Music Therapy in Palliative Care

Article excerpt

Correspondence and reprint requests: Jennifer Jonas, 186 Old Orchard Grove, Toronto, Ontario M5M 2E5, Canada.

We've heard time and again that music can "soothe the savage breast" or that "music hath charms to heal." The power of music has been acknowledged and used throughout our history. From ancient Egyptian times to the present day, music has been an important part of every culture. It has been used to heal, to communicate, to inspire those in war or hard labour, to celebrate, and to entertain.

In this paper, I will discuss the therapeutic powers of music and show how it is applied in palliative care by a trained music therapist. I use case studies to demonstrate how music can promote relaxation, strengthen and support a person's faith, reinforce self-identity through reminiscence, and uplift mood.

Ancient beliefs about the power of music formed the roots of music therapy, which began in the 1940s in the United States. Music therapy was first applied after WWII in American hospitals, initially to rehabilitate war veterans. Today, music therapy is used in almost any institution that cares for a special-needs population, such as hospitals, schools, nursing homes, rehabilitation centres, group homes, crisis centres, pain clinics, correctional facilities, health centres, and palliative-care units.

In 1977, the Royal Victoria Hospital of Montreal offered the first music therapy program in palliative care. Susan Munro, the therapist, found that music had a diverse potential that suited it to the various needs of ill and otherwise suffering patients. (1) Aldridge, an authority on music therapy in the hospital setting and a professor in the Faculty of Medicine at the University Witten Herdecke in Germany, believes that music therapy is a unique resource in coping with disease. He said, "rather patients find their creative beings in music." (2)

With the growing acceptance of complimentary medical approaches, more hospitals are including creative arts therapies and adding music therapists to multidisciplinary teams. Programs, such as the one established by Susan Mandel at the Hospice of Western Reserve, use music as an adjunct to the holistic care offered to patients and family members. (3) In the supportive-care program at the Memorial Sloan-Kettering Cancer Center in New York City, music therapy is used to promote relaxation, to reduce anxiety, to supplement pain control methods, and to enhance communication between patient and family. (4)

The music therapy program with which I am affiliated at St. Michael's Palliative Care Unit in Toronto, Ontario, was initiated 4 years ago after an 8-month trial period. The purpose of the trial was to introduce staff to music therapy and to demonstrate its benefits with patients. Because of the positive feedback received from the patients and staff, funding was granted for a part-time music therapist.

This palliative-care unit cares for a maximum of 10 patients who are offered music therapy once a week. Before I meet with the patients, I seek such background information as the patient's diagnosis, their clinical condition, level of pain or anxiety, cultural background, religious affiliation, level of family support, and musical preferences. From this informal assessment, I develop initial goals for each patient. Once prepared, I enter the room with guitar and music folder in hand.

The Principal Goals of Music Therapy

Over the last 4 years, the principal goals of this music therapy program have been to:

* reduce the perception of pain and promote relaxation;

* support a patient's faith;

* reinforce self-identity through reminiscence; and

* decrease depression and uplift the patient's mood.

I will discuss these goals in the remainder of this paper and present illustrative case studies.

Reducing Pain and Promoting Relaxation Through Music

When patients are suffering from pain and discomfort, music can promote relaxation and offer a sense of calm. …