MUSIC THERAPY AT THE END OF LIFE: A CRITICAL INTERPRETIVE SYNTHESIS OF THE LITERATURE

Abstract

The purpose of this study was to provide a critical interpretive synthesis (CIS) of the literature focused on music therapy at the end of life. The guiding question for this inquiry was, “What is the essence of the music therapy experience at the end of life, as it is explained across the literature?” Music therapy has been offered in hospice and palliative care in the United States, almost from its inception, when the first hospice in the United States opened in 1974. Since then, hospice has grown to be one of the most common settings for music therapists. The abundant literature addressing music therapy at the end of life demonstrates the meaningfulness of this clinical work, however, little synthesis of this literature has been published. CIS, a research methodology developed in 2006 by Dixon-Woods, et al., offers researchers a method for synthesizing diverse bodies of literature, and explicitly integrates quantitative, qualitative and non-empirical literature. Unlike methods for conventional systematic reviews, researchers using CIS draw from distinctive traditions of meta-ethnography to synthesize, build synthetic constructs, and generate a synthesizing argument. The resulting argument—an integrative, coherent theoretical framework—comprises a network of constructs and the relationships between them. Through the capacity of music therapy to establish, reestablish, or enhance the connection to self, connection to others, and connection to spirituality for people at the end of life, Connection emerged as the synthesizing argument in this study. As such, Connection became the unifying theoretical framework linking existing constructs across the literature. Within this framework, the role of the music therapist as companion emerged, demonstrating the essence of their presence to facilitate those connections, within a therapeutic relationship accelerated and enhanced by the music. This critical interpretive synthesis of the literature on music therapy at the end of life provides a meaningful resource for music therapists working in end of life care, or for those who aspire to do so. The meaningful work of individual authors is strengthened by the unifying connections made in this synthesis and music therapists are offered a theoretical framework from which to approach clinical work and a potential focus for therapy. This study illuminates some of the subtleties and complexities of music therapy at the end of life and brings to the forefront a deeper understanding of how music therapy impacts the end of life experience.