MUSIC 2MT3 Lecture Notes - Lecture 10: Palliative Care, Precomposed Character, Pain Management

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What does MT in palliative care look like?
Not just people who are actively dying - many of the patients are lucid and/or
cognitively aware.
-
Video example: MT goes to people's homes in palliative care
MT reminds people that they are not alone in dying.
She just provides support, tries to connect them to the fact that they are
still alive and to work with them within their current abilities in the here
and now.
-
Interventions can be …
In pre-composed music
Songwriting or song analysis (e.g., life review/history)
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Hospice and Palliative Care
Philosophy of care - end of life
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Team oriented care
-
Patient led
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Enhance comfort and quality of life
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Prevent suffering/relieve pain
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Guided by wishes of the patient, not the physician
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Hospice Team & Music Therapy
MTs can focus the interventions across physical, emotional, spiritual, cognitive
or social needs.
-
Whole person.
-
Non-invasive, cost-effective
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Common goals
Psychosocial (anxiety, loss, spirituality, autonomy/control, isolation, family
cohesion)
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Pain management
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Manage dyspnea (shortness of breath) - entrainment
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Manage sleep difficulties
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Biopsychosocial
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Interventions
Music listening
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Improvisation
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Singing (see video)
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Songwriting
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Music playing
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GIM
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Lyric analysis
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Iso-principle - matching the patient's mood with the music
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Note: most interventions are not just about supporting the individual, but also
the individual's family.
-
Awareness of Surroundings
If you're in a room with someone at the end of their life, that person has usually
has become non-coherent.
-
Other people in the room are talking over them and there's little true
engagement with the person.
E.g., "he/she is not there"
From the philosophy of palliative care, we should still treat someone as if
they were cognitively present.
-
Video: Diving Into the Gray Zone
The way we establish if a non-responsive patient is conscious or not, we
use fMRI and ask questions.
Often, patients we think are not aware actually are.
Just recognizing the complexity of the brain is extremely important.
-
MT in Palliative Care
About living to the fullest - in the moment.
It's so important to consider what interventions mean to a person (e.g.,
singing with you, singing for a loved one, hearing songs from their past,
etc.)
-
Lecture 10: Music Therapy and Palliative Care
Tuesday, June 5, 2018
2:28 PM
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Document Summary

Not just people who are actively dying - many of the patients are lucid and/or cognitively aware. Video example: mt goes to people"s homes in palliative care. Mt reminds people that they are not alone in dying. She just provides support, tries to connect them to the fact that they are still alive and to work with them within their current abilities in the here and now. Guided by wishes of the patient, not the physician. Mts can focus the interventions across physical, emotional, spiritual, cognitive or social needs. Psychosocial (anxiety, loss, spirituality, autonomy/control, isolation, family cohesion) Iso-principle - matching the patient"s mood with the music. Note: most interventions are not just about supporting the individual, but also the individual"s family. If you"re in a room with someone at the end of their life, that person has usually has become non-coherent. Other people in the room are talking over them and there"s little true engagement with the person.

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