Hospice and Palliative Care Music Therapy: A Guide to Program Development and Clinical Care

By Walworth, Darcy Deloach | Journal of Music Therapy, Spring 2007 | Go to article overview

Hospice and Palliative Care Music Therapy: A Guide to Program Development and Clinical Care


Walworth, Darcy Deloach, Journal of Music Therapy


Milliard, R. E. (2005). Hospice and palliative care music therapy: A guide to program development and clinical care. Cherry Hill, NJ: Jeffrey Books. (124 pages)

Throughout this text, the innovative and motivating themes of successfully creating and funding music therapy programs for endof-life care are masterfully intertwined with the history, evidencebased practices, clinical protocols, and intervention techniques of hospice music therapy. Milliard clearly and concisely provides both entry level and seasoned music therapists a tool unlike any other offered to date, a comprehensive resource for improving the quality of care for patients provided by music therapists along with detailed descriptions for successfully implementing a new hospice music therapy program. As stated in the foreword, this text was successfully piloted in a graduate level hospice music therapy class showing its usefulness for furthering student's educational knowledge of the intricacies surrounding hospice music therapy practice. This text is also extremely useful for practicing music therapists within the hospice and medical settings as well as any professional wishing to transfer excellent intervention techniques and business guidelines discussed in the text. The book is divided into five chapters starting with the historical background of hospice care and ending with discussion on marketing music therapy and the creation of a business plan for successful program implementation.

The first chapter orients the reader to the development of hospice care dating back to the Ancient Greek times. The hospice and palliative care movement's revival and interest in the United States is then well documented with a useful timeline provided for readers comparing England, Canada, and the United State's major steps in the proliferation of the palliative plan of care within medical communities. Statistics regarding how many hospice organizations exist in America and how many music therapists report working in a palliative care or hospice setting are provided for readers, documenting the need for a comprehensive music therapy text such as this with information for successfully developing new programs. The basic structure of a hospice care organization is provided for readers who are unfamiliar with this setting. Milliard also cites the use of music within hospice or palliative care by nonmusic therapists, but advocates for the additional patient benefits when a professionally trained music therapist provides music. Chapter one ends with a list of recommended resources beneficial for advocating use of a professionally trained music therapist within hospice care settings.

Chapter 2 provides a detailed description of the range of clinical needs for patients receiving palliative or hospice care. An example of Hilliard's unique ability to educate readers about this topic is found in an excerpt describing death: "As births and lives are all unique, deaths are also individual experiences." (p. 19). Although readers might not initially think to compare the death process to the beginning of life, Hilliard's perspective on the experience of death is skillfully interwoven throughout the text, making the topic less daunting. Patients with a terminal illness show common signs of impending death and readers are provided with a table listing the indicator as well as suggested interventions to increase a patient's comfort level. The remainder of Chapter 2 discusses patients' clinical needs including a "good death", anticipatory grief, communication, pain management, anxiety reduction, emotional support, spiritual support, support for the caregiver, socialization, and maintaining quality of life. As supported by this list, Hilliard is comprehensive in providing readers with the holistic care required for patients at the end of life.

A literature review covering the use of music therapy for end-oflife patients' clinical needs begins Chapter 3. Both qualitative and quantitative research is reviewed and readers are provided a very useful table summarizing all of the quantitative studies discussed in the text. …

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