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Deb Bartlett • May 12, 2020

COVID-19 is drawing attention to palliative care in LTC homes

Until recently, when a long-term care resident’s health took a turn for the worse, they were sent to hospital, where they would be cared for on the appropriate unit, possibly on the palliative or supportive care unit. Regardless of the unit, the patient received palliative care from hospital staff who were trained in providing palliative care.

As the availability of hospital beds became a problem, more long-term care residents stayed in place, and received palliative care from the staff. While there are positive aspects to not moving a sick, frail, elderly resident to be cared for by strangers at the end of their life, the flip side is that many long-term care staff have not been trained to provide palliative and end-of-life care, and the homes themselves may not be properly equipped to provide supportive care.

In the past few years, more long-term care homes are acknowledging that their residents are receiving palliative care. Many homes have created beautiful palliative care suites, in which residents die in a homey space surrounded by their loved ones. Many include an extra bed or cot for a family member to stay around the clock. Room 217 has seen an increase in staff seeking some training on providing palliative care, and specifically how the integration of music can support not only the person dying, but also their loved ones, and even staff.

Music has many benefits in palliative care. To help front-line caregivers (long-term care physicians, nurses, PSWs), volunteers, and friends and family understand how incorporating music into the provision of palliative care, Room 217 has created a Guide for Using Music in Hospice Palliative Care . It has been written in sections to simplify use according to the caregivers.

Music changes the physical environment, and helps all caregivers address the dying person’s physical, emotional and spiritual needs. Music can help everyone in that space to express whatever emotions they have - fear, joy, anger, or gratitude. For the caregivers , music fills space when words may escape them, and acts as a bridge for connection. Used intentionally, music can distract the dying person from pain, and may relieve them of physical symptoms like agitation, restlessness, shortness or breath, and insomnia. Breath can be synced to music to encourage regular respiration.

Music can also fill space. Even when no one is in the room with the dying person, music can create a peaceful ambiance, and a presence in the room. It is this final point that makes music such an important part of end-of-life care during these times of COVID-19. It is gut wrenching, but people are dying without their loved ones near in ICUs and long-term care homes across Canada. Room 217’s music was designed for palliative care; having our albums available means frontline healthcare workers can alleviate symptoms and assure families that their loved ones are not alone.

Room 217’s music collections were created to support caregivers. In addition to being a tool for them to use for the dying person, the albums are ideal for self-care, helping caregivers to de-stress and relax. Music also has a role in grief and bereavement. There are many ways that caregivers can support all care partners with music. For easy reference, check out our infographics on music in palliative care. There are four in total: Using Music in Hospice Palliative Care; 10 Ways to Use Music When Your Loved One is Dying; Room 217's Music Collections 1-4; and Meeting 7 HPC Clinical Goals with Music. We've designed these to be downloaded and printed.

By Shelley Neal March 8, 2024
I initially trained with MUSIC CARE to work with Seniors in Long Term Care who were experiencing dementia and Alzheimer’s Disease. This is the path I travelled with my mom. My training with Music Care and Room 217 supported capacity building in selecting music that was played on my harp or chosen recorded music. The music centered on the care of the individual and their specific needs. My job was to determine the individual’s specific and select music to address these needs. The music selected helped to build community, support sleep, talk about life experiences, create a background landscape of sound, support connection to decrease isolation and loneliness, as well as coming alongside people dying. My training with Music Care helped me understand how to support people “where they were” physically, emotionally, and spiritually. Through using beat, tempo, melody, and timbre, I could cater the music and desired support required for individuals or small groups. My profession is teaching. I am a special education teacher and use music in my primary teaching as a method for learning, practicing language skills, transmitting information about science studies or math equations, as well as having fun and creating our own songs. My teacher toolkit married exceptionally well with the knowledge and skills provided by the Music Care Certification training. Recently, my work with students has involved individual programming for the medically fragile children and the palliative children. I use music (repeating the chorus several times) to engage and connect with the kiddos. We use music to "talk" about feelings (our communication is through eye gaze, eye blinks, and squeezing hands), and content material. I use music to enjoy our relationship of being together. At times, due to medication for seizures, my little ones can be very sleepy. I increase the tempo, engaging in tapping the beat on her hands and using silly action songs. The giggles and wiggles make it magical. I also use music to tell stories (my students have CVI, cortical vision impairment, so visual perception is difficult). This helps the child to engage in the story arch and adventures. Music is my conduit for reaching out and being with the students. Recently, I had the sacred journey of visiting one of my children in ICU at Sick Kids. I was invited to come to say "goodbye". A dear friend who was an ICU nurse in a different department told me (AKA, insisted) that I bring my harp with me. I wasn't sure if this would be appropriate for the family. However, with the permission of the mom, I bravely packed my harp up and took it to the Unit. It was a beautiful evening of talking with their mom and dad about how special their child was in my life. I played the kiddo's favorite songs and then ended with "The More We Get Together". The little one opened their eyes and stared at me. We hugged, and I left. They passed the next morning. I consider this time to be a sacred gift. Music Care Certification has given me the confidence and toolset to work alongside people and to journey together. It is a time a beautiful, difficult, or sacred time that I have been honoured to participate in.  Thank You
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