A-Z List

Terminal Illness and Music Therapy

Goals and Methodologies

by Jennette Eckert - Fall 1999

Problem Areas for Clients

Problems Encountered with Terminal Illness Patients:

  • Depression
  • Fear
  • Anxiety
  • Loneliness
  • Anger
  • Frustration
  • Grief
  • Coping with leaving others behind
  • Bargaining
  • Denial
  • Acceptance

Concerns of patient- includes fears of pain, isolation, abandonment, hurting others, uncertainty, unfinished business, losing independence, and being forgotten

Needs of patient- includes physical and emotional support, expression of emotions, communication, preservation of individuality, approval of family and friends for medical treatment chosen/rejected and for own actions, honesty, protecting family and friends from pain s/he feels s/he causes

Concerns of family and friends- need to: feel they are doing all they can (i.e. involve in treatment, if possible), talk, express feelings, communicate, be heard, know their feelings of sadness are OK, work through stages of grief, let patient go

Stages of Grief: Denial and isolation, anger and resentment, bargaining, depression, acceptance

Music therapy goals for targeting these problem areas

Taken from a presentation by my professor Lee Anna Rasar at the Oncology Rehabilitation Symposium in Memphis in 1998.

  • Deal with death meaningfully
  • Verbalize emotions and ideas that may be threatening to express otherwise
  • Serve as source of comfort and reassurance
  • Serve as springboard for open discussion
  • Divert from problem-oriented life/death-oriented life
  • Serve as tool to review past life
  • Serve as opportunity to be creative and satisfied with self
  • Provide emotional support
  • Provide vehicle for communication between patient and family
  • Provide outlet for appropriate expression of emotions and encourage this
  • Assist with grieving process (through medium of music)
  • Review past life
  • Deal with present life
  • Prepare for/anticipate future
  • Prepare for death: physically, materialistically, intellectually, spiritually, and emotionally
  • Assist in communion with God
  • Decrease fears about hospitalization-physical and emotional
  • Decrease fears about death
  • Decrease anxiety about medical procedures
  • Reduce duration of nausea
  • Decrease need for analgesic medication
  • Increase relaxation
  • Provide focus of attention
  • Develop pain distraction
  • Improve reality orientation
  • Improve memory
  • Improve breathing skills
  • Provide distraction from routine
  • Provide routine/organization of time
  • Focus on on-going project, develop goals, and keep up spirit
  • Set and meet short-term goals
  • Provide aesthetic experience
  • Provide fun experience
  • Develop constructive use of leisure time
  • Improve motor skills
  • Develop/regain language skills
  • Develop coping skills
  • Develop problem-solving skills
  • Develop functional skills with prosthesis

Music Therapy methods used for treatment

More information from handouts from Lee Anna Rasar's presentation at the Oncology Rehabilitation Symposium in Memphis in 1998.

Here are some physiological, behavioral, and physiological/behavioral effects of music documented by research.

  • Physiological
  • ICP-intracrainial pressure
  • BP-blood pressure
  • HR-heart rate
  • RR-respiratory rate
  • Respiratory status-TLV/VC, peak flows, IF/EF
  • IgA-Immunoglobulin A (spit and sing study)
  • Interleukin/Cortical
  • FPA-finger pulse amplitude
  • GSR-galvanic skin response
  • T-cell formation
  • Gastric motility (helps digestion)
  • Uric acid secretion
  • Motor programming for walking, running, dancing
  • Biceps/triceps move together instead of split second apart
  • Muscle relaxation/tension
  • ROM-range of motion
  • Endurance
  • Effort
  • Initiation of activity
  • Pain perception/tolerance
  • Behavioral:
  • Elicits emotional responses
  • Induces mood
  • Induces sleep
  • Helps to focus attention
  • Improves cognitive organization skills
  • Improves memory
  • Improves cognitive organization skills
  • Improves word recall
  • Orients to here and now
  • Creates associative learning
  • Physiological/Behavioral:
  • Improves oral/motor musculature-improved articulation
  • Improves prosody, fluency, rhythm, vocal range
  • Improves breath support/control
  • Elicits movement
  • Develops neurological patterning