What Is Music-Thanatology?

Music-Thanatology | A Music Vigil | The Music


Music-thanatology is a professional field within the broader sub-specialty of palliative care. It is a musical/clinical modality that unites music and medicine in end of life care. The music-thanatologist utilizes harp and voice at the bedside to lovingly serve the physical, emotional and spiritual needs of the dying and their loved ones with prescriptive music.

Prescriptive music is live music that responds to the physiological needs of the patient moment by moment. For example, by observing vital signs such as heart rate, respiration and temperature, the music-thanatologist provides music that is tailored to each specific situation. The warmth of this living music can bring solace, dignity and grace to those nearing the ultimate journey at the end of life.

This music can help to ease physical symptoms such as pain, restlessness, agitation, sleeplessness and labored breathing. It offers an atmosphere of serenity and comfort that can be profoundly soothing for those present. Difficult emotions such as anger, fear, sadness and grief can be relieved as listeners rest into a musical presence of beauty, intimacy and compassion.

Music-thanatology is not intended to entertain or distract the patient. Instead, this music allows the patient to enter into the unbinding process of letting go in his or her own very personal way. It affords families a chance to be with their loved one in a very intimate yet safe atmosphere where words are not necessary and the words that are said can come from a deep place, aided by the music.

Since antiquity, music and medicine have a long tradition as allies in healing. Music-thanatology is a contemporary field rooted in that same tradition. It has developed over the past three decades through the foundational work of Therese Schroeder-Sheker. Today there are music-thanatologists practicing throughout the United Sates and in several other countries around the world.

As medical technology becomes even more advanced, its practitioners recognize that there is suffering that eludes even the most sophisticated medical treatment. Many physicians and caregivers welcome music vigils as an integral form of care that offers an opportunity for relieving suffering and bringing comfort.
Created: August 06, 2000     Last updated: September 22, 2008

Music Vigil

The word "vigil" means watchfulness or a period of watchful attention. A music vigil is the time during which a music-thanatologist is present and offering prescriptive music using harp and voice for the benefit of the patient and their loved ones. It is recognized that family and caregivers are experiencing grief, loss, change and a desire to support the patient. They are encouraged to be present for the vigil.

A quiet setting assists the music to be effective. Applause or comment is not necessary during the silence between the musical offerings. The patient and others present are simply invited to receive the music. Vigils usually last from 30 minutes to an hour.
Created: August 06, 2000     Last updated: September 22, 2008

The Music

The music used in the vigil setting is contemplative music using harp and voice. The Certified Music-Thanatologist (CM-Th) works to provide a musical presence that draws together and responds to the various streams of diagnosis, prognosis, personal, spiritual and social context, as well as the presenting and ever changing physiological parameters of the patient.

The music is delivered to support the process that is taking place within and around the patient. Musical elements such as rhythm, pacing, volume and tone are tailored, or prescribed, live at the bedside, and the delivery changes constantly in attentive response to the patient. For example, the length and shape of a musical phrase can correspond to the rise and fall of the patient's breath. Fluctuations in dynamics can reflect variations from restless to calm, or from effort to ease. Rhythm may be an avenue to achieve a close synchronization, and letting go of that rhythm may support the possibility of inner and outer movement. This is not to say there is a particular formula to be followed, only that live music at the bedside provides a broad spectrum of choices for the trained practitioner to employ in seeking to accompany patients, families and caregivers as they work through the end-of-life process.

In general, the music is quiet, restful, and meditative. While the material used might draw from sources such as sacred song (Gregorian chants, hymns, prayer and praise songs), lullabies and other traditional forms, it is important to understand that these sources simply provide seed material which can then be tailored to suit the needs of the situation at hand. Prescriptive music is not dependent on specific repertoire. Instead, it is a way of being present to both the obvious and the subtle aspects of a situation, analyzing options, and responding in a deeply musical way. Whether conscious or unconscious, the patient is always in charge of the musical direction because we connect at the level of breath, pulse, temperature, pain, effort, and tension; things that we all share by dint of our basic humanity. With this focus, the music can address the needs of each unique individual. In this way, the music seeks to be an expression of beauty and love; and as such, it transcends diverse affiliations of faith and culture.

While there is certainly a place for commonly known music or "old favorites" during many phases of life, music-thanatologists will distinctly steer toward music that is unassociated with particular memories, thoughts or feelings. With this intention of holding a focus on the present moment, the alternation of sound and silence will tend to encourage the listener to simply receive on a deep level.
Created: August 06, 2000     Last updated: September 22, 2008