Music Thanatology: Prescriptive Harp Music as Palliative Care for the Dying Patient

As the concepts of hospice and palliative care for the dying have gained acceptance in both the medical community and general society, increased opportunities have developed for music therapists to work with patients who are terminally ill. Developed by Therese Schroeder- Sheker, music thanatology is a field whose practitioners provide musical comfort, using harp, at the bedside of patients near the end of life. During these prescriptive "music vigils", the clinicianmusician individualizes the music to meet the patient's needs, carefully observing physiological changes and cues, breathing patterns, and synchronizing the music to match the patient. Using data collected from 65 patients, this study was designed to assess the effectiveness of prescriptive harp music on selected palliative care outcomes using a sample of de-identified data forms from past music vigils. Sixty-five patients were administered a 25-95 minute intervention of prescriptive harp music. The two certified music thanatologists collected vital signs (respiration rate, pulse rate and rhythm) before the vigil began (T1) and again following the vigil (T2). Observational indicators (wakefulness, agitation and depth of breath) were also assessed at (T1) and (T2). Results from this study provide evidence that a prescriptive vigil conducted by a trained music thanatologist may have a positive affect on dying patients. Patients were more likely to experience decreased levels of agitation and decreased levels of wakefulness (the patient was in a more restful state), while also being able to breathe more slowly and deeply with less effort. Findings suggest that the health care community as well as family members should consider music thanatology as a form of palliative care for dying patients. Future research in music thanatology is necessary to provide further evidence that supports existing programs or hospices which provide music thanatology as a service and to encourage the establishment of future music thanatology training programs 1 Little research has been done concerning the effectiveness of palliative care therapies for the dying. Most potential patients die before thorough research can be completed or before pre/post tests can be implemented. This lack of research on the final days and hours of life is unfortunate because there are opportunities to make these last moments more peaceful and positive by examining them more carefully. Elizabeth Kubler-Ross, a pioneer in the field of death studies, stated that the best way possible to study death and dying is to allow critically ill patients to be the teachers (1969). If research can identify effective palliative care therapies by observing patients and studying their responses, more people can benefit from the comforting effects of palliative care