Features October 2018 Issue

Soothing the Stresses of Heart Disease

Music therapists make it easier for patients to cope with serious heart conditions.

It’s common for patients with advanced heart disease to struggle with their illness. Long hospitalizations, major surgeries and fear of running out of treatment options can leave them feeling frightened, anxious, hopeless and exhausted.

This is when a music therapist can help. By playing or singing the patient’s favorite music, a music therapist can relieve a patient’s pain and anxiety, elevate their mood and restore feelings of joy and hope. The effects are physical, as well as psychological.

“We watch heart rate, blood pressure and respiration rate drop and facial muscles relax,” says Debbie Bates, MMT, MT-BC, manager of the Music Therapy Program at Cleveland Clinic. “Even when a patient is not awake or responsive, we can see the impact of music on their monitors.”

Music for Heart Patients

Laura McFee, MT-BC, provides music therapy to adults hospitalized at Cleveland Clinic with heart disease. Oftentimes, these patients have end-stage heart failure and are waiting for a heart transplant or receiving a left-ventricular assist device.

How Laura approaches a therapy session depends on the patient’s needs and wishes. “We are never sure what a patient will need until we meet,” she says.

She discusses music preference, then asks them to rate their pain, anxiety and mood. She may also ask how they have been sleeping and whether they have symptoms such as shortness of breath. This information helps her formulate the goal of the session.

For example, patients who are anxious about impending surgery may need help relaxing and expressing pent-up emotions. If they are waiting for a transplant, the focus may be on coping with a long hospital stay or fear a new heart won’t arrive in time.

Sometimes she puts people to sleep, because that’s what they need, or helps them obtain pain relief. “Refocusing on music can block pain receptors,” she says.

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Debbie Bates plays the guitar to help relax a patient.

SUPPORT IN TROUBLED TIMES

A 65-year-old man waiting for a heart transplant loved gospel music. “He couldn’t move very much, because his heart was so weak, but he loved to sing,” McFee remembers. Over a three-month period, they worked on various gospel pieces, which he recorded in the hospital and shared with his family. He remained passionate and motivated. After his transplant, he recovered quickly and was able to return home in record time.

LULLABY FOR A STRESSED ADULT

The woman had just undergone the latest of several open-heart surgeries. She was anxious and could not sleep. McFee asked her to think of a location where she felt relaxed and used guided imagery to take her there. McFee timed the beat of an ocean drum, which sounds like waves, to her patient’s breathing and gradually slowed it down. Before the session was over, the patient was sound asleep.

A Matter of Choice

Because patient-preferred music often has the most therapeutic effect, a music therapist must be ready to play or sing any type of music a patient requests.

No genre is more relaxing than another, they are quick to point out. It’s all about preference and the personal meaning a patient attaches to music.

“The memories we associate with certain types of music can be intense. When patients listen to their favorite music, they are often able to recall a different time in life and may forget they are in the hospital. This elevates their mood,” says McFee.

There are times, however, when music without memories produces a better result. “It allows you to disconnect and relax,” she says.

Participation Optional

How involved a patient wants to be in music therapy depends on their diagnosis and whether they sing or play an instrument. Many simply want to listen to music. For these patients, the music therapist will select works likely to be therapeutic. When McFee sees the potential to help improve a patient’s medical condition, she encourages them to participate in music-making using an instrument on her cart that doesn’t require special training or talent to play.

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Cleveland Clinic

Lisa McFee plays music requested by a heart patient.

“When patients have become deconditioned from a long hospital stay, it can be helpful to move their body. They do it automatically, without thinking, while playing an instrument,” she says.

Similarly, singing can help lung transplant patients by encouraging diaphragmatic breathing.

While anyone can request a music therapy session if they think a patient might benefit, some patients just aren’t up to it. That’s okay, says McFee. “It’s their choice, and they don’t often get to make choices in the hospital.”

Transitioning Home

What patients learn about themselves through their music therapy sessions makes many want to continue listening to music at home. Indeed, they may derive more benefit than they expect.

Listening to music also been shown to make the heart contract more strongly, adding to the benefit of heart-failure medications.

A study published earlier this year found that listening to instrumental music enhanced the effect of blood pressure medication by significantly lowering heart rate. This did not occur in patients who took their medication without a dose of music.

Regardless of its tangible physical and mental benefits, music simply elevates the spirit. “It’s important to be aware of how you react to music, but in general, listening to music is good for everybody,” says Bates.

To locate a music therapist (MT) in your community, visit www.musictherapy.org/about/find. For information on board certification in the pro­fes­sion (MT-BC), visit www.cbmt.org.

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