Academic journal article The New Zealand Journal of Music Therapy

Hospice Family Caring Behaviours during Music Therapy

Academic journal article The New Zealand Journal of Music Therapy

Hospice Family Caring Behaviours during Music Therapy

Article excerpt

ABSTRACT

Palliative care uses a team approach to improve the quality of life of patients and their families facing life-threatening illness, addressing physical, psychosocial and spiritual suffering (Sepulveda, Marlin, Yoshida, & Ullrich, 2002). Music therapy with hospice patients receiving end of life care frequently takes place when visiting family members are present. The audit detailed in this paper focused on caring behaviours that occurred during such music therapy sessions. Observation of 52 hospice in-patients, identified as near the end of life, was conducted during the normal course of music therapy. An investigator-designed tool was used to record before and during session observations. Data collection was carried out by the investigator, who was also the music therapist. Data were analysed using descriptive statistics. Findings describe changes in visiting family members' caring behaviours towards patients during music therapy, the most frequently observed being greater focus on the patient, softened facial expression, expressing emotion in tears and moving to sit closer to the patient. These findings suggest that music therapy may be conducive to family expressions of care.

KEYWORDS:

Music therapy, palliative care, hospice, caring behaviours, family

Introduction

Hospice philosophy accepts that patients and their families are the focus of care during a life-limiting illness (Mary Potter Hospice, 201 2). As patients near the end of life, communication of thoughts and feelings by their loved ones often becomes increasingly important but can also be more difficult (Krout, 2003). Working as a music therapist, the first author saw that music therapy frequently facilitated observable caring behaviours by family members towards their dying loved ones. Similarly, Krout (2003) observed increased family communication during music therapy with imminently dying patients and their loved ones. This coming together often facilitated the necessary letting go by both patient and family as death approached (Krout, 2003). The National Cancer Institute (201 3) suggests that the relationship between a dying patient and loved ones will affect their ability to cope with their bereavement.

The audit described in this paper sought to consider family members' expressions of care to their dying loved ones in an inpatient hospice during music therapy. Specific questions asked of the enquiry included: Do family caring behaviours increase during music therapy? During music therapy what observable caring behaviours do families show to their dying loved one? What are the most frequent caring behaviours? Are there any associations between type of caring behaviour and demographic characteristics of the patient?

Music therapy at the end of life

The care given in hospice by an interdisciplinary team aims to meet the physical, psychological, and spiritual needs of clients (Aldridge, 1996). As the patient shifts from living to dying they may be confused and anxious, become less alert or unresponsive (West, 1994). This sacred and highly privileged work requires respect, skill and sensitivity (Becker & Camlin, 2004). Anstey (1 991) suggested that listening to a patient and responding with care and compassion may have greater therapeutic value than a clinical procedure. Music therapy adds an individualised, creative dimension to symptom management and facilitates life-affirming experiences at the end of life (Daveson, 2011), as professional music therapists use music in a therapeutic relationship to give physical, psychosocial or spiritual support (O'Callaghan, 2004). Hogan (1997) investigated how terminally ill patients experienced music therapy. This phenomenological study was conducted with nine patients who had been diagnosed with cancer and were receiving hospice care. Their responses to music therapy included crying, smiling, becoming angry, reminiscing, sharing in the singing, looking thoughtful and talking about their life and people in it. …

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