November is National Hospice and Palliative Care Month in the United States, and in discussing the particular place that music therapy has in hospice and palliative care, I have been looking at special songs that have led to significant moments in care at the end of life. Previous posts were dedicated to the spiritual song “The Beautiful Garden of Prayer” that was significant for spiritual and emotional support and a set of Filipino folk songs that helped bridge cultural boundaries with a client with dementia. In this post, I’ll discuss another favorite song of mine for hospice music therapy: “Shoo Fly Pie and Apple Pan Dowdy.”
It is a common misconception, I think, that the most therapeutic music in hospice is the slow and relaxing kind. It is true that many patients referred for music therapy in hospice and palliative care need relief of pain and anxiety, and music therapists do structure music for relaxation for many patients. Music therapists have the ability to address many other needs through music, however. Two common goals are to help patients with dementia connect with their family members or other caregivers and to provide emotional support to those caregivers as the patient’s illness progresses. A variety of music can help address these needs by changing the mood in the room or sparking discussion or reminiscence.
In supporting verbal interactions, one technique is to choose songs that are familiar to the listeners and personally significant in some way, as was discussed in this previous post. Another technique is to choose songs that might not be as familiar but that are useful in their musical elements and in their lyric content. “Shoo Fly Pie and Apple Pan Dowdy” is one of these songs. It is upbeat and lighthearted, and it is in the big band style that is popular among many older adults. I have not had many clients who knew the lyrics well enough to sing along, and many family members have not been at all familiar with this song, but the lyrics lend themselves to reminiscence – about the special treats someone’s mother used to make, about the cooking a patient did herself, or even just about the normal routine of a family.
I had a hospice patient recently who was in the end stages of dementia, and while she was alert and responsive to music in most sessions, she spoke very little. Her daughter was present during one session in which I sang “Shoo Fly Pie and Apple Pan Dowdy” as a change of pace from the dozen or so songs the daughter had requested in previous sessions. My patient’s daughter did not know this song, but it did lead to a conversation about her mother’s love of baking and how she always had some sort of baked good for dessert each night at the family dinner table. We talked more about the routines of her family growing up and the things she and her mother like to do together in more recent years. Our discussion led to other song ideas and more singing, which helped to keep both the patient and the daughter engaged with each other in the moment during the session – both were smiling at each other, holding hands, with the daughter stroking her mother’s hair. The music helped to bring about a tender mother-daughter moment that was less focused on the difficulties of the present than on the loving relationship they had enjoyed for so many years. As a music therapist, this was a need that I could identify and a musical intervention that I could facilitate.
What are the special songs in your family? For music therapists, what songs have been surprisingly powerful in your sessions? Please share your thoughts in the comments section below!
This post is part of an occasional series on special songs to share with your loved ones. For more song spotlights, click here.