Exploring the “thin place” between life and death: Compassion-Focused Relational Music Therapy (CRMT) for terminal agitation in advanced cancer in a hospice setting

Abstract

Delirium and agitation are highly prevalent in the last days of life for cancer patients and can be distressing for patient, family and staff. Although guidelines recommend meticulous assessment of spiritual and psychological factors and a holistic response, in practice sedation is commonly used (particularly in hospital settings) in spite of ethical, professional and family ambivalence and mis-communication around this practice. A Compassion-Focused Relational Music Therapy (CRMT) approach proposes that the “thin place” between life and death can be explored and held within music, potentially reducing patient, family and staff distress (a ’triangular model of suffering’) and provide an important bridge between care-giving and bereavement. A mindful approach (breath, body-awareness, compassion) integrates with the use of ‘vocal holding’ and ‘lullament’ in order to support the elements of a ‘good death’; safety, peace, love, forgiveness and letting go. This article describes a case study of a CRMT intervention with a hospice patient dying from mesothelioma. It also presents a mixed-methods feasibility study research protocol.