Music Therapy in Palliative Care

By Antonietta Desideri

Music therapists are accredited through the Canadian Association of Music Therapists, and are often registered psychotherapists. Antonietta (Toni) Desideri, MMT, MTA, RP, has been a music therapist for 14 years, and is the Director of Creative Minds Music Therapy, and currently works in a Paediatric Hospital Setting. 

Music therapy is the use of music towards therapeutic goals. A music therapist becomes skilled at various ways to use music; as an expression of thought and feeling; a mirror of states; and a connector of people. In palliative care, all these aspects of music and music-making come together in an embroidery intended to support the moment and the echoes of it that ring afterward. Enter the mind of a music therapist, for impressions in time. 

Where can it begin? With a diagnosis; an inhale; a journey still untraveled. To the client: let’s get to know each other, and let me know you through the drumming I match, and the vocals created in the space between us. Therapist, music and person become linked and this strengthens, as does the illness. A relationship based on creative expression of needs, feelings, and process: the same as guitar progressions, lyrics, vocal melodies and loud or gentle sounds. As your needs change, my role changes, and I follow as the support of emotional containment, until I mirror it back to you when you can no longer. And so it continues. 

The first ring of the guitar fills the air. As I search within myself, the space required for this moment, I watch Mom cry above her child. The sound becomes a flowing reflection of the heaviness in the room; the guitar picking as my fingers quietly play an extension of what I sense and see. The song evolves as a child’s breath is held steady by sedation, and a father heaves deep sighs. The song is a reflection of who this child and family once were – and still is, but cloaked in grief. This child loved the song and it is sung in comfort for both him and his parents,  with dignity. As the song plays on, Mom and Dad are able to hold, grieve, and build a memory with song. And so it continues on. 

The last days, after many before this, with sessions full of feelings, favourites, laughs and expression. Death is near, and known by those in the room. This is the last session; the last expression and experience together in music. These last moments are a plenty of states, not just grief. It includes laughter, connection, and being in the moment with playing small instruments. Oh, shake, and such effort to shake small until the end: one last arm raise to finish the song with a finale, for herself and her family. The experience is ingrained in the memory.  And so it continues forward.  

A song for her children. A song for her husband. A song for her. What will she leave behind? What can she process for herself? Tell me, so that I can fill the lyrics of your heart and put it to music. What will the end product be? An expression of feelings, thoughts, and affirmations. And so it continues forth.  

A heartbeat is the sound of a life. When put to words and music, it becomes a legacy. What is it about your child that you know? What do you want to remember always within a lyric? Let me ask you the easy and hard questions – the parallel process. How can I best put together this beautiful representation of your child? I do it with full heart, and listen for the contentment of completion as it feels right. It becomes an impression of a child in a rhythm and melody. And so it continues ahead.    

A family circle around the room. A song of familiarity of many years ago. Eyes open slightly in recognition, as a wrinkled hand reaches up. Is that a small grin on her face, as my voice increases in inflection and floats above, cloaking her like a childhood memory suddenly come to life? Family members once again see the person they know, even if just for a glimpse. It is the glimpse most worthy. Music becomes the vehicle for many things: love, presence, connection and letting go. 

And so it is.