Music therapists

How music therapists address palliative care

Music therapists help people with a life-limiting illness to remain connected with the life they have lived and to improve their current situation and quality of life through the use of music.

Scope of practice

Music therapists support people of all ages and abilities to improve their health in cognitive, motor, emotional, communicative, social, sensory, and educational domains by using both active and receptive music experiences. These creative experiences include music-based improvisation, composition, playing, listening and discussion. [1-3]

Role in palliative care

Palliative care provides a support system for people living with a life-limiting condition to live as actively as possible, with dignity, for as long as possible. It is active and supportive care that seeks to maximise quality of life. [4] It is useful well before death and not limited to care of the dying. [3]

In helping people with palliative care needs, a music therapist [3,5-8]:

• is led by the person’s symptoms and their sense of what is important to them to co-create realistic goals and expectations with the person in the face of impending death within the context of a therapeutic relationship
• engages actively with the person and/or family and friends in singing, song writing, improvisation, music imagery, music-based relaxation or life review, as well as listening to music, according to a person’s musical preferences
• assists with management of symptoms such as pain, fatigue, anxiety, delirium, depression, spiritual needs, and ability to cope through assessment, music therapy methods, counselling, and instrument borrowing
• assists to help maintain function or with adaptation to decreasing function
• create recordings and songs to be left as a legacy for family and friends
• can use improvisations and familiar music to support emotional well‐being and quality of life for people with living with dementia
• can assist connectedness between patients and those significant to them through shared music experiences and music-based legacy creation
• liaises within the care team to promote best outcomes
• can collaborate with other professionals such as physiotherapists in music and movement, spiritual care practitioners in planning memorial services, occupational therapists in music playing/performing
• provides support to family and carers, including bereavement support.

To benefit from music therapy, a person does not need any musical background such as musical talent, the ability to play an instrument, or to read music. [9] Music therapy is a complementary therapy frequently used in palliative care and paediatric oncology. [6,9-11] Music therapists may work in palliative care as only part of their role or have a palliative care caseload with a specialist role. They may be a member of a multidisciplinary team or work as a sole practitioner.

The RACGP aged care clinical guide (Silver Book 2019) recognises the role of allied health professionals in team care arrangements for a proactive person-centred approach to palliative care. [12] Palliative Care Australia also recognises the importance of access to information and support from a diverse range of allied health services for patients, families and carers. [13]

The role of allied health in palliative care is to provide the person with as much therapy time as possible. The goal of allied health in palliative care is around maintaining and improving functional ability. There may be a blurring of roles across allied health professions in palliative care more than in other care contexts.

Allied Health workers provide care in all practice settings. For further information on the specific area of practice go to Practice Settings.

Practice support

Useful evidence-based information and resources on rehabilitative palliative care are available from Hospice UK.

Using evidence

Although music therapists may be familiar with evidence and evidence-based practice through their training and continuing professional development (CPD), keeping up to date can be time-consuming.

CareSearch provides the tools to help find and use palliative care evidence. This includes PubMed searches on a multitude of topics and sections dedicated to Searching for Evidence and Using Evidence in Practice.

For support in applying evidence in practice, check out the Journal Club Basics page on CareSearch which provides information on the benefits of and practical pointers in setting up or joining a journal club.

Guidelines

Guidelines specific to music therapy and palliative care in Australia have not been published, however, the Palliative Care Service Development Guidelines 2018 (332kb pdf) provides an overview of music therapy (as part of allied health) in palliative care. [13]

Resources for Patients, Carers and Families

Music Therapists have an important role in supporting patients, carers and their families with information. The CareSearch Resources for Patients, Carers and Families provides links to useful information including fact sheets and printable resources Music Therapists can download and share.

Education

The National Palliative Care Strategy 2018 lists as a priority the ability of medical, nursing and allied health graduates to identify and address people’s palliative care needs (Priority 2.1, p15). [14] This is highlighted in the Essential Elements of the National Consensus Statement: Essential elements for safe and high-quality end-of-life care which also recognises the importance of the role of an interdisciplinary team. [15]

Courses

CareSearch lists a collection of Palliative Care eLearning resources for allied health for independent learning.