Music as a Therapeutic Resource in End-of-Life Care

Abstract

Music has been used in a variety of settings by nurses and other providers to ease their patients' physical, emotional, and spiritual distress. In end-of-life settings, music has been shown to improve quality of life. Nurses have noted the usefulness of music in practice but perceive that they have limited knowledge and skills about how to use music and lack the resources to implement its use. Drawing on knowledge from music therapy and music-thanatology, we describe the receptive approach to the use of music in palliative care and hospice settings. This approach is characterized by active listening and using techniques that are accessible to nurses who may not have music training. Nurses can help patients select music that evokes memories or feelings and helps divert their attention from emotional and physical distress. Music may be an effective tool for reviewing one's life, through which a patient moves toward acceptance of death by giving meaning to his or her life. Near the end of life, prescriptive music may be used during bedside vigils to accompany the patient in the transition from life to death. KEY WORDShospice care, music, nursing, palliative care M usic is basic to the human experience. From lullabies that calm fretful babies to mournful dirges over the dead, music marks lives' ordinary and extraordinary events. William Congreve, an English playwright and poet, in 1697 penned the famous line ''Music has charms to soothe a savage breast'' in his tragic play The Mourning Bride. Two hundred thirty years later, another English writer, Aldous Huxley, 1 noted, ''After silence, that which comes the nearest to expressing the inexpressible is music.'' Music can engage the human spirit and reach the deeper realms of a person's psyche and spirit, lending itself to easing physical and emotional distress as well as serving as a vehicle of transcendence from suffering to ease, and from life to death. Nurses have noted the usefulness of music in practice but perceived that they have limited knowledge and skills about the use of music and resources to implement its use. 2 The purposes of this article are dual: (1) to describe the therapeutic use of music in hospice and palliative care settings using examples from practice and (2) to inform nurses and other clinicians of resources to enhance their use of music in their practice with patients at the end of life. Drawing from the music therapy literature, this article details the roles of music in palliative and hospice care and describes ways in which clinicians can use music effectively in supporting their patients who are approaching the end of their lives.Healthcare providers in a variety of settings have found music's remarkable attributes to be beneficial. A burgeoning literature exists on the effective use of music in long-term-care facilities, care of the elderly, and care of persons with dementia. Similarly, terminally ill children and adolescents benefit from music, which can help them feel supported, improve self-esteem, express emotions, resolve conflicts, ...

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