Melodic Memories

Hospice patients—and family—benefit from music therapy.

Angelic Health music intern volunteer Mike Skalski and Music Therapist Karen Melita, have regular music therapy sessions with Mike Bagnell for bereavement.
by Margie Barham, MBA, director of Public Relations and Giving, Angelic Health
As an Angelic Hospice patient, the late Betty Bagnell received music therapy, which improved her mood and helped her sleep. “She absolutely loved it,” says her son Mike. “She would get really involved and would be one big smile. She is shown here with Angelic music therapists Tori Baccari and Karen Melita.

Do you smile and sing along when you hear an old favorite song on the radio? Most of us find that music takes us back to more carefree days. But did you know that tapping your foot or singing to a much-loved tune not only brings you joy but can also have great health benefits? In fact, music therapy is used in healthcare to improve mood and reduce pain.

“Music therapists may be accomplished singers and musicians, but their purpose is not to entertain,” explains Angelic Health Hospice Music Therapist Karen Melita, MMT, MT- BC.

Although making music is enjoyable, music therapy goes deeper, offering a purposeful value to listening to music, playing an instrument, or singing a song.

“Music therapy provides a way to meet the wide-ranging emotional needs of individuals, and to help provide comfort and improve quality of life,” Melita says.

In hospice care, music therapy is used to treat the psychological impact of a terminal diagnosis, which can include shock and anger by both the patient and family members, as well as fear of death and loss of independence in later stages. Music therapy in bereavement supports the scope of emotions that can surface after loss.

“Music therapy can be used as a vehicle to communicate the vulnerable and intense feelings that often arise,” explains Melita, “It can create a safe space to convey uncomfortable feelings, as well as be a place for joy, reminiscence, and laughter.”

Mike Bagnell is receiving music therapy through Angelic Health as part of hospice bereavement service following the death of his brother James and mother Betty earlier this year. His mother also received music therapy as a part of her hospice care.

“She absolutely loved it, he recalls. “She would get really involved and would be one big smile. She would remain either upbeat and alert for a while afterwards, or she would fall right asleep.” For Bagnell, having bereavement music therapy has helped him through the loss of his family members.

“It helps keep a little bit of Ma in the house,” he says. “I enjoy the sessions a lot and look forward to them.”

He now includes music into his morning routine each day, using songs as prayer. “My day starts with singing “How Great Thou Art,” “The Old Rugged Cross,” and “Amazing Grace,” he explains. “I am now incorporating Christmas carols into the day. I never thought I could sing, but now I’m getting into it.”

Music therapists use evidenced-based practices to meet the individual needs of clients. Music is always centered around the client’s preferences, and the client’s songs are most often played live for the client, to enhance engagement and provide a personalized experience. Music therapy interventions may range from music-making; music listening; songwriting; guided relaxation; improvisation; music and pain management; and music legacy projects.

“Music as self-expression helps people share personal messages with one another that are often difficult to say in conversation,” explaines Melita, who has both a bachelor’s and master’s degree in music therapy from Temple University in Philadelphia. She’s been facilitating music therapy groups and individual sessions for over 20 years and now focuses her work in hospice care.

“Songs can even be left as a gift,” she says. “A song legacy can be an original or precomposed song that is meaningful to the client. The client can choose a song that conveys a special message to their loved one. A song legacy can provide comfort to those left behind, and it’s a gift that lasts long after the loved one has passed.”

The first thing that a music therapist does is to work with the client, caregivers, and treatment team to establish individualized clinical goals. For instance, someone experiencing depression may wish to alleviate these symptoms by using music therapy to improve their mood, but they may also wish to develop insight into their current situation. Songs can be used as a reflective tool to help clients find meaning and hope.

Music therapy can also be used to treat other symptoms associated with depression like anxiety, insomnia, and trouble focusing. From classic country to modern pop, during a music therapy session, you may participate in a variety of music selections, based on your preferences. You may even play a musical instrument, sing, or be asked to compose your own song together with the therapist. Dancing and improvising to the music may also be a part of your session.

“Songs are personal to us,” Melita explains. “We all have our own music that brings us meaning and lets us feel what we need to feel. When individuals listen or sing along to their special songs in music therapy, it is natural that strong emotions may come up. Music therapy offers a safe space to express whatever feelings arise, from anger, frustration, and loss, to joy and happiness. Music lets individuals release these strong emotions, either by being involved in the music firsthand or even cathartically by listening.”

Music therapy can be a place to explore intense emotions associated with end of life, but it can also be a place to be light and fun. Often, music therapy can vary significantly from session to session, depending on the needs and wants of the client. The music therapist provides a supportive environment for the client to explore feeling and express themselves.

To become a music therapist, one needs more than talent. Music therapists go through rigorous training in an approved undergraduate and graduate level program. In addition to studying music therapy, performance, and therapy applications with a variety of populations, they also take courses in biology and psychology and go through an extensive clinical internship and ongoing credentialing continuing education courses.

But using music and sound to improve mood has been around for hundreds of years. The Tibetan culture for instance uses sound therapy to calm, focus, inspire meditation, and bring peace of mind. Sound therapy uses tools to achieve specific sound frequencies, while music therapy focuses on addressing symptoms like stress and pain.

Melita offers some advice for those of you who want to apply the science of music therapy in your own home. “Music has a way to help us when we are stressed; motivate us and lift us up when we need it” One of the keys to music’s benefits lies in the connection with the listener. So here are a few of her tips:

• Create your own playlists of songs that are special to you. This can be a great resource to utilize. You can choose songs with a theme, like messages of hope or strength. These can be from whatever genre you like. Songs can help carry us through when we are feeling down. Keep these special songs on your phone.

• Upbeat songs to work out to can sing powerful messages. Choose songs that are the pace you’d like to be as you walk/run/workout and choose themes to help motivate you.

• Speaking of motivation, for those of us who need some for all this extra cleaning during these crazy times, make a fun playlist to listen to and motivate your household to pitch in, during small increments of time (like one or two songs to clear the table and do the dishes, etc).

• When we experience prolonged feelings of loss or sadness, we shouldn’t be alone. Working with an experienced music therapist is recommended to help process these difficult feelings.

“Music is a way to connect us to people and memories and take us back to those times. It can also give us hope for the future and remind us that we are not alone,” she says. “Especially during difficult, challenging, or controversial times like we have experienced with COVID, we each need to know that we’re all in this together. Music helps us to remember that.”