Medical Music Therapy, Psychiatric Music Therapy, Geriatric Music Therapy, Music Therapy for Autism, Music Therapy for the Developmentally Disabled, Music Therapy Assisted Childbirth, Music Therapy in Palliative/Hospice Care

"Words can never reach far enough into music to touch her essence. However, with trying, our words will become more musical, our respect and wonder more absorbing, our understanding of music and ourselves deeper."

-- C. BEREZNAK KENNY


Music therapy for the terminally ill is a challenging undertaking in any sense of the word. Therapists working in the palliative care/hospice setting must concern themselves with the physical, psychologic, social, and spiritual aspects of a life-threatening illness as well as be deeply aware of the personal impact that music has on each person. Also to be considered is how each person approaches his/her own illness and end of life. Within this context, music therapy aims at diminishing the impact of the diverse crises around terminal illness and death, but not at resolving them. The choice of how music is to be used during care as well as the choice not to have any music at all are important and should be respected. That being said, many benefits to having a music therapist as part of a multidisciplinary team are known. They bring with them another facet to the whole person care that is needed in order to offer the most comfort to the terminally ill. The following list of uses of music therapy with these patients is adapted from an article by Susan Munro, MT and Balfour Mount, MD entitled "Music Therapy in Palliative Care" which appeared in the Canadian Medical Association Journal and which stemmed from their work at the Royal Victoria Hospital in Montreal, Canada.

Music therapy in palliative/hospice care can be a very rewarding area of practice, but it must be approached intuitively and with concern for the total person involved--from either the patient's or the therapist's perspective.

Physical

  • promoting muscular relaxation
  • breaking the vicious circle of chronic pain by stimulating endorphine release and by relieving anxiety and depression thus altering the perception of pain
  • facilitating physical participation in activities to the degree possible
  • inducing sleep
  • providing distraction to re-focus attention and thus relax the aggravated wretching reflexes which can cause frequent vomiting

Psychologic
  • reinforcing identity and self-concept
  • altering the patient's mood, including easing anxiety and lessening depression
  • helping the patient recall past significant events
  • providing a nonverbal means of expressing a broad range of recognized and unconscious feelings
  • reinforcing reality
  • expressing fantasy
  • as a direct appeal to the emotions
  • as a creative new coping skill to fear and anxiety

Social
  • as a means of socially acceptable self-expression
  • as a bridge across cultural differences and isolation
  • as a bond and sense of community with family members and others, past and present, through the mental associations aroused
  • as a link to the patient's life before the illness
  • providing an opportunity to be part of a group
  • as entertainment and diversion

Spiritual
  • providing means of expressing spiritual feelings and feeling comforted and reassured
  • providing an avenue for expressing doubts, anger, fear of punishment, and questions regarding the ultimate meaning of life

Music Therapy tools most used in this setting include personal cd or tape players with light and comfortable headphones, musical instruments which are portable and easy to use satisfactorily by someone with little or no musical training (omnichord, autoharp, drum, tambourine), musical instruments which can be played for the patients by the therapist and family members (piano, organ, guitar, flute, violin), an extensive cd/tape library with selections ranging in mood, style, and ethnicity and which can be accessed at any time of day or night, large print songsheets and hymnals, and any other supplies which would help in a patient's creative self-expression (including art supplies).

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"Music therapy in palliative/ hospice care ... must be approached intuitively and with concern for the total person involved."

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