As it often is after the death of a loved one, it was a sad time for Randy. Rather than dwell on loss, he decided to do something he has done hundreds of times before: Go to the local hospice and play his music for the patients.... giving back seemed to be the right road.
Intuitively, most are aware that music creates a space for healing-whatever level that healing may be. It has many names such as therapeutic music or sound healing; if you Google "music and healing research," an astounding number of credible citations appear from respected associations to major universities. Most have heard about reduction in stress and pain. But the research is not just anecdotal. Music science objectively moderates heart rates, respiratory rates, and blood pressure; research has shown increased oxygen saturation percentages in those with chronic lung disease, less tremors in patients with Parkinson's disease, patients with Alzheimer's disease who seem to "wake up" when certain music is played; the list goes on.
Music therapy has been around since the 1940s when physicians notice a positive effect that music had on the soldiers with "shell shock" (now more commonly known as posttraumatic stress disorder). For decades, veterans were the primary patients worked with by music therapists. In the 1970s, the hospice movement started to enter the health care continuum, largely due to Dr Elisabeth Kubler-Ross, who advocated for home care and patient choice for the terminally ill. Two decades later, it became apparent that hospice patients could benefit from music. And currently, there are not enough people certified to work with music in hospice patients, veterans, or patients with dementia/Alzheimer's disease.
In discussion with Mary Superak, a Board Certified Music Practitioner (CMP), at Mercy General Hospital (Dignity Health) in Sacramento, CA, she works one-on-one with patients at the bedside, closely watching their physical and emotional responses. At Mercy General, the CMPs are under the Spiritual Care Services department. Often, she plays in intensive care units and is given parameters for vital signs for each patient; if necessary, she must alter the music she is playing according to the individual's physiological response.
Music therapists can be board certified, and there are credentialing bodies and requirements, not unlike for case management. The American Music Therapy Association and the Certification Board for Musical Therapists have a Scope of Professional Practice, Professional Code of Ethics, professional competencies, and Standards of Clinical Practice.
These special hospice nurses are often referred to as having a "hospice heart"-and often create a bridge for those to "cross over." Music can also help create that bridge. Back to Randy's story. Randy played that December holiday for many patients in many rooms-and throughout the hallways; his Native American flute created its healing tones, for whatever was needed and accepted. After a considerable time, Randy headed to the door with a holiday greeting. At first, he got no response. While walking out, the charge nurse came running up to him stating that four people had passed during his playing that evening. His initial thought was that he should have practiced more; but the nurse went on to tell him that these people had been struggling too long and were finally able to let go.
Music is a powerful tool and should be in the case manager's integrative medicine toolbox. No, music does not prolong life, but it does add life to the time left.
case management; music therapy