Singing together

 

Co-operation in palliative care

I have had the good fortune to work with Lucanne Magill at Memorial Sloan Kettering Cancer Center, New York where there is a Department of Integrated Medicine and learn from her and her patients about working with people in palliative care. As Lucanne  says, “So much of what we do is beyond words and it is really because of this transcendental nature of music that important healing in music therapy can and does occur”. In her four themes in music therapy, she proposes that music builds relationship, enhances remembrance, gives a voice to prayer and instils peace. In the presence of music, when transformations begin to occur and healing begins, that it is in the lived moments of music therapy that the essence of our work - music therapy, spirituality and healing- is experienced and known.

Peace

Patients often long for comfort, relief from pain, peace of mind, relief from interruptions, uncertainties and relief from lack of control. Lois, age 68, had metastatic cervical cancer and was receiving palliative care for her difficult-to-manage pain. She was agitated and angry. She was referred by a doctor who requested music therapy to help her with her pain and agitation. She was reported by staff to be a “difficult patient” due to her incessant demands. When we went to her room, the patient’s son and friend were in far corners of the room. We asked her, “What music would help you today?” Lois answered, “I want to be in peace” so we sang sang a chant, the lyrics of which contained the words “Peace is flowing over you, you are waiting. Peace is flowing over me. I am waiting. Peace is flowing over us. We are waiting.”

You can read about Lucanne’s work and mine in a variety of books and articles 
(see Collected Works). 
The Spirituality and Psychiatry Special Interest Group of the Royal College of Psychiatrists published an article “Songs at the end of life” based on this work and it can be found in their archives following a lecture I gave to the Royal Society of Medicine in 2005.http://www.rcpsych.ac.uk/college/sig/spirit/publications/NL_18/Professor%20David%20Aldridge%20%20%27Songs%20at%20the%20end%20of%20Life%27%201.6.05.pdf

Other words were improvised in the song to echo Lois’s needs and hopes. At the end of the music, Lois said: “I am in beauty, I am in peace.” This example demonstrates the use of the aesthetic characteristics of music to reach, help calm agitation and help instill feelings of peace.

The music had reached her and also had a calming effect on the family. During the music, the son moved closer to Lois and faced her, appearing calm and relaxed. In time, the son became more involved in the singing of this chant for his mother, and healing of many years worth of dissension between them began to take place. The lyrics of the song met the patient’s needs and the tempo and dynamics conveyed the state of peace, the state for which she had hoped.

Music Therapy in Palliative Care
New Voices
Edited by David Aldridge
Paperback, ISBN-10: 1-85302-739-1 ISBN-13: 9781853027390, 200pp, 1998http://www.jkp.com/catalogue/book.php/isbn/9781853027390

Within the last decade music therapists have developed their work with people who have life-threatening illnesses and with those who are dying. Music therapists working in different approaches, in different countries, showing how valuable the inclusion of music therapy in palliative care has already proved to be.

It is important for the dying, or those with terminal illness, that approaches are used which integrate the physical, psychological, social and spiritual dimensions of their being. Music is  important for working not only with the patient as an individual but with the ward situation, friends and family members. By offering patients the chance to be creative they become something other than patients - they become expressive beings, and there is an intimacy in music therapy that is important for those who are suffering.

Health, the Individual, and Integrated Medicine
Revisiting an Aesthetic of Health Care
David Aldridge
Paperback, ISBN-10: 1-84310-232-3 ISBN-13: 9781843102328, 224pp, 2004http://www.jkp.com/catalogue/book.php/isbn/9781843102328

David Aldridge

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