Palliative Care

Participating in Neurologic Music Therapy®, through instrument playing, song-writing, or music listening can celebrate what a person can do at a time when they may be experiencing losses in areas of their life. Song-writing can be a meaningful experience of self-expression or legacy work. Having thoughtfully selected music played for the individual can increase comfort, aid in sleep, and reduce anxiety.

Living with a terminal illness results in needs surfacing in a number of areas in an individual's life. These needs range from physical to emotional and spiritual. In the current shift towards client-centered and holistic care for the palliative patient, more attention and consideration is being given to the psychosocial needs of the person.

Because of music's emotional characteristics, its deep personal significance to an individual, and its non-verbal expressive qualities, music therapy can be a profound emotional and spiritual support to the palliative individual. It can also serve as a powerful mode of self-expression and release. This is especially important as the palliative stage in a person's life is often when they experience a deep desire to express and to be heard.

The Use of Music Therapy in Palliative Care

Neurologic Music Therapy® can be used to address a variety of needs of the terminally ill individual including:
     - Self-expression
     - Life Review
     - Comfort
     - Spiritual Support
     - Pain Management
     - Empowerment
     - Significant Activity to Share with Loved Ones

Expression

Expressing needs is important for the palliative individual. It allows them to share emotions, to resolve issues, explore important life themes, and to receive the response of empathy and support. Because of the characteristics of music, it can be an effective non-verbal form of communication and expression. Music can help an individual express that which is difficult to put into words. Music can also be a venue of release for emotions such as frustration, fear, or discouragement.

Lyrics of personally significant music to the patient often serve as the bridge to conversation about themes the patient needs or desires to discuss.

Using music as an expressive tool may be accomplished using live, pre-composed, or recorded music or by improvisation with or for the patient. An important music therapy intervention is song writing. A patient may choose to write a song with the music therapist about a theme they would like to express or may wish to write a song as a gift for a loved one.

Life Review

Personally significant music can provide opportunity for life review. Listening to meaningful music often triggers memories that can be shared and reflected upon. Defining, celebrating, or resolving, significant life events is an important aspect of the palliative stage of life.

Comfort

Playing or listening to personally significant music can provide emotional support during difficult times. Music played at a slow tempo and in soft dynamic levels results in a physical response of slower breathing, helping to reduce anxiety and can aid in sleep induction.

Spiritual Support

Music is a key element of many faith practices. Music reflecting a person's spirituality or faith practice can provide self-expression or testimony, comfort, and encouragement.

Pain Management

Although music cannot remove or cure pain, it can serve as a distraction. Music, with its emotional qualities and musical elements, can be a stronger stimulus than the pain, resulting in a distraction away from it.

Live music played in a slowing tempo and in a soft dynamic range can result in reducing anxiety and aid relaxation. This can help break the pain-anxiety-pain cycle.

Empowerment

Music therapy can provide empowerment to a population who often see themselves as powerless. Music therapy allows the palliative patient to make choices and to be in control. Song choices, musical instrument selection, and song writing with the music therapist, all serve to give the palliative individual an opportunity to succeed and have a sense of empowerment. It provides an opportunity to focus on what an individual can do at a time when they may be facing many loses.

Significant Activity to Share With Loved Ones

Sharing or creating music with loved ones provides opportunity for the palliative individual to experience a significant, rewarding activity at a time when previous forms of shared activity may no longer be possible.

Conclusion

The music therapist will choose from a variety of interventions depending on the needs, interests, and strength level of the patient. The music therapist may be the primary music maker or, when appropriate, may provide instruments for the patient to use in music making with the therapist. Live, improvised, or recorded music may be used.

Music therapy is a powerful, holistic response to the needs of the palliative individual. It provides a vehicle for self-expression and reflection, opportunity to receive comfort and support, and the experience of empowerment and validation.

Published in AVISO Issue 62, Spring 2010