“Where words fail, music speaks.” Hans Christian Andersen
Eventually death comes to all of us. Eventually there comes a time when the men in white coats can do no more for us and that’s because they have no more to give us – even the most advanced medical treatment fails. So the men in white coats raise the white flag in admission of defeat: they can no longer keep us alive. Cue the music thanatologist who, though no more a saviour than the doctor, can ease our passage onwards through music. Thanatology is the academic study of death from a range of perspectives, for example religious or anthropological. Music-thanatologists use music to help patients who are “actively dying”, i.e. dying within 48 hours, or who have received a terminal diagnosis (within six months).
Despite the fact that since the genesis of time, music and medicine have been allies in the healing sphere, music thanatology is a relatively new specialization which falls under the broader umbrella of palliative care. The profession boasts its own association (Music-Thanatology Association) with set standards for certification. Music thanatology aims to “unite music and medicine in end of life care”.
Unsurprisingly, the most important tool in the music thanatologist’s toolbox is music: prescriptive music, which has been shown in a number of studies to bring comfort and relief to those who are suffering or who are at the end of their life. They are employed by a range of medical organisations and work wherever patients are: hospices, hospitals, nursing homes or private homes. Read on for more information about this highly specialised career and watch music thanatologists performing and discussing their work in the video below:
The Role of Music
“The music seeks to be an expression of beauty and love; and as such, it transcends diverse affiliations of faith and culture.”
Music thanatology uses ‘prescriptive music’, which is described by the Association as ‘live music that responds to the physiological needs of the patient moment by moment”. This means that the music thanatologist will tailor his or her music to fit the patient’s physiological state by observing the patient’s vital signs, such as heart rate and breathing. The music thanatologist has to respond, moment by moment, to both the physical and existential needs of the patient. Both his personal and spiritual, as well as his emotional and social needs need to be taken into account, in addition to his declining physiological state. Although the music itself is contemplative, it will change in dynamics, for example in rhythm, volume, tone and pace depending on the state of the patient. An example of this is, if the patient moves from calm to restless, or restless to calm. This means that, ultimately, it is the patient that sets the musical direction for the music thanatologist; the music thanatologist then responds in a “deeply musical way” in order to ease the patient’s symptoms such as pain, agitation, sleeplessness and laboured breathing.
The ultimate objective of music thanatologists is to provide music that supports the processes that are taking place within and without the patient. Such music provides comfort and succour to the patient, reducing the intensity of emotions many feel at this time, emotions which include denial, anger, fear and grief.
These ‘music vigils’, as they are so called, typically last for 30 to 60 minutes, and each is unique depending upon the requirements of each patient. Someone who is dying quickly may be given a single vigil, whereas a patient whose dying is prolonged may be given several music vigils over their last days, weeks or months.
The music allows the patient to ‘let go’ in his or her own way. It gives loved ones the opportunity to simply ‘be’ with the one dying without the need to utter any words. As such, music thanatologists provide real support to both patient and loved ones.
The instruments used by all music thanatolgists are the harp and the voice. It is the harp’s portability and polyphonic range that lends itself well to music thanatology and not, as many assume, a "sentimental caricature of heaven". The harp is also easily paired with the voice, which conveys human presence and can take on the flow of the harp’s melody.
Training and Certification
As a minimum requirement into the profession and unsurprisingly, prospective music thanatologists must play the harp, an instrument which takes years of diligent practice and training to master. In addition, every prospective music thanatologist must have a basic understanding of music theory, for example reading and notating music. Music thanatology training is a highly intense, rigorous two year programme of study. The education reflects elements of the following distinct educational models: medical training, conservatoire training, seminary and the liberal arts. Students are also required to undergo a clinical internship during which they are typically mentored by an MTAI-certified music thanatologist.
The Music Thanatology Association offers a ‘best practice’ certification based on the achievement of a range of professional standards for competence. The certification programme is challenging and comprises a number of core competencies: personal competencies, professional competencies, musical competencies, medical competencies, clinical competencies and thanatological competencies. In addition there is the requirement for “documentation of training”. Furthermore, certification is only available to individuals who have completed a “music thanatology education”.
The standards outlined by the Music Thanatology Association are designed to “guarantee the quality of our profession.” Those who achieve certification will have demonstrated all the competencies individually.
Music thanatology students must pass a background check and undergo drug screening. They are also required to have taken personal health insurance and various immunisations before the internship.
Earning Potential for Music Thanatologists
The income for music thanatologists could be considered to be modest: websites such as SalaryQuest place the average earnings for a music thanatologist at $21,700 with a maximum of around $43,400. That said, according to jobs website Indeed, a music thanatologist can fetch an average salary of up to $49,000.
Given the median salary for music thanatologists, it probably wouldn’t be wrong to conclude that those working as music thanatologists for a living do so out of an intrinsic motivation to help those who are dying, as well as their families. Indeed, many practitioners describe the work as being as much spiritual as it is medical.
Most of us will know, or come to know, someone who is facing the end of life in difficult and challenging circumstances. Unfortunately, we live in world that appears to have a ‘head in the sand’ approach to dying, even though it is a part of life. Music thanatologists do more than provide soundtrack for life’s last gasps. They bring vital, physical, emotional and spiritual support by way of prescriptively delivered music to patients who are at the end of their life’s journey and their loved ones. So I hope to see more music thanatologists in the world, helping us transition with greater ease out of life.
See Also: 5 Jobs for Music Lovers
Over to you: What’s your takeaway about music thanatologists? Have you or anyone you know had any experience with music thanatologists? Do you think they provide a valuable service to society?
Share your comments and thoughts about the profession in the comments box below.