Music Therapy at End-of-Life: A Curative Role in Palliative Care

      During my senior year as a music therapy undergraduate student, I had the opportunity to live and volunteer at a Hospice home for those who had a prognosis of 3 months or less to live and did not have a stable living situation. While I was not yet a practicing music therapist, the experiences I had there shaped my understanding of the particular power of music and prevalence of spiritual care in this population. 

       Hospice/End-of-life care is palliative in a physical sense - by definition, palliative care means relieving symptoms and maximizing comfort without necessarily treating the cause of a condition*. But the end of life can be the most curative and restorative time in a person’s life spiritually, relationally, and emotionally – the volunteers and residents at this home understood that better than anyone I have met. As I watched our residents physically decline, I also got to watch them enter a period of spiritual, social, and emotional growth unmatched up until now in their lifetime. I saw a resident reconnect and reconcile with family members who previously thought she was already dead. I saw residents who had thought there was nothing left to believe in feel a sense of relationship with God. I saw despair relinquish its cold grip on those it seemed to hold the tightest. 

       When Brian (pseudonym) came to us, he had been released from a 20-year prison sentence only one year prior, was unhoused for that year, and now he was dying of cancer. Brian found that songwriting was the best way to express his regret for, struggle with, and victory over addiction. At my suggestion and with the help of other volunteers at the house, he wrote a song to be played at his funeral and to express to his family what emotions and hardships fueled the start of his addiction, how sorry he was for the hurt it had caused them, and how he had finally found healing. 

       In Hospice, Music Therapy takes on a uniquely primary role in patient care - medicines do their work to keep the client/patient comfortable, but in many ways the curative work falls to the doctors of the soul; chaplains/priests, counselors, and of course, music therapists! Legacy songwriting projects like Brian’s under the guidance of a board certified music therapist are an excellent tool for clients to review their lives, process regrets, remember triumphs, and leave something for their friends and family to cherish forever (aiding in their processing of grief as well). Music Therapists can record the heartbeats of patients to be used as a keepsake on their own or as a backing beat to a song (shameless plug for Keynote’s Heartbeat Recording Clinic coming up on February 26th at Music on Grand!). Group singing can help increase closeness and foster reconciliation between family members and their loved one during a time when it can feel like they are fading further and further away.

      Creativity is uniquely human. All artwork, but specifically music, has a piece of its creator in it. By encouraging and assisting terminally ill clients in music-making, music therapists help affirm their human dignity during a time when it could easily be undermined, and give them an opportunity to leave a “piece of themselves” behind for their loved ones and the world. No matter our physical state or how much time we have left, when we create, we heal.

*Palliative care can be pursued alongside curative care at any stage of life and is not limited to use in Hospice, however in the case of Hospice, curative care is not pursued.