Special Issue 11 (1) 2019 “Exploring the spiritual in music: Interdisciplinary dialogues in music, wellbeing and education” – Article (first published on 24 November 2019)
Exploring the “thin place” between life and death: Compassion-Focused Relational Music Therapy (CRMT) for terminal agitation in advanced cancer in a hospice setting
University of Bristol, UK
Delirium and agitation are highly prevalent in the last days of life for cancer patients and can be distressing for patient, family and staff. Although guidelines recommend meticulous assessment of spiritual and psychological factors and a holistic response, in practice sedation is commonly used (particularly in hospital settings) in spite of ethical, professional and family ambivalence and mis-communication around this practice. A Compassion-Focused Relational Music Therapy (CRMT) approach proposes that the “thin place” between life and death can be explored and held within music, potentially reducing patient, family and staff distress (a ’triangular model of suffering’) and provide an important bridge between care-giving and bereavement. A mindful approach (breath, body-awareness, compassion) integrates with the use of ‘vocal holding’ and ‘lullament’ in order to support the elements of a ‘good death’; safety, peace, love, forgiveness and letting go. This article describes a case study of a CRMT intervention with a hospice patient dying from mesothelioma. It also presents a mixed-methods feasibility study research protocol.
palliative care, advanced cancer, terminal agitation, music therapy, mindfulness, compassion, spiritual care, psychological care
Kate Binnie is a senior research associate on the Wellcome Funded Life of Breath project and is based in the department for academic primary care, University of Bristol. She runs courses for music therapists and other healthcare professionals: ‘Breath-body-mind integration in supportive and palliative care’ trainings run at the Sobell Centre for Education. She also teaches on the advanced psycho-spiritual module, Palliative Care MSc, King’s College London. [firstname.lastname@example.org]