Music therapy is the most recent addition to the overall care provided by Gilchrist Hospice. And because this service is new to this particular hospice community, I have had the opportunity to really define what music therapy means in end of life care and how it can be used. In its simplest explanation, music therapy is the use of music (most often live) to help address patient needs and manage symptoms. In hospice, music therapy is another level of care that compliments other disciplines already in place. I believe music therapy is effective, in most cases, because music is something that most people can relate to. Music has the ability to immediately reach our hearing, thinking, and feeling.
Music therapy is effective because it provides a safe, non-threatening opportunity for self-expression, an alternative means for finding relief from pain, and a way for developing relationships (both with the therapist and others). Especially in a medical setting, when patients and caregivers really have very little control over what is happening (disease progression, procedures, medication, loss of independence and privacy), music therapy can provide an opportunity to instill control back into the lives of patients and caregivers. When faced with a life-limiting illness and the decision to stop curative treatment, the impact on the patient and caregiver is extraordinary. Along with other members of the interdisciplinary team, the music therapist is able to still “treat” physical and emotional needs using music.
When a patient is actively dying and the family/caregivers are gathered at the bedside, music can become an essential component of that patient’s care. Often, when a patient is actively dying, breathing becomes labored and heavy, the physical body starts to change in its appearance, and often it becomes a “waiting game.” Those gathered may be experiencing anxiety, sadness, frustration, fear, etc. It has been my experience that offering music at this time, helps to alleviate many of these physical and emotional needs. For the patient, a music therapist can sit at the bedside and use live music to help regulate breathing, provide comfort and relaxation through familiar sound, and offer a supportive presence. Because it is believed that a dying person is still very aware through the sense of hearing, music can be used to let the patient know that they are not alone. For the family, offering choices regarding type of music can help bring some control to the family with regards to what is happening. Families can choose music that they believe the patient would want or choose music that has lyrics which will help to express some of the emotions being felt. By choosing music and engaging with the therapist, the family is given an active role in the patient’s care up to the very end.
In hospice care, diseases that produce a slow, steady decline make up a large percentage of the population. A disease of the mind that eventually inhibits all functioning can be devastating. Patients and families are not faced with the decision regarding curative treatments, because there are none. Traditional relationships are changed from parent-child to patient-caregiver. And while other disciplines are able to address some of the needs these patients may present with, music therapy is able to provide a substantial amount of the care.
The philosophy of this music therapy program is to meet the patient where they are, physically and emotionally, and try to bring about change using music that can be changed and/or adapted based on the patient’s reaction. The therapist working with this unique population must have an absolute sensitivity to how music has been used by the patient, what music has meant to the family, and what affects music might have in the moment. The music therapist must be open to using the most basic fundamentals of music to bring about extraordinary change that will affect the lives of the patient and families they are serving…Come back to The Gilchrist Blog next week for Part 2.
For more information about Music Therapy at Gilchrist Hospice Care, visit our website.