I have been thinking a lot about how music therapy contributes to the care of patients at the end of life. In my work in hospice, perhaps the most frequent thing I do is sing familiar songs and accompany myself on guitar while the patient and family listen. This intervention can seem deceptively simple to an outside observer – it might just look like a private concert of the sort an entertainer would present to a larger group, or it might remind someone of traditional Christmas caroling, in which people go door-to-door and sing whatever songs are in their repertoire. In music therapy, though, deliberate choices are made about what songs to sing and how to present those songs. I will write more about how I make those decisions in a future post, but for now, I wanted to share a personal story about the power of one particular song for a special person in my life.
I have just returned from spending a few days with my family to celebrate the life of my grandmother, who died last week after a long illness. My grandma played the piano and sang beautifully, and she had stacks of sheet music, songbooks, and hymnals near the upright piano that stood in the home I visited so often as a child. She particularly loved the hymns that were part of her United Methodist religious tradition, and I knew that much careful thought was put into the songs that would be sung at her funeral. Of the music shared in this service, the song that particularly struck me was one that I did not know well: “The Beautiful Garden of Prayer.” Unfortunately, my grandma did not have access to music therapy as she neared the end of her life, even though she did receive hospice care, but I imagine that this song would have been an important part of music therapy with my grandmother. At the same time, I am sure this song, as with many songs I shared with my grandma, will be one that I share with hospice patients in the future.
What makes this song work? Of course, no song is a magic trick that affects every person the same way, and it is important to remember that a combination of personal associations and musical qualities factor into how a person experiences hearing any song.
On the personal level, “The Beautiful Garden of Prayer” was touching for my grandma and for us family members at her funeral for several reasons. This had been one of my grandma’s favorite songs – she associated this song with the comfort of her faith, and it reminded her and her family of the beautiful place she believed she would enter after her time on this earth had ended. It was also part of one collection of hymns my grandma had spent so much time learning and playing throughout her life – my father remembered that this was one of my grandma’s favorite songs in the “old hymnal” that was replaced by a newer edition several years ago. This was made more special when the soloist looked in the front cover of the dusty, well-worn book she was using for the funeral service and discovered my grandmother’s handwritten name, just below the stamp for her old Sunday school class. (I’m the lucky family member that got to take this well-worn hymnal home as a special keepsake.) This was a special song that was part of a tradition dear to my grandmother. Similar personal or spiritual connections may play a role in the therapeutic use of this song with another client.
On the musical level, this song has a gentle, lilting melody in a compound meter, with a rhythm that feels somewhat like rocking or dancing a waltz. The song is in a major key, lending a “happy” sound to listeners who are most familiar with Western music. The lyrics paint a picture of a beautiful, welcoming garden, with comforting spiritual images. Any of these musical elements can be part of my consideration as to the appropriateness of this song in a therapeutic context. This song also works well to start at a moderate tempo and gradually slow down to a gentle andante, which is helpful in the process of musical entrainment, in which the music helps the listener to move into a more relaxed state as the body’s rhythms match the slowing rhythms of the music. Overall, musically and lyrically “The Beautiful Garden of Prayer” is less serious and somber than some spiritual songs, which can also be beneficial in some therapeutic contexts.
“The Beautiful Garden of Prayer” was a special song for a special person in my life and provided comfort to my family as we mourned her loss. This same song has the qualities that can make it just as special and important to another client in music therapy, so it now has its place in my repertoire.