Music Therapy and Pain Management in Palliative Care
15 Jan 14
Shannon Ingersoll, MTA
Jim was in bed when the music therapist arrived at his room. He was restless and uncomfortable, and expressed, “I am in a lot of pain today.” He was curled up on his side, his large hands gripping the bed rail, his face creased with pain. His wife was sitting with him, looking concerned and anxious.
The music therapist offered a simple musical relaxation and explained to both of them that it could greatly assist with his pain today. She asked him what words he might like to hear to feel more relaxed, and he said “peace”. His wife chose blue as a peaceful colour. They both chose the image of a sunny meadow near their home as a favorite place they knew and loved. The music therapist then offered to close the blinds to reduce the bright light and then encouraged Jim and his wife to close their eyes and focus on their breath. “Slowly breathe in and out, and listen to the rhythm on the guitar.”
The music therapist improvised and spoke a simple guided journey, using the images, words and colours they had chosen, creating a visual landscape and taking them into the story, while she played a steady, slow rhythm on the guitar, gauging the pace of the music to match Jim’s breathing. She ended the relaxation with a soft lullaby that was a favourite of Jim and his wife.
During the session, Jim’s breathing deepened and visibly fell into a steady, slower rhythm. The creases in his brow softened and his grip released. He let go of the bed railing, and rolled on to his other side. His body had a more relaxed pose and his breathing was deeper. At the beginning of the session, his wife had opened her eyes several times when she heard Jim move. Eventually, she was able to focus on the music and the journey more and her eyes remained closed when Jim moved, her body visibly relaxed. Her mouth softened as her breathing deepened and she finally fell into a quiet sleep. The therapist stayed with them in silence for a few moments and when they did not wake, the therapist quietly left the room.
Three days later, the music therapist met with Jim and his wife again and he said his pain was “much better today”. They shared that after the last session they had both slept ‘long and soundly’, which the wife said they both needed. The therapist encouraged them to try the relaxation CD’s in the room and to find one that she and Jim enjoyed, so they could develop that response to the music and relax easily when they needed it.
This is just one example of the power of music to make a difference in this environment. In Palliative Care, one of the most important goals is to reduce a client’s level of pain so as to decrease the use of medication and to achieve as high a level of quality of life in the last days of these clients as possible. Teaching the relaxation tools to a client so they can develop a relaxation response on their own also gives them a sense of control over a life that is slipping away. The live music and relaxation sessions can also greatly assist family members and caregivers in dealing with stress and give them a much needed break, as well as bring them closer to their loved one in a meaningful way, creating opportunity for closure at the end of their life.