Sarah Pearson • November 3, 2016

From Magic to Method: Getting Specific about the Language of Music Care

Using music in care can feel magical. It can also feel confusing.

There is a transcendence that comes from a personal care aid suddenly humming “Moon River” with a resident with advanced dementia, who has been in distress for hours until the familiar melody invites him to hum along. There is a mysteriousness when a family gathers around the bedside of their dying loved one and sings old family songs. There is something miraculous about a teenager with debilitating depression who comes to life when she plays a song she wrote on the guitar.

It’s also hard to define what exactly happens sometimes. It’s hard to know what to call it. And it’s often unclear what to call the people who facilitate these experiences. Are they experts? Practitioners? Specialists? Or simply people who have an awareness of music and how they can use it to strengthen relationships?

Room 217’s article 10 Domains of Music Care: A Framework for Delivering Music in Canadian Healthcare Settings was published last month in the Music and Medicine journal and we hope, it is going to make this gray area a lot clearer.

In the past year at Room 217, we’ve devoted ourselves to helping clarify the language of music in care. Thanks to media coverage and a growing evidence-base of research, most medical professionals need little convincing that music can play a vital role in health care. Yet there is a discrepancy between how music is valued in health care, and how much it’s used.

Based on some preliminary research Room 217 has conducted, this discrepancy is mainly a confidence issue. So, our Music Care Training program seeks to fill in that gap and give caregivers both confidence and competence to use music to the best of their abilities, where it fits their scope.

But with so many ways to practice music care, defining roles can be confusing.

Since music can be integrated across so many domains of care – from nurses humming with patients to music therapists running one-to-one sessions, to social service workers organizing coffee house nights to symphony musicians playing string trios in a hospice – there is a need to get specific in our health care contexts about what specific practice is being used.

Language can be confusing too. So often in the media and in health care contexts, the words “music therapy” are used to describe any therapeutic use of music. This language is simply inaccurate. In Canada, music therapy is an accredited scope of practice requiring a minimum of four years of university training and a 1000 hour internship. It’s not that music therapists do something better or worse than other people using music in care; it’s just that music therapy refers to one specific approach. Even in my own workplace, volunteer musicians are sometimes referred to as providing “music therapy” – a misunderstanding that can complicate roles and public perceptions for everyone.

While the language confusion can be frustrating for practitioners, it also makes sense, given how little clarification exists in the literature and in health care communities about different music care approaches.

Having some framework for locating different practices within music care seems necessary and timely. The Room 217’s music care framework consists of ten domains that can help us clarify what musical consideration is being made, who is making it, and what their role is in the circle of care. Having this framework in the literature will hopefully only make these gray areas clearer, and ultimately help advocate for more music being used - used in diverse ways, used ethically, and used by a broad scope of professionals, volunteers and family members.

Music care is an approach, not a practice. It can be embraced by many different practices, and we want to empower people to use music to the best of their abilities, and within the ethical container of their roles. With the right language, we can better leverage that magic of music care by fitting it into the practical methodology of our caregiving roles.

Join us for the annual Music Care Conference in Toronto on November 12th, where each of the ten domains will be explored in depth through presentations by experts, and hands-on experience of music.

A guitar , cowboy hat , cowboy boots and hay are on a wooden table.
By Shelley Neal April 2, 2025
I undertook the MUSIC CARE Certification program when I had journeyed through caring for my mother with Alzheimer’s. It was during my training, I learned how music works in terms of timbre, melody and rhythm and beat, music care domains and music care strategies. It helped me to support mom as the disease progressed. I continued to certify through Music Care and then I had the joy of teaching others the level 1 program Fundamentals of Music Care Theory and Context . I have loved coming alongside others in Long Term Care and using music to support giving voice of what is within one’s life, preventing isolation and loneliness, creating community. I enjoyed all it all. Then, I found myself once again in the Emergency Room with Tim, (my family member) as we were helping him home in his palliative journey. My “outside life” took a back seat and my inside hospital life began. Tim’s was failing and he was no longer able to open his mouth and swallow to obtain nutrient’s due to Parkinson’s . We tried various types of foods, textures and flavours, however, opening his mouth and swallowing remained inaccessible. Tim loved Glen Campbell and Rhinestone Cowboy . When he was a young man, he would repeated play this song until the LP was worn through. He was given a new Glen Campbell CD at Christmas and the song was welcomed back into our lives. There I was ,in my new environment on the tenth floor of the hospital, playing Rhinestone Cowboy. Tim sang along. He actually sang along! He moved his mouth, swallowed and sang along. We were able to get pureed food into his body. Later, the disease continued to ravage his body and Rhinestone Cowboy helped us connected with other such as the speech language pathologist, doctors, cleaning staff and nurses. We sang and danced together with the music and Tim smiled. He knew he was part of a community who loved him. As we knew the end was coming, I played music with a simple melody, 60 beats per minute and soft timbre on my harp to support Tim as he fell into sleep. Near the end, I used tonal music in simple phrases to support calmness matching his breath. Tim passed peacefully and gentle. Today, at his funeral our last song “Rhinestone Cowboy”. After hearing the importance of this song, all the people present joined in singing to honour the village of Tim that so lovingly cared for him. Music Care training has become a natural rhythm in my life to use with aging and sick family members, supporting young children’s learning and providing self-care when I was tired after intense caregiving.
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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