How music therapy is changing health care in this rural Nova Scotia town

For Rebecca McDonald, watching the demeanour of a palliative care patient change as she strummed the notes and belted the lyrics of a classic Patsy Cline tune is what inspired her to be a music therapist.

As a teenager, she would accompany her mother — an intensive care nurse — to play in an open common room at a hospital in Peterborough, Ont.

She describes one interaction with a grumpy older man as being the impetus for her career aspirations.

"His reaction was the most dramatic reaction I've ever seen to music," said McDonald, detailing how the man went from appearing unhappy and confused to excited and engaged.

"He was saying, 'Do you know this one? Do you know that one?' It was amazing to see how much music can help a person."

McDonald followed her dream, and was recently hired as a music therapist on a contract basis in the palliative care department at St. Martha's Regional Hospital in Antigonish, N.S. The unit has never had a dedicated music therapist.

McDonald, 23, said she hopes to use her craft to help people who have been given difficult, life-altering diagnoses.

"Quality of life can be kind of a difficult thing to talk about in palliative care," she said. "But it provides a safe space for them to have that social and emotional expression."

She said music is a powerful tool, and a song can often bring people back to a certain time in their lives.

"I'll play a song and maybe it prompts a story about this person's family or this person's childhood," said McDonald, who completed her music therapy degree at Acadia University in Wolfville, N.S.

"It's a way for them to connect with someone through that music."

Music therapy is much more than playing songs for patients. It's clinical work that applies musical interventions to help people through a therapeutic relationship.

'Highlight of their stay'

The sector is gaining momentum within health care across the country.

There are only 3.5 full-time and part-time music therapist positions within the Nova Scotia Health system. They are in Antigonish, New Glasgow, Halifax, Dartmouth and Lunenburg, the organization said.

But it noted there are other positions funded through partner agencies and music therapists working on a voluntary basis.

In a statement, spokesperson Brendan Elliott said music therapy reduces anxiety and pain, improves well-being and promotes social interaction for people in hospitals who are generally isolated from the community.

Elliott said taking a "whole-body approach" to healing has been proven to have better outcomes for patients and an overall better hospital experience, adding that people have described it as "the highlight of their stay."

"Music helps people connect and make memories," said Elliott. "The end-of-life transition is an experience, and music helps to define experiences in a positive way."

McDonald said she often begins a session with a conversation about music, asking things like whether it is important to them and what sort of music they like.

Patients can get involved

She then plays songs at their request — she finds classic country to be a favourite genre in the palliative care unit at St. Martha's.

Music therapy is very adaptable, she said.

"Within these sessions we are observing patients' reactions to music, and sometimes the patients want to sing along with you and they want to play, so I'll bring in handheld percussion instruments," said McDonald.

"Sometimes they're tapping their feet or they're tapping their tray table. And sometimes maybe a patient is quite fatigued and they say, 'Can you just play?'"

Music therapists can also help patients write songs as a way to express their emotions or to leave behind some sort of message.

"It can be very validating to people to hear their own words in music, because lyrics are so important to a lot of people, " said McDonald, noting March is Music Therapy Awareness Month in Canada.

"That's something that sticks with them."

Tom Curry has been a music therapist at St. Martha's for nine years and in schools throughout Antigonish, a university town of roughly 4,300 people.

Curry, who works in the acute care and geriatric rehabilitation units, said music therapy can have a big impact in smaller communities.

He described being stopped in the street by appreciative people, telling him stories about how he helped their dying or sick loved one through a difficult time.

"It's those little things that are these little moments of realizing that what I'm doing is making a difference," said Curry, who attended St. Francis Xavier University and has stayed in the community ever since.

"It's important that we bring people in the community together — let them know that they're going to be OK."

Elliott said staff at St. Martha's have noticed a marked difference in patients since Curry started working there.

"We have seen patients from the stroke and geriatric rehabilitation units get up, get dressed, put on makeup and go to group sessions down the hall following music therapy sessions," he said, adding that doing these sorts of activities support a patient's discharge from the hospital.

Curry — who helped advocate for McDonald's position over the past year after she completed her 1,000-hour internship with him through the Canadian Association of Music Therapists — said he feels a sense of responsibility to advocate for music therapy and its benefits.

He hopes the work being done at St. Martha's will serve as an example of how music can be applied in health-care settings in rural communities throughout the province.

Curry also touted the work of local organization Arts and Health Antigonish, which also helped advocate to Nova Scotia Health for the new position.

'Music is for everybody'

McDonald is currently on a six-month contract with Nova Scotia Health, so part of her work will be tracking the impact music therapy has had on the unit through surveys and testimonials to help make a case to make the position permanent.

Elliott said Nova Scotia Health will be closely monitoring the pilot project in the hopes of adopting similar methods in other health-care settings. 

"Early indications show this is a program that would provide strong benefits in a variety of ways for patients from one end of the province to the other," he said.

McDonald said she is grateful to be starting her career at St. Martha's to help build on the work Curry has done in the community over the past decade, and to help the field grow.

"This is something that brings people together," said McDonald. "Because music is for everybody."