth who were born around 1900-1920 and forget they're all dead now and today's old people are the middle aged people of our youth, the baby boomers and those a shade older, who were young in the 50s and 60s.

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Leorning Cniht
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quote:
Originally posted by Belle Ringer:

Interesting point upthread that today's people in their 70s-90s are not singing the songs we gray haired associate with our own grandparents. I've been to nursing home sing-alongs where the leader is passing out words for "bicycle built for two" to people who relate to swing era and 50s music, not turn of the last century.

Ha!

My Dad's in his 70s, and I grew up with him singing "Daisy, Daisy" to me, very badly. (And I have inherited his lack of musical ability.) He has, as I remember, 50s stuff in his record collection, but what he would choose to listen to is different from what he would choose to sing. What he sings are basically music hall staples that are easy to sing...

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Zappa
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and they'd better play the Stones, Deep Purple, and Dylan when I make my way in there ...

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and mayhap this too: http://broken-moments.blogspot.co.nz/

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Zappa
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For those of us who are stuffy anglo-catholics and similar sacramentalists, there is always the dispensationlist issue of those who receive communion when that is at issue, chew Jeus thoughtfully, then drown him in a luke-warm cup of tea or attach him to the underside of the wheel chair.

Those are both actualities from my years of leading worship in assisted living ... they earthed my sacramental theology no end [Eek!]

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shameless self promotion - because I think it's worth it
and mayhap this too: http://broken-moments.blogspot.co.nz/

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Gee D
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The hymn tunes of their youth will be remembered, no matter else they forget. Madame went to the funeral of the wife of a former ++Sydney. His mind has gone to the extent that he had no idea what the nice place was that his sons had taken him to, save that it was nice - it happened to have been their parish church for decades. No idea why his shirt was a bit different at the collar or why it was purple. But all through the service, he knew the hymns by heart and sang along.

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Not every Anglican in Sydney is Sydney Anglican

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Dennis the Menace
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I play for a Communion service once a month at a care home. Three hymns, all very well known. Usually 'Trust and Obey' 'Blessed Assurance' and a couple of other 'pot boilers'. Someone gives out a sheet with the words as I play over and they are collected after each hymn to stop paper rustling etc. The attendance varies from 8 (last time) up to 25. A retired minister and his wife were regular attenders until her death 3 months ago. She was a dear person who knew the words to all hymns, at times getting verses confused.

The singing almost month was almost non existent! If I sing whilst playing I lose my place and timing etc!

It is a very simple service with a reading and a 5min sermon on the reading and Communion, over in 35 mins.

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"Till we cast our crowns before Him; Lost in wonder, love, and praise."

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