Music therapy helps hospice patients cope

By Peggy Ussery
Media General News Service
Published: July 8, 2008

CLAYHATCHEE — Ruby Pouncey never sang in the church choir.
She never needed a hymnal to sing along. She knew the words by heart.
Pouncey’s not able to go to church anymore. Heart failure has confined her to a hospital bed in her Clayhatchee home. A small embroidered pillow lies near Pouncey’s head. “My Lord is my strength and my song,” it reads, part of a scripture from Exodus.
Listening to music, especially her church hymns, was a part of her life. Surrounded by a loving family, her mind clear, Pouncey seems at peace with the life she has led and the life that awaits her. Family photos surround this mother of four boys and three girls. Her husband, Harry, still tends the family farm. But on this day, he sits near his wife’s bed, listening as therapist Rachel Matthews sings and strums his wife’s favorite hymns on a guitar.
From time to time, Ruby Pouncey whispers the words.
Then sings my soul, my saviour God, to Thee
How great Thou art, How great Thou art
Matthews works as a music therapist with Wiregrass Hospice. Piano is the instrument she grew up playing, but a guitar is what she typically plays for patients. It’s not as cumbersome to transport as a keyboard, and the pleasant sound of an acoustic guitar is soothing for the patient.
Music therapy mixes psychology and music. The music is used to improve a patient’s physical and psychological functioning as well as their quality of life. Matthews quotes research on endorphins and serotonin levels and how they change when you listen to music, how patients need less pain medicine when music is played. Music as a therapeutic tool is something most people should relate to even if they don’t realize it, Matthews said.
After all, when we’re depressed we may tend to listen to one type of music. When we’re angry or happy, we may listen to other types. It’s the same idea behind the music chosen for exercise versus the music selected by restaurants or spas, she said.
“It’s really interesting how people use music,” Matthews said.
Some bright morning when this life is over
I’ll fly away
To that home on God’s celestial shore
I’ll fly away
For a hospice patient like Pouncey, the therapy is a relaxation technique, an outlet for her to express her feelings and cope with issues a person may face toward the end of their life. The music therapy creates a non-threatening environment.
“Most patients have requested spiritual music of some type,” Matthews said. “… Spirituality is something people go back to even if they haven’t been there for a long time.”
And while it’s not a goal of the therapy, Matthews said just as often people will talk about the music they want played at their funerals and why.
In the sweet by and by,
We shall meet on that beautiful shore;
In the sweet by and by
We shall meet on the beautiful shore.
Matthews has played piano since she was 7. But when she went off to college, it was physical therapy she pursued as a career. She had never heard of music therapy until a family friend mentioned it.
“I knew I wanted to work with people, and I knew music was my tool,” Matthews said.
She eventually received her bachelor’s from the University of Alabama and did a six-month internship in Pennsylvania. She went on to work with adult cancer patients at Duke University. She’s now a board certified music therapist with the American Music Therapy Association.
Music therapy is not as simple as knowing how to play music. The goals are similar to other therapies.
“A musician with no therapeutic skills won’t be as effective,” Matthews said.
A typical session lasts about an hour, and patients are often referred by doctors, social workers or chaplains. In some cases, patients play instruments during sessions. There may even be lyric analysis of the music selected by the patient. It’s a therapy used with children, adolescents and adults, according to the American Music Therapy Association, and is a tool to address mental health needs, developmental and learning disabilities, brain injuries, chronic pain and age-related illnesses such as Alzheimer’s disease.
For hospice patients, music becomes more about coping even if it’s not the patient who needs help.
“I’ve found a lot of patients are very at peace with things,” Matthews said. “A lot of times, the family struggles with letting go.”
Love lifted me!
Love lifted me!
When nothing else could help
Love lifted me!
Separating the therapist from the person is not always easy. Having worked with terminal patients for so long, Matthews has learned there’s always a patient who leaves an impression.
“If it never affects you in some way, then you need to find another career,” Matthews said. “If you walk away from a patient’s bedside without knowing more about what life’s about, then you’re too jaded. It’s a huge privilege for a patient to let you into their home at end-of-life times.”
I’ve got a mansion just over the hilltop,
In that bright land where we’ll never grow old;
And someday yonder we will never more wander,
But walk the streets that are purest gold.
It’s the words of the hymns that mean so much to Ruby Pouncey. Her faith is the most important thing in her life, followed by her family, which now includes 12 grandchildren, 13 great-grandchildren and one great-great grandchild.
What has she learned from illness? Rachel Matthews asks her. The Lord, Pouncey replies, saved her and will see her through.
“I might give out, but I’m not giving up,” she said.