A Post-Hoc Analysis of Music Therapy Services for Residents in Nursing Homes Receiving Hospice Care
Hilliard, Russell E., Journal of Music Therapy
This study analyzed the use of music therapy for residents in nursing homes receiving hospice care. An ex-post facto design was utilized to evaluate participants' length of life on the hospice program, time of death in relation to last visit by the social worker and music therapist, the number of sessions and total number of minutes spent in direct care by the social worker and music therapist, and care plan needs treated by the nurse, social worker, and music therapist. A total of 80 participants' medical records were randomly selected for this study. All participants were in nursing homes, 40 of whom had been referred to music therapy. Results showed no significant differences on the time of death in relation to last visit by hospice professional, but there were significant differences in the length of life for those receiving music therapy. Females in this study lived significantly longer than males. Participants received significantly more music therapy sessions than social work sessions, and music therapists spent significantly more time in direct care with participants than did social workers. Care plan needs were analyzed graphically and indicate that music therapists meet important needs of participants.
The modern-day hospice movement is relatively young with its inception in the United States beginning in 1974 (Torrens, 1985). In the past decade, hospice professionals have embraced music therapy for their patients and have recognized the value of music in end-of-life care. One of the fastest growing areas for hospices is in the long-term care facilities such as nursing homes and assisted living facilities (Miller & Mor, 2001). Healthcare professionals caring for persons who are elderly have recognized a need for hospice services in long-term care facilities as people who are dying often have complex issues requiring specialized treatment. Music therapy programs have been growing in hospice and palliative care (Hilliard, 2004), and music therapists have been called upon to serve patients in nursing homes who are receiving hospice care. Although this clinical trend has been growing, there are no known studies investigating the use of music therapy for this population in the literature.
The literature is rich with studies exploring the effects of music therapy in meeting a variety of needs for the elderly. Prickett (2000) reported that the number of data-based research articles have increased several hundred percent in the past two decades, and that trends are emerging which allow the literature to guide clinical practice. In a review of literature, Brotons, Roger, and Pickett-Cooper (1997) concluded that patients with Alzheimer's disease and related dementias benefit from music therapy sessions even late into their illness. Music therapy enhanced cognitive, social and emotional functioning of these patients. Agitation behaviors have been treated successfully with music therapy, and subjects have had significantly lower agitation behaviors during and after music therapy sessions (Brotons & Pickett-Cooper, 1996). Music therapy has assisted family members to engage more positively with patients with late-stage dementia (Glair & Ebberts, 1997), and alert responses of people with late-stage dementia have been increased while singing (Glair, 1996). Participation in small group reminiscence music therapy sessions has been shown to treat depressive symptoms among patients with dementia (Ashida, 2000). In yet another study, music therapy was utilized to help elderly persons adhere to a physical rehabilitation program (Johnson, Otto, & Glair, 2001). While many studies document the effects of music therapy in specific areas, one study reported how music therapy was used to enhance the quality of life of elderly persons (Vanderbark, Newman, & Bell, 1983).
Evaluating the effects of music therapy for end-of-life issues is less reflected in the literature. The majority of studies are program descriptions (Hogan, 1996; Nakagami, 1997; Starr, 1999; TraugerQuerry & Haghighi, 1999) and case studies (Beggs, 1991; Colligan, 1987; Hilliard, 2001; Martin, 1991), but they do not include descriptions of nursing home programs for residents with a terminal illness. …