Music Therapy Can Increase Quality of Life for Those in Hospice
For many, music from certain eras can bring back memories of better times. For others, music soothes anxiety or gets them pumped up for a workout. When it comes to people living with dementia, music can help in all of those ways, but it can also help cognition.
Hospice organizations are keenly aware of the soothing power of music. Sometimes the music may be used casually, by the facility or the family, knowing that this is a type of music that the person who is in the dying process had always enjoyed. Increasingly, though, employing trained music therapists has been favored. This type of therapy seems especially helpful with those who are dying from Alzheimer’s or other forms of dementia. Perhaps this is because in the final stage of dementia, people have usually moved beyond the point where conversation is possible.
Karen Sholander, a life-long musician, is a board-certified music therapist (MT-BC) in Dallas, Texas. She works with hospice patients and their families, helping them navigate through any terminal diagnosis to closure at the end of life. Many of her patients have dementia.
I asked Karen to answer some questions via email about the nuts and bolts of music therapy. Our conversation, edited for length, is below:
CBB: Karen, music has been shown in studies to increase quality of life for people living with dementia and, in some cases, it seems to improve their cognitive functioning. Music for hospice patients is also about quality of life. Do you work with both communities or just with hospice?
Karen Sholander: I currently work only with hospice patients and their families, many of whom have dementia. I visit patients in their homes, group homes, or larger facilities, and the majority of sessions are one-on-one. Some patients live in a small residential care home, so I may implement a group music therapy session with all of the residents, but only if this still meets the goal for the individual patient. When family members are present, I always invite them to participate in the sessions as terminal illness affects the whole family unit. Family members often become the voice of their loved one, and that voice needs to be heard.
CBB: What drew you to this work?
KS: I have been a musician my whole life and have always felt called to use my gifts to enhance the quality of life for seniors living in care facilities. When I began volunteering to play the piano several years ago in a nearby memory care facility, I was just amazed at the responses to the music. I was told by the care staff that their patients experienced improved mood and congeniality as I played, and this effect lasted after I left. I had people sit beside me on the piano bench who couldn’t tell me their own names, yet they could sing every word to an old, familiar song. I started exploring the effects of music on the brain, found that music therapy was a field of study based on research and evidence, and knew I needed to go back to school to learn how to use this musical gift of mine to best meet the needs of individuals.
CBB: Do you need special qualifications in order to provide music in a hospice setting?
KS: To be credentialed as a music therapist, you must first earn a bachelor’s degree, bachelor equivalency, or master’s degree in music therapy. Students take music courses, music therapy for various populations, and psychology courses as well as basic college courses. They must pass proficiency tests in piano, voice and guitar. Part of this degree plan is completing over 200 hours as a practicum student and a six-month, 1,000-hour internship with a board-certified music therapist.
Following the internship, candidates then take a board certification exam to earn the title of MT-BC (Music Therapist-Board Certified). Music therapists are recertified every five years by completing continuing education courses. MT-BC’s are bound by a Scope of Practice and Code of Ethics, and many belong to the professional organization, the American Music Therapy Association (AMTA). Although some people may claim to “do” music therapy, only professionals with the MT-BC credential have been educated, trained and certified as such. Several states have moved towards a state licensure to protect the professional standards and title. And just a note: it is music therapy, not musical therapy, and never musical therapist!
CBB: What instrument or instruments do you use and why?
KS: The main instruments I use in therapy sessions are the guitar and singing. I find that the guitar is an intimate instrument that allows me to be close enough to my patient to provide…
Helpful Tools:
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