Music in Hospices

Music therapy is becoming increasingly popular in Indian settings. A group of volunteers from NADA Centre for Music Therapy have begun working on a series of lecture-demonstrations in various Indian cities and towns. This author has been associated with such attempts since the late nineties, when he had to encounter dissent from the intellectuals and even wrath from many.

Fully recognizing the role of music as a positive nutrient for healthy living, the movement which started in the late nineties through isolated lectures here and there, came to be established as a centre, Nada Centre for Music Therapy and registered in Chennai.

The priority was to engage in research and publication so that there is massive awareness about the goodness in music. 

Several publications made by the Centre such as What is Music, Raga Therapy, Medicinal Music, Music Therapy, Self-Music Therapy became instant hits among those who loved music and believed in its therapeutic importance in life. This was followed by the popular “internet” training course, Distance Learning Programme, which has so far seen three batches of enthusiastic students learning music therapy. These students are drawn from various music cultures across the globe. They are not only music therapists but also drawn from various fields: such as education, psychology, psychotherapy, medicine, behavioural science and also the IT industry.

In this article, we will share our experience with hospices, where terminally ill patients are lodged, after the medical professionals give up their attempts in saving them. At this stage, music therapy makes an attempt to ensure calmness and composure in them and helps in making the remaining span of their life as pleasant as possible. 

The Hospice Music Therapy 

Hospice Management in India —as elsewhere, requires a team of hospice music therapists, who are trained in selecting appropriate music, based on the individual needs of the inmates. These music therapists are expected to know not only of various styles of musical structures but also the various problems associated with managing the patients, who can be depressed, ill-tempered, unfriendly and non-responding to their proposals! 

Music Therapy in End-of-Life Care 

Using music for unwilling patients is the most difficult experience for any music therapist! It is therefore necessary that the music therapist should take this work as a challenge in his or her career and to be prepared for any or all adverse responses from the patients. Thus, he or she should be good at individual assessments of patients and to develop goals and interventions accordingly. Music therapy, being a complementary medicine, should also be well-integrated with the plan of care, as may be prescribed by the hospice physicians, who will take final decision in the matter. 

Thus, the whole project calls for a successful collaboration with the transdisciplinary team. Apart from this, the techniques to meet the physical, emotional and spiritual needs of patients and their family not only through music but also through counselling gets priority in such settings. 

Drumming, the Simplest of the Sessions 

This author is of the view that simple forms of music (such as iterative bhajans and kirtans in Indian scenario) are ideal for healing the wounded and the traumatized patients. It would be quite effective if the therapist could persuade the inmates to start learning the skill of drumming. A few make-shift drums, made of used tins and dubbahs can make such an impact in joint performance in the mindscape of these patients! One can also witness how these people can temporarily forget their tragic fate with the occasional smiles on their faces! 

Life Review 

Many psychotherapists claim that life review of such patients can help them overcome their suppressed emotions. It would be ideal if some “sad” music is played in the background. It is this author’s experience that melancholy in music — which is 100 percent pleasant — helps in countering the sad feelings in humans and even making them as pleasant as possible! 

Listening to Music for Pain Remediation 

Music is now known as a powerful means to overcome pain and gloom. Daily listening to music — at least three times a day – immediately after their meal has also been found to be useful. While listening to such music, based on the patients’ choice, we find that topical songs and assertive expressions which build confidence prove more effective. We recommend assertive (rajasic) ragas rendered subtly as the appropriate category of music for the hospices. For instance, ragas such as Hamsanandi, Malayamarutham, Bilahari, Mohanam, Piloo, Hamsadhwani, Darbari Kanhada etc — rendered in mild timbres of instruments like flute, santoor, sitar, veena etc — and also in medium tempo, and played in low decibels (volume) can help the inmates immensely. 

Song writing 

This is a new concept in music therapy, quite popular in the U.S. This calls for a dialogue between music therapist and the patient, each one improving a musical melody with some lyric or other. Even this lyric need not be meaningful, as we find even nonsense lyrics (as in rap) helps people overcome their depression. Such song writing exercise can be recorded and played back to the patient with whom it was associated. 

Bibliography 

Bagchi, Kalyan 2007 Music Therapy as an Alternative Medicine New Delhi: Society for Gerontological Research 

Sairam, T. V. 2007. Self-Music Therapy, Chennai: Nada Centre for Music Therapy.

This article was published in AYURVEDA AND ALL OCTOBER 2010 – Pages 29, 30 

Edited by Geeta Shreedar, August 10, 2021