The hospice patient knew she was dying and her devoted husband knew she was dying. But they continued to deny that sad fact to one another despite her pancreatic cancer diagnosis.
Dr. Amy Clements-Cortes, a board certified music therapist, knew music could help them express their feelings to each other. “The patient and I would write or choose songs that reflected important memories to them. We would sing the songs and talk about what the lyrics meant,” she says.
“La Vie En Rose,” for example, was a memory of their trip to Paris. “At the end of each session, her husband would come back into the room and together we all shared a relaxing journey through music and a closing song,” Clements-Cortes says.
The couple ended up with seven songs that held deep meaning and ultimately opened up communication between them. “When we finished, we had a concert,” Clements-Cortes says. “It was quite emotional.”
Music therapy is the clinical use of music interventions with a professional music therapist to accomplish individualized goals, according to the American Music Therapy Association. Music therapy interventions within the hospice setting can be designed to:
- Manage stress
- Alleviate pain
- Express feelings
- Enhance memory
- Improve communication
Music as a therapeutic tool began taking shape shortly after World War II when music educators and musicians went to veterans hospitals to lift the moods of former soldiers undergoing both mental and physical rehabilitation, says Clements-Cortes, a registered psychotherapist and assistant professor at the University of Toronto in Ontario, Canada.
“What makes music therapy a unique effective therapeutic intervention is that a music therapist uses music as a tool to create a relationship between the client and therapist, working on goals in all domains: motor, spiritual, psychosocial, communication, cognitive and emotional,” she says, adding, “It’s such a non-threatening intervention and it really complements all the other therapies.”
Music therapy is most commonly used to alleviate pain and anxiety, Clements-Cortes says.
“If someone is in pain or they have labored breathing, music therapists can match their heart rate and respiratory rate and, with music, bring it to a much more relaxed state,” she says.
Music also releases endorphins —your brain’s feel-good neurotransmitters, as described by the Mayo Clinic —resulting in pleasant emotions that help raise a person’s mood and decrease their pain perception, sometimes quite rapidly, she says. It is also particularly helpful to patients with end-stage dementia, who suffer irritation or agitation.
“When a patient is agitated, irritated or having angry outbursts,I think of these as responsive behaviors in which they’re responding to something that is or isn’t there,”Clements-Cortes says.
A music therapist can divert that patient’s attention by having them engage in something meaningful, thereby calming agitation, she explains. Such natural, safe symptom management aids in the patient’s comfort and quality of life.
Music therapists also sing with patients, play instruments or write lyrics to open the door to a discussion of emotions. Some patients choose to write songs expressing their love; others write songs to release pent-up feelings; and some compose lyrics to articulate their emotions.
One 90-year-old patient, a retired lawyer, chose to write an opera.
“We wrote an opera together because that was his plan,” she says.“We had written songs of lamenting and grief, and opera was the only musical modality that could represent the dramatic feelings he was having.”
The characters in the opera we remembers of his family — both living and dead.
“He passed away before he finished writing the last piece and he had asked me, before, if I would finish it and take it to his family,” says Clements-Cortes, who fulfilled his wish.
Music therapy helped another hospice patient explore something she never experienced in childhood — play.
“She was a child Holocaust survivor… and never experienced a real childhood,” Clement-Cortes says. “I gave her several musical instruments to play. She said,‘Now, I have a chance to play and explore.’ It was such a different and meaningful experience for her.”
Patients often write and perform or record their songs to leave as legacy gifts to their loved ones. One patient who was in her 40s wrote a song for her children as a legacy gift. “We invited her children to come to a session and I performed the song for them. It was highly emotional, but it helped with their grief,” Clement-Cortes says.
“We are using music to help people say important words like ‘goodbye’ or ‘I love you,’ — the work of relationship completion,” she says. “It helps people find a place of closure and peace.”
Visit Amy Clements-Cortes’s website at notesbyamy.com