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Thursday, December 31, 2009

Music Therapy Brings Comfort at End of Life

THURSDAY, Dec. 31 (HealthDay News) -- Music therapy is used to help Alzheimer's patients remember and autistic children calm down. Now, a University of Alabama student is using her voice and guitar to comfort dying patients in hospice. Families gathered around the bedside of a dying loved one often request hymns, such as "Amazing Grace," while others ask for favorite classic rock songs, such as songs by the Beatles, that evoke happier moments, said Sarah Pitts, a senior majoring in music therapy. "I want to be with people when they need someone to provide them with some type of comfort," Pitts said. She recently played for an older woman who was just hours from death. Gradually, the woman's breathing began to slow. Her family gathered around to say their goodbyes. "The family later said hearing the songs she liked made things a little bit better." Music therapy is about more than playing pleasant music, said Dena Register, an associate professor of music therapy at the University of Kansas who has also worked in hospice. Instead, it's aimed at improving a patient's quality of life, using music as the medium. "We are not teaching people how to play the guitar or the piano, or singing just to entertain," Register said. "There is always a more targeted goal. In hospice care, it can be any number of things: pain management, to repair relationships or to help a patient express their wishes to family and friends." An increasing body of research is providing evidence of the power of music. A 2007 study found music therapy dramatically improved the mental and physical condition of patients receiving palliative care. In the study, some 200 patients aged 24 to 87 with chronic or advanced illnesses, such as cancer, pain disorders, AIDS and sickle cell disease, received music therapy sessions, in which they were able to choose the type of music they wanted to hear played on a keyboard. Physical and psychological tests done before and after the sessions found that music therapy decreased patient anxiety, pain and shortness of breath. More than 80 percent of the patients said the music improved their mood, as well as that of their family members, according to the study by researchers at the Cleveland Music School Settlement. Pitts was motivated to reach out to patients at Hospice of West Alabama after her brother learned he was facing a potentially fatal heart defect and needed immediate surgery. "While I was in that waiting room, I felt like I needed somebody there to play a song," Pitts said. "It's simple but it could be a huge thing for a family dealing with this type of death or a trauma." Her mentor, Andrea Cevasco, an assistant professor of music at the University of Alabama, was impressed with Pitts' willingness to tackle such a challenging and potentially emotionally wrought assignment. "As an undergrad myself, I never pictured myself doing any kind of hospice work," Cevasco said. "Personally, I wasn't ready to deal with death and dying as an 18- to 22-year-old." Music therapy can be used in many settings and for all age groups, from premature babies to children with disabilities to seniors with dementia. Certified music therapists, who have training in music, psychology, physiology and other disciplines, are called on to help with a wide range of physical, emotional and social issues. Music therapists are often versed in music from many genres to match the preferences of patients, Register said. Children with cerebral palsy, for example, might play the drums to encourage them to stretch and use muscles in a way that might seem painful during physical therapy, Cevasco said. Singing can be used with special education students to help them learn to vocalize sounds properly or to teach social skills such as taking turns. For dementia patients, music from their earlier years may be used to help orient them in time and evoke pleasant memories, Pitts said. "Music therapy can be fun and take away the monotony of whatever it is we are trying to accomplish," Pitts said. "Music provides a certain emotional and even a physical response. For people in hospice, it can give them a moment to come together as a family, to remember a wonderful time and to have one positive thing come out of that person dying."