Music was always important to the late Kim Van Horn. A trained vocalist, Kim sang at weddings and other engagements, and as a young adult she auditioned for a Philadelphia opera company.
“Singing is something I’ve always loved to do,” she said in a Health at Iowa interview a few weeks before her death on March 30, 2013. “It’s a big part of who I am.”
Kim hadn’t performed publicly for years, however, because her ability to sing was hampered by type 2 diabetes and related health issues. She had kidney failure, and for seven years she received dialysis four times a week near her home in Clinton, Iowa. She also had heart problems and other diabetes-related complications.
“She didn’t have the strength and the lung capacity,” says Laura Meyer, Kim’s partner and caregiver. “She had a beautiful voice but she couldn’t use it like she used to.”
Obviously, managing her diabetes and maintaining her dialysis regimen were Kim’s top priorities but some days were challenging, both physically and emotionally. Yet her well-being received a tremendous boost from the music therapists and palliative care specialists at University of Iowa Hospitals and Clinics, Laura says.
Kim first became familiar with those specialists after being airlifted to UI Hospitals and Clinics in mid-2012. This episode followed six days spent at her local hospital.
“She was having a lot of health issues. It was a tough time,” Laura explains, “but thanks to palliative care, we were able to talk through and better understand and accept what was happening. And with music therapy, we were able to move ahead.”
KIM DISCOVERS A TURNING POINT
As part of the palliative care team at UI Hospitals and Clinics, music therapist Meredith Cairer met Kim and Laura. Through their conversations, Meredith learned which music meant the most to Kim and Laura. Music therapists are trained to have a large repertoire of music, and Cairer was able to provide several meaningful songs in the session. It was then that Kim had the opportunity to sing again, and an “immediate connection” was forged.
“Meredith was a godsend,” Kim said later. “I was able to come through with my feeble voice, as it was, and I could see it touched her. That really did something for me in that I could touch someone else with what I can do.”
Moreover, the experience reminded her of the power of music and gave her a tool to help manage her illness, she said. During Kim’s hospitalization at UI, Meredith returned for a follow-up visit and brought a CD of music—“songs she thought Kim would like,” Laura says—for Kim and Laura to listen to in the hospital room.
“We continued listening to it at least three times a week at home,” Laura says. “It enlightened us. We remembered Meredith and we remembered what the music did for us.”
Stories like Kim’s are not uncommon, as music therapy is an important component of palliative care, which refers to the relief of pain and the management of symptoms and stress associated with serious illness or injury. A palliative care team—doctors, nurses, therapists, social workers, and others—works with patients and families to meet a patient’s physical, psychological, social, and spiritual needs. It’s not strictly end-of-life or hospice care; palliative medicine also is used while treatments and cures are still being pursued.
As part of the palliative care team, music therapists are consulted when the patient or his or her family experiences significant distress, grief, or pain, notes Ann Broderick, MD, associate professor of internal medicine and director of the adult palliative care program at the UI.
“Music therapists are important team members in helping patients manage pain and other symptoms, as well as anxiety and changes in mood,” Ann says. “And while the ‘healing’ properties of music have long been recognized, there is a growing body of research pointing to specific therapeutic benefits.”
Indeed, even a cursory Internet search yields dozens of published studies and news articles detailing how music therapy has helped patients with a variety of conditions—cancer and respiratory diseases; speech and language problems; limitations in movement and mobility; memory and cognition issues; and anxiety and mood disorders, among others.
Music therapy also helps the families of patients. As an example, Broderick cites an intensive care unit situation where a patient is hospitalized after a serious accident or sudden stroke; it’s clear that recovery is not possible, and the patient’s family is in the throes of grief.
“Such a devastating moment often is best addressed when we have a music therapist assist families with grief expression,” Broderick says. “While sometimes there’s no expression from the family because they are still coming to terms with what’s happening, sometimes it’s the music that allows the family to express their emotions, reflect on special memories, or simply interact with their loved one and one another at the bedside. The music therapist ‘knows’ this kind of room and has the expertise to work with families in these situations. It’s very compelling.”
Kim Hawkins, a music therapist at UI Hospitals and Clinics, agrees.
“A patient and family may have differing emotions and experiences of grief and differing ways of expressing those emotions,” Kim says. “Music helps people relate to their experiences. Board-certified music therapists are trained in identifying and providing music as a tool for expression and facilitating the relationship between individuals and their needs. We offer music-based interventions, whether it’s a song that matches a mood, singing that distracts from pain or loss, or music that motivates movement and interaction.”
Kim notes that music therapy has been an established discipline for more than 60 years. Public awareness and requests for music therapy are growing, as people are demanding quality and family-centered focus in their medical care. “People are recognizing the benefits of focusing on quality of life, and that includes both music therapy and palliative care,” she says.
NOT JUST ‘PERFORMERS’
“Initially, some patients and families think we’re just performers—that we’re coming in simply to sing a song,” adds Cairer. “In fact, music therapy is much more than that. We are using music as therapy to achieve specific goals. In Kim’s case, music allowed her the opportunity to express herself again in singing, which validated her life and helped her identify music as a coping skill to use in the future.”
For the late Kim Van Horn, music therapy “made all the difference.” She returned home to Clinton to continue her dialysis, and sometimes returned to UI Hospitals and Clinics for follow-up care.
What changed, Kim said at the time, was her “attitude” and overall quality of life.
“I only saw Meredith twice during my initial hospitalization, but she really made an impact,” Kim said in an interview a few weeks before her passing. “She brought me out of a dark cloud, and I know what to do if I’m in that dark spot again. Music enables you to make an emotional connection with other people and with yourself. How can you not feel better when you’re singing?”
More on music therapy
- Research has shown that music therapy helps patients with a variety of conditions—cancer and respiratory diseases; speech and language problems; limitations in movement and mobility; memory and cognition issues; and anxiety and mood disorders, among others
- In 2012, the adult and pediatric palliative care teams at UI Hospitals and Clinics and UI Children’s Hospital became the first in Iowa to achieve Advanced Certification in Palliative Care from The Joint Commission, the organization that accredits U.S. hospitals and health care