Research on Music Therapy in End of Life Care
Music therapy in end of life care brings a range of benefits from reduced anxiety to increased feelings of closeness and spiritual support. Much research on the topic has surfaced in the past two decades. Here are some of the highlights.
Examples of Research in Music Therapy in End of Life Care
Hilliard, RE (2003). The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. Journal of Music Therapy, 41(4) 266-81.
Purpose: Evaluate the effects of music therapy on quality of life, length of life in care, physical status, and relationship of death occurrence to the final music therapy interventions of hospice patients diagnosed with terminal cancer.
Subjects: Adults who were living in their homes, receiving hospice care, and were diagnosed with terminal cancer.
N: 80 subjects participated in the study and were randomly assigned to one of two groups: experimental (routine hospice services and clinical music therapy) and control (routine hospice services only).
Measurement: Quality of life was measured by the Hospice Quality of Life Index-Revised (HQOLI-R), a self-report measure given every visit. Functional status of the subjects was assessed by the hospice nurse during every visit using the Palliative Performance Scale. All subjects received at least two visits and quality of life and physical status assessments.
Result: A repeated measures ANOVA revealed a significant difference between groups on self-report quality of life scores for visits one and two. Quality of life was higher for those subjects receiving music therapy, and their quality of life increased over time as they received more music therapy sessions. Subjects in the control group, however, experienced a lower quality of life than those in the experimental group, and without music, their quality of life decreased over time.
Hilliard, RE (2004). A post-hoc analysis of music therapy services for residents in nursing homes receiving hospice care. Journal of Music Therapy, 41(4) 266-81.
Purpose: This study analyzed the use of music therapy for residents in nursing homes receiving hospice care.
Measurement: An ex-post facto design was utilized to evaluate participants’ length of life on the hospice program, time of death in relation to last visit by the social worker and music therapist, the number of sessions and total number of minutes spent in direct care by the social worker and music therapist, and care plan needs treated by the nurse, social worker, and music therapist.
N: A total of 80 participants’ medical records were randomly selected for this study. All participants were in nursing homes, 40 of whom had been referred to music therapy.
Results: Results showed no significant differences on the time of death in relation to last visit by hospice professional, but there were significant differences in the length of life for those receiving music therapy in end of life care. Participants received significantly more music therapy sessions than social work sessions, and music therapists spent significantly more time in direct care with participants than did social workers. Care plan needs were analyzed graphically and indicate that music therapists meet important needs of participants.
Hilliard, RE (2006). The effect of music therapy sessions on compassion fatigue and team building of professional hospice caregivers. Arts in Psychotherapy, 33(5) 395-402.
Purpose: Evaluate the effects of music therapy on compassion fatigue and team building of professional hospice workers.
Participants: Nurses, social workers, and chaplains and were employed for at least one year in hospice care.
N: Seventeen participants engaged in one of two experimental music therapy groups.
Design: Experimental group 1 utilized an ecological music therapy approach with an open, free form without structure and encouraged participation in the live music experiences of instrumental improvisation as well as toning and chanting. Experimental group 2 utilized a didactic music therapy approach with a structured format wherein interventions were planned and facilitated by the music therapist a priori. Such interventions included guided meditation with live music, lyric analyses, and music and movement.
Measurement: To measure compassion fatigue, the Compassion Fatigue Scale (CFS) was used as a pre- and post-test measure in each group. To measure team building, the Team Building Questionnaire (TBQ) was used as a pre-and post-test measure in each group.
Results: Statistical analyses indicated a significant improvement in team building in both groups but no significant differences with regard to compassion fatigue. Further research studying the effects of music therapy on compassion fatigue and team building of professional hospice caregivers is recommended.
O’Callaghan, C. (1996) Lyrical themes in songs written by palliative care patients. Journal of Music Therapy, 33(2) 74-92.
Purpose: This study examines the use of song writing in palliative care. Modified grounded theory and content analysis approaches were used to investigate the lyrical themes and categories (groups of concepts) in 64 songs written by 39 palliative care patients.
Findings: The eight themes that emerged in the songs were: self-reflections, compliments, memories, reflections upon significant others (including pets), self-expression of adversity, imagery, and prayers. The seven most frequently recurring categories were: compliments to family members, staff, other patients and friends about their personal qualities and their impact upon the patients’ lives; messages of positive feelings for and experiences with people, including love, care and that one needs people; memories of relationships with people, both living and deceased; existing in the future; expressions of the adverse experiences resulting from living with the illnesses of multiple sclerosis and cancer descriptions of stories and nature imagery scenes; and gratitude to family members, staff, and God.
Results: The author argues that song writing is a worthwhile technique for some palliative care patients because the Iyrical themes suggest that the process may aid in meeting their physical, psycho-social, and spiritual needs. The song writing paradigm that facilitated the palliative care patients’ song writing is also presented.
Salmon, D. (2001). Music therapy as psychospiritual process in palliative care. Journal of Palliative Care, 17(3), 142-146.
Purpose: This paper proposes a theoretical framework for understanding how music therapy elicits and supports depth experiences in palliative care. The author explores music therapy as a containing or sacred space in which ventures into the realm of psychospiritual awareness may safely occur. The ultimate goal is to facilitate the process of connecting to that which is psychologically and spiritually significant for the patient, thereby transforming experiences of suffering into those of meaning.
Additional Published Research
Music Therapy in End of Life Care
Brotons, M. & Kroger, S.M. (2000). The impact of music therapy on language functioning in dementia. Journal of Music Therapy, 37(3), 183-95.
Brotons M. & Marti, P. (2003). Music therapy with Alzheimer’s patients and their family caregivers: a pilot project. Journal of Music Therapy 40(2), 138-150.
Cevasco, A.M. & Grant, R.E. (2003). Comparison of different methods for eliciting exerciseto-music for clients with Alzheimer’s Disease. Journal of Music Therapy 40(1), 41-56.
Clair, A.A. (1996). The effect of singing on alert responses in persons with late stage dementia. Journal of Music Therapy, 33(4), 234-247.
Clark, M.E., Lipe, A.W., & Bilbrey, M. (1998). Use of music to decrease aggressive behaviors in people with dementia. Journal of Gerontological Nursing, 24(7), 10-17.
Gerdner, L.A. (2000). Effects of individualized versus classical “relaxation” music on the frequency of agitation in elderly persons with Alzheimer’s disease and related disorders. International Psychogeriatrics, 12(1), 49-65.
Gregory, D. (2002). Music listening for maintaining attention of older adults with cognitive impairments. Journal of Music Therapy, 39(4), 244-264.
Hilliard, RE (2001). The effects of music therapy-based bereavement groups on mood and behavior of grieving children. Journal of Music Therapy, 38(4) 291-306.
Hilliard, RE (2001). The use of music therapy in meeting the multidimensional needs of hospice patients and families. Journal of Palliative Care, 17(3) 161-66.
Hilliard, RE (2001). The use of cognitive-behavioral music therapy in the treatment of women with eating disorders. Music Therapy Perspectives, 19 109-113.
Hilliard, RE (2003). Music therapy in pediatric palliative care: A complementary approach. Journal of Palliative Care, 19(2) 127-32.
Hilliard, RE (2004). Hospice administrators’ knowledge of music therapy: A comparative analysis of surveys. Music Therapy Perspectives, 22(2) 104-08.
Hilliard, RE (2005). Hospice and palliative care music therapy: A review of the empirical data. Evidence-Based Complementary and Alternative Medicine, 2(2) 173-78.
Hilliard, RE (2006). Music therapy in pediatric oncology: A review of the literature. Journal of the Society for Integrative Oncology, 4(2) 75-79.
Hilliard, RE (2007). The effects of Orff-based music therapy and social work sessions on grieving children. Journal of Music Therapy 44(2), 123-138
Romo, R. & Gifford, L. (2007). A Cost-benefit analysis of music therapy in a home hospice. Nursing Economics, 25(6), 353-358.
Standley, J. & Walworth, D.D. (2005). Cost/Benefit Analysis of the Total Program, in J. Standley (Ed.), Medical Music Therapy, 33-40. Silver Spring, MD: American Music Therapy Association.
Walworth, D.D. (2005). Procedural-support music therapy in the healthcare setting: a cost-effectiveness analysis. Journal of Pediatric Nursing, 20(4), 276-84.