Music therapist Becky Pansch of Fairview Hospice in Minneapolis and client Kevin Pollari in his living room | Credit: Marie Gentile, Fairview Health Services
Table of Contents
Introduction
If you or someone you love is facing a terminal illness, you may feel overwhelmed by the physical, emotional, and spiritual challenges that come with it. You may wonder how to cope with the pain, the fear, the grief, and the loss of control. You may also want to find ways to make the most of the time you have left and to leave a lasting legacy for your loved ones.
Music therapy is a form of therapy that can help you and your family deal with these issues. It involves using music and musical activities to improve the health and well-being of people of all ages and backgrounds. Music therapy can help you express your feelings, communicate with others, relax your body and mind, cope with pain and stress, enhance your spiritual connection, and create a meaningful life story.
Music therapy is not a new idea. Different cultures and religions have used it for centuries to heal and comfort the sick and the dying. In recent years, increased research has shown the benefits of music therapy for terminally ill patients and their families. According to the American Music Therapy Association, music therapy can help terminally ill patients and their families by:
Music therapy is also in high demand among terminally ill patients and their families. A National Hospice and Palliative Care Organization survey found that 90% of hospice patients and families wanted music therapy as part of their care. Still, only 35% of hospices offered it. This shows a gap between the need for and the availability of music therapy services for this population.
This article aims to inform you about music therapy and how it can benefit you and your family if they are facing a terminal illness. We hope this article will inspire you to explore music therapy as a source of hope and healing for you and your family. Music therapy can help you and your family cope with the challenges of a terminal illness and make the most of the precious moments you have together. Music therapy can be a melody of hope for the terminally ill.
What is Music Therapy, and How Does It Work?
Music therapy is a type of therapy that uses music and musical activities to help people who are facing physical, mental, emotional, or spiritual challenges. It is an allied health profession, which means it works with other health professionals, such as doctors, nurses, social workers, and counselors, to provide the best care for patients and their families.
Music therapists are trained and certified professionals who have completed a clinical internship and a music therapy degree. They use their knowledge and skills in music and psychology to assess the needs and preferences of each patient and family and design and implement a personalized music therapy program.
Music therapy can involve different approaches and techniques, depending on the patient's and family's goals and interests. Some of the common music therapy approaches and techniques are:
Songwriting: This is when the patient and family create their songs or lyrics, with or without the help of the music therapist. Songwriting can help patients and families express their feelings, thoughts, and experiences and create a meaningful and lasting memory.
Improvisation: This is when the patient and family make music on the spot, using their voice, instruments, or objects. Improvisation can help the patient and family explore their emotions, communicate with each other, and cope with uncertainty and change.
Guided imagery occurs when the patient and family listen to music and imagine a scene or story related to their situation. It can help the patient and family relax, reduce pain, and find comfort and hope.
Lyric analysis is when the patient and family listen to or read a song's lyrics and discuss its meaning and relevance to their lives. Lyric analysis can help the patient and family understand and cope with their feelings, beliefs, and values and gain insight and perspective.
Singing is when the patient and family sing along to recorded or live music or sing their songs. Singing can help the patient and family improve their breathing, voice, and mood and bond with each other and the music therapist.
Instrument playing: This is when the patient and family play musical instruments, either alone or together, with or without the guidance of the music therapist. Instrument playing can help the patient and family improve their physical, cognitive, and emotional skills, have fun, and enjoy themselves.
Relaxation is when the patient and family listen to soothing music and practice breathing, meditation, or other relaxation techniques. Relaxation can help the patient and family reduce stress, anxiety, and pain and promote well-being and peace.
Music therapy can help terminally ill patients and their families in many ways, such as:
Communication: Music therapy can help terminally ill patients and their families communicate with each other, especially when words are not enough or too challenging to say. Music therapy can help the patient and family express their feelings, needs, and wishes and listen and understand each other better.
Emotions: Music therapy can help terminally ill patients and their families cope with the complex and intense emotions that come with a terminal illness, such as sadness, anger, fear, guilt, and loneliness. Music therapy can help patients and families release, regulate, and transform their emotions and find comfort, joy, and hope.
Pain: Music therapy can help terminally ill patients and their families manage the physical and emotional pain that they may experience. It can help the patient and family distract, soothe, and control their pain and enhance the effects of medication and other treatments.
Stress: Music therapy can help terminally ill patients and their families reduce the stress and pressure they may face. Music therapy can help the patient and family relax, calm down, cope with stress, and improve their quality of life and well-being.
Spiritual: Music therapy can help terminally ill patients and their families enhance their spiritual well-being, which is their sense of meaning, purpose, and connection. Music therapy can help the patient and family explore and express their spirituality and find support and comfort in their faith, values, and beliefs.
Legacy: Music therapy can help terminally ill patients and their families create a legacy, the lasting impression and memory they leave behind for their loved ones and future generations. Music therapy can help the patient and family build and share their life stories, songs, messages, and gifts and celebrate and honor their lives.
The Evidence and Benefits of Music Therapy for the Terminally Ill
You may wonder if music therapy works and if it has any scientific evidence to support its claims. The answer is yes. Many studies and reviews have proven that music therapy is effective and beneficial for terminally ill patients and their families.
For example, a recent study by Continua Group found that music therapy improved the quality of life and well-being of hospice patients and their caregivers. The study involved fifty-one hospice patients and thirty-eight caregivers who received music therapy sessions for six weeks. The results showed that music therapy:
Reduced pain, anxiety, depression, and fatigue for both patients and caregivers
Increased comfort, relaxation, happiness, and satisfaction for both patients and caregivers
Enhanced communication, bonding, and support between patients and caregivers
Helped patients and caregivers cope with grief and loss
Another example is a meta-analysis by Bradt et al. that reviewed fifty-two studies on the effects of music therapy on palliative care patients. The meta-analysis found that music therapy had a moderate to large positive effect on:
Psychological well-being, such as mood, stress, coping, and quality of life
Physical well-being, such as pain, nausea, heart rate, and blood pressure
Social well-being, such as communication, relationships, and isolation
A third example is an article by AARP that explains how music affects the brain and its functions. The article reported that music can:
Stimulate the brain regions involved in memory, emotion, language, and movement
Enhance the brain's plasticity, which is the ability to change and adapt
Protect the brain from aging and cognitive decline
Boost the brain's mood and motivation
These are just some of the many studies and reviews that show the evidence and benefits of music therapy for terminally ill patients and their families. Music therapy can help terminally ill patients and their families improve their health and well-being, making their end-of-life journey more peaceful and meaningful. Music therapy is a promising and valuable therapy for terminally ill patients and their families, and it deserves more attention and improvement to reach its full potential and impact.
Case Studies of End-of-Life Patients Who Benefited from Music Therapy
P. B: The patient was lying in bed with eyes open. The music therapist provided relaxation and encouraged comfort through live sedative guitar with humming. After evaluating the response to sedative guitar and humming, the music therapist continued to provide sedative music with the humming of the preferred music. The music therapist met and talked briefly with the patient's daughters, facilitating and encouraging moments for interaction and comfort via calming touch and speaking softly to the patient. Upon completion of the session, the patient was calm, lying in bed with eyes closed and a relaxed muscle tone. The patient's family expressed gratitude for the time and service.
B. M: the patient was seated in the lounge area, displaying a blank effect upon the therapist's arrival. They transitioned to the room with the therapist's assistance. The music therapist provided live music interventions to encourage engagement and increase quality of life. Upon engaging in “Blue Skies,” the patient brightened in response to the music and the interaction. They demonstrated engagement throughout the session and communicated preference via gestures, tapping, and intermittently brightening in response to the music and interaction. Upon completion of songs, the patient returned to displaying blank affect. The patient displayed blank affect with eyes open upon completion of the session.
E. O: The patient presented with blank affect lying in bed. The music therapist provided live music interventions via sedative guitar and humming. After evaluating tolerance to humming and sedative guitar, the music therapist began to sing live, familiar songs. The patient intermittently made eye contact with the music therapist in response to the music and interaction. The music therapist also observed verbal interactions from the patient, indicating seeing items that were not in the room. The patient was intermittently redirected to the music, turned their head towards the music therapist, and provided eye contact. Upon completion of the session, the patient displayed calm, lying down with eyes closed and a relaxed muscle tone.
T. B: Patient present lying in bed with eyes closed upon therapist's arrival. The music therapist provided live music interventions via sedative guitar to encourage relaxation. The patient opened their eyes twice in response to the music and interaction, looking towards the music therapist and saying “hello.” The patient was easily redirected back to resting after communicating with the music therapist. The music therapist continued to provide sedative guitar throughout the session, adding humming upon determination of the patient's tolerance to the music. The patient continued to rest throughout the session. Upon completion of the session, the patient was lying in bed with eyes closed and a relaxed muscle tone.
R. F: The patient presented lying in bed with eyes closed upon the therapist's arrival. The patient's wife was also present in the room. The music therapist provided live music interventions via voice and guitar. The patient and wife shared musical preferences throughout the session. The patient intermittently opened his eyes in response to the music and interaction. While listening to “Country Roads” per request, the patient smiled in response to the music. He also engaged in verbal discussion with his wife throughout the session and shared affirmations in response to memories shared by his wife. The music therapist provided a listening ear and validation throughout the sharing of memories and the relationship between the patient and their wife. Throughout the session, the patient and wife verbalized feeling “calm” and “relaxed” in response to the interventions. Upon completing the session and lying down with his eyes closed, sharing farewell and expressing gratitude for the services provided, the patient displayed calm.
S. F: Patient presented lying in bed with eyes closed upon the music therapist's arrival. The patient opened their eyes upon hearing the therapist's greeting. The music therapist provided live music interventions via familiar songs with voice and guitar. The patient demonstrated active engagement and active listening. She intermittently opened her eyes in response to the music and interaction. The patient chose the style of music (stimulative vs sedative) with prompts and encouragement. The patient displayed calm upon completing the session and lying down with eyes closed and a relaxed muscle tone.
S. M: Patient presented seated upright in the chair with a smile. The music therapist provided familiar songs via voice and guitar to encourage social interaction, stimulation, and reminiscence. The patient demonstrated active engagement and singing lyrics to known songs, brightening, laughing, and swaying in response to the music and interaction. The patient made eye contact with the music therapist while listening and singing. The patient verbally discussed memories with the music therapist's encouragement and validation. Upon the session's completion, the patient smiled and laughed brightly and shared farewell with the music therapist.
H. M: The patient is lying in bed listening to the radio upon the music therapist's arrival. The patient shifted to turn off the radio and winced. With validation, the patient shared that he was currently in pain. The music therapist provided music relaxation via sedative guitar and humming to support pain management. The patient closed his eyes and began to rest in response to the music. The patient began to display a relaxed muscle tone throughout the session, eventually falling asleep and resting while listening to the music. Upon completion of the session, the patient remained asleep, eyes closed, deep breathing, and a relaxed muscle tone.
How to Access Music Therapy Services and Resources Without Traveling
If you are interested in music therapy, you may wonder how to access services and resources without traveling. Traveling can be difficult, costly, and stressful for terminally ill patients and their families, especially if they live in remote or rural areas or have limited mobility or transportation options.
Fortunately, there are many ways that you can access music therapy services and resources without traveling, such as:
Home-based care is when a music therapist visits you and your family and provides music therapy sessions in your environment. It can be convenient, comfortable, and personalized for you and your family, saving you time and money on traveling.
Telehealth is when a music therapist connects with you and your family through a phone, computer, or tablet and provides music therapy sessions remotely. Telehealth can be flexible, accessible, and interactive for you and your family, and can also overcome the barriers of distance and location.
Online platforms: This is when you and your family use online platforms, such as websites, apps, or social media, to access music therapy resources, such as information, education, music, videos, or podcasts. Online platforms can be informative, engaging, and supportive for you and your family and offer various choices.
Community organizations: This is when you and your family join or partner with community organizations, such as hospices, churches, schools, or clubs, that offer music therapy services or resources for their members or clients. Community organizations can be welcoming, inclusive, and collaborative for you and your family and provide a sense of belonging and connection.
Here are some examples of music therapy providers and programs that offer these options for terminally ill patients and their families:
Every Day Harmony is a music therapy charity that provides home-based and telehealth music therapy services for people with life-limiting illnesses and their families in Northern Ireland. Every Day Harmony aims to improve its clients' quality of life and well-being through music therapy and raise community awareness and understanding of music therapy.
Music Therapy Association of BC: This professional association represents and supports music therapists and music therapy students in British Columbia, Canada. The association offers online platforms, such as a website, a blog, and a podcast, that provide music therapy resources, such as information, education, music, videos, and stories, for the public and its members.
Riley Hospital for Children: This children's hospital in Indiana, USA, provides comprehensive and specialized health care for children and their families. Its music therapy program offers home-based, telehealth, and community-based music therapy services for children with life-threatening or chronic illnesses and their families.
We encourage you to contact a certified music therapist or an organization to learn more about music therapy and how it can benefit you and your loved ones without traveling. You can find a music therapist or a music therapy organization near you by visiting the websites of the American Music Therapy Association, the World Federation of Music Therapy, or the International Association for Music and Medicine. You can also ask your doctor, nurse, social worker, or counselor for a referral or a recommendation. Music therapy can be a melody of hope for you and your family, and you can access it without traveling.
Hospices with a Music Therapy Program
If you or your loved one are facing a terminal illness, you may have heard of hospice care as an end-of-life care option. Hospice care focuses on providing comfort, dignity, and quality of life for people with a life expectancy of six months or less. It differs from palliative care, a broader type of care that can be given to anyone with a serious illness, regardless of their prognosis or treatment goals.
Hospice care differs from palliative care in terms of eligibility, duration, and location of services. To be eligible for hospice care, you or your loved one must have a terminal diagnosis from a doctor and choose to stop any curative or life-prolonging treatments. Hospice care is usually provided for as long as you or your loved one needs it if the doctor certifies that the prognosis is still six months or less. Hospice care can be provided in various settings, such as your home, a nursing home, a facility, or a hospital.
One of the services that hospice care may offer is music therapy. Music therapy is a form of therapy that uses music and musical activities to help you or your loved one cope with the physical, emotional, cognitive, and spiritual challenges of a terminal illness. Music therapy can help you or your loved one:
Create a legacy, such as a song, a recording, or a playlist
Music therapy can also benefit your family and caregivers by:
Providing support, education, and guidance
Enhancing bonding, intimacy, and communication
Easing grief, loss, and bereavement
Improving mood, well-being, and quality of life
We hope this section has given you some information and insight into hospice care and music therapy. If you or your loved one are interested in hospice care and music therapy, you can contact a hospice provider or a music therapist near you to learn more. Hospice care and music therapy can be a melody of hope for you and your family.
How Hospices Can Start a Music Therapy Program
If you are a hospice provider or administrator, you may be interested in starting or expanding a music therapy program for your patients and families. Music therapy can enhance the quality of hospice care by addressing the physical, emotional, cognitive, and spiritual needs of terminally ill patients and their families. It can also benefit your hospice staff by providing support, education, and satisfaction.
Starting or expanding a music therapy program may seem daunting, but it is not impossible. Here are some steps and considerations that can help you create a successful music therapy program for your hospice:
Hire a board-certified music therapist: A board-certified music therapist (MT-BC) is a professional who has completed a degree in music therapy, a clinical internship, and a national exam. An MT-BC has the knowledge and skills to assess, plan, implement, and evaluate music therapy interventions for hospice patients and families. An MT-BC can also collaborate with other hospice staff and provide training and supervision for music therapy students or volunteers. You can find an MT-BC near you by visiting the websites of the American Music Therapy Association or the Certification Board for Music Therapists.
Build a foundation and consider the essentials: Before you start or expand your music therapy program, you must have a clear vision, mission, and goals. It would help if you also considered the essentials, such as the budget, space, equipment, policies, and procedures. You need to allocate enough resources and support to ensure its quality and sustainability.
Design specialized programs: Once you have a foundation and the essentials for your music therapy program, you can design specialized programs that meet your patients' and families' specific needs and preferences. You can offer music therapy services, such as individual or group sessions, home-based or facility-based care, live or recorded music, active or receptive interventions, and music vigils or legacy projects. You can also tailor your music therapy interventions to the different stages and phases of the hospice journey, such as admission, stabilization, decline, transition, and bereavement.
Make the program interdisciplinary: A music therapy program is not a standalone service but a part of the multidisciplinary team that provides holistic care for hospice patients and families. A music therapy program should work closely with other hospice staff, such as doctors, nurses, social workers, chaplains, counselors, and volunteers, to coordinate and integrate the care plan for each patient and family. A music therapy program should also communicate and document each patient and family's music therapy goals, interventions, and outcomes and share the feedback and evaluation with the interdisciplinary team.
If you want to start or expand a music therapy program for your hospice, you may also want to find some tips and resources that can help you along the way, such as:
Finding funding sources: Funding is one of the main challenges for starting or expanding a music therapy program. You may need to seek funding from various sources, such as grants, donations, fundraisers, contracts, insurance, or reimbursement. You may also need to demonstrate the value and impact of your music therapy program to potential funders, such as by providing evidence, testimonials, stories, or data.
Establishing partnerships: Partnerships are another key factor for starting or expanding a music therapy program. You may need to establish partnerships with various stakeholders, such as music therapy associations, organizations, schools, researchers, advocates, media, or community groups. You may also need to network and collaborate with other hospices or music therapy programs with similar or complementary goals, services, or populations.
Evaluating outcomes: Evaluation is essential for starting or expanding a music therapy program. You may need to evaluate the outcomes of your music therapy program for your patients, families, staff, and organization, such as using surveys, interviews, observations, assessments, or scales. You may also need to use the evaluation results to improve, modify, or justify your music therapy program and report or disseminate your findings to relevant audiences.
Promoting awareness is another essential element of starting or expanding a music therapy program. You may need to promote your music therapy program to your patients, families, staff, and organization, as well as to the public and the health care system. You may also need to educate and inform them about the benefits, evidence, and availability of music therapy for hospice care and invite them to participate in or support your music therapy program.
Finally, we encourage you to consult with music therapy associations, organizations, and experts for guidance and support when starting or expanding your program. You can find many helpful resources and contacts on the websites of the American Music Therapy Association, the World Federation of Music Therapy, and the International Association for Music and Medicine. You can also contact other hospices or music therapy programs with experience and expertise in music therapy for hospice care. Music therapy can be a melody of hope for your hospice, and you can start or expand a music therapy program with some planning and preparation.
Conclusion
This article taught us about music therapy and how it can benefit terminally ill patients and their families. Music therapy uses music and musical activities to help people cope with the physical, emotional, cognitive, and spiritual challenges of a terminal illness. Music therapy can improve the health and well-being of terminally ill patients and their families and make their end-of-life journey more peaceful and meaningful.
We have also learned about the evidence and benefits of music therapy for terminally ill patients and their families based on many studies and reviews that show the positive effects of music therapy on psychological, physical, and social well-being. We have also learned to access music therapy services and resources without traveling, such as home-based care, telehealth, online platforms, and community organizations. We have also learned about hospices with a music therapy program and how hospices can start or expand a music therapy program.
Music therapy is a promising and valuable therapy for terminally ill patients and their families, and it deserves more attention and improvement to reach its full potential and impact. If you are interested in music therapy, we encourage you to:
Contact a certified music therapist or a music therapy organization to learn more about music therapy and how it can benefit you or your loved ones
Seek music therapy services and resources that are available and accessible to you or your loved ones without traveling.
Support music therapy research and practice by participating, donating, advocating, or volunteering
Share your feedback or experiences with music therapy with us or with others who may benefit from music therapy
We hope this article has inspired you to explore music therapy as a source of hope and healing for you and your family. Music therapy can help you and your family cope with the challenges of a terminal illness and make the most of the precious moments you have together. Music therapy can be a melody of hope for the terminally ill. Thank you for reading.
