How Music Tends and Heals in Palliative Care

Faith Today recently printed a story called “Gently into the arms of Jesus” which touched on the urgent need for improved palliative care in Canada. We invited a specialist in one particular and unique corner of the creative possibilities in palliative care to share on the FT blog. 

by Sarah Pearson

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Music has a role to play in palliative care, says practitioner Sarah Pearson.

In end-of-life and palliative medicine, strong relationships are the central element to providing excellent care. Getting to know the patient – their interests, desires, fears, and values – and building trust with them, is any palliative practitioner’s first step.

As a music therapist working in end-of-life care, I am fascinated by how music can support and strengthen relationships at the end-of-life.

Music always happens in relationship – a relationship between performer and audience, or between performing musicians, or within a community or family, or within a relationship with oneself and one’s sense of beauty and meaning. The rehearsing choir or jazz quartet will experience music in relationship to each other; the father singing a lullaby to his infant child will experience music in relationship to his suckling audience; the guitar-playing songwriter composing by herself one quiet night will experience music in relationship to her beliefs, values and views of the world.

It’s these relationships that drive the music. Without the relationship, the musicians would have no need to make music.

Music has a rich and valuable role to play in hospice and palliative care.

When we are involved in someone’s dying process, music can add richness to this mysterious, often painful, and very often beautiful experience. Music can strengthen relationships and invite presence. It doesn’t have to be about having the best voice, or playing an instrument, or having music training. Music care is about relationship.

When I’m not working in a hospital, I work for the Room 217 Foundation, designing programs and educational material to support caregivers of all stripes to incorporate music into their care. The Room 217 Foundation provides resources and education for caregivers on music, from therapeutically-informed CDs to conferences. Our most comprehensive program is a 3-level certificate training program for caregivers of all backgrounds, called the Music Care Certificate Program (MCCP).

Our mandate is to make music available and accessible to caregivers when they need it most.

Many of Room 217’s end-users are hospice and palliative care workers. They have an inherent sense that music provides healing and comfort to patients and their families at the end of life, but very little experience or confidence using music themselves. They’re just not quite sure where to start.

Introducing music into a palliative care relationship can be intimidating for some, although it doesn’t need to be. Whether you are a health care provider, family member of a person who is dying, or currently receiving palliative care yourself, music can find its way into the dying process and help make it more meaningful.

Here are three simple ways to use music to strengthen relationships in palliative care:

  • Ask the question: “What is some music that is significant to you?” If someone were to ask me, “What’s your favourite song?” I would have no idea how to answer. Music has far too meaningful a presence in my life to pick a favourite. However, when we ask, “what is a song that has been significant in your life?” we invite a rich opportunity for meaningful story-telling and sharing. Asking a person if they can share a meaningful song with you can create intimacy and emotional closeness very quickly. Listening to these songs together, and sharing stories of songs that are significant to each other, creates an environment of both contemplation and togetherness that can be quite appropriate at the end-of-life.
  • Allow space for singing. Singing is a powerful healing tool that humans and other mammals use instinctively. Many of us in North America have unlearned the natural instinct to sing. See what it feels like if you gently sing a lullaby to someone you care for, or a nostalgic children’s song, or a silly song that begets laughter (the best medicine of all). Sing songs that have personal significance – hits from teenage years, children’s songs, hymns that mean something special to the person. Sing quietly, imperfectly, and with care and compassion. If you’re connected to your caring instinct, you won’t go wrong.
  • Speak Through Songs: Sometimes music can speak the big emotions more effectively, or more comfortably, than words. Invite your client, loved one, or patient to pick songs that express something they would like to say, either to a person or to the world. It can be one song, or an entire album. You too can share songs that express something you would like to say to your loved one or client something words are hard to express. It can be happy, sad, reminiscent, angry, silly, pensive or forlorn; the music can tell a story, speak a prayer, or say I love you. Listen to the recording together, or if you’re a performing musician, play or sing it. You can discuss it after or simply let the music hang in the air and speak for itself.

In one music therapy group that I facilitate, we have banned all three of the following statements: “I’m not musical.” “I’m not a musician.” “I love music, but I’m bad at it.”

We have come to believe that these statements simply don’t help anybody in any way. They simply keep us separated from the truly enjoyable power of connecting through music in this group.

Similarly, we encourage our participants to use music wherever they can. We run workshops to help build confidence to get in touch with a caring music instinct. We work hard to show that anyone can use their voices in a caring way, despite whether they’ve been told their whole lives that they “can’t sing.”

Because while it is true that being a great performing musician involves skill, and practice, and discipline, and a certain level of mastery, music itself is about something bigger than skill, practice, and mastery.

Music is about relationships. And in end-of-life care, relationships are the most vital lifeline of all.

Sarah Pearson is a music therapist and program development coordinator for the Room 217 Foundation. Read Faith Today‘s story on palliative care and physician-assisted death. 

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