The Contribution of Music to Positive Aging: A Review

Many people value music as an important part of their everyday lives. The published literature reveals that the role of music in life is varied: it can be recreational, educational, social, emotional, therapeutic, and spiritual. The importance and relevance of music depends on the life needs and interests of the individual and the social group within which he/she lives. It is now widely recognized that music for many older people is crucial in supporting a sense of well-being. The article reviews the evidence on the role of music in promoting health and well-being, and how it can produce positive psychological and physiological benefits for individuals. The aim of this article is to increase awareness among health professionals of the importance of music and discuss how it can be used to add to older people's lives.     

The role of music in young adults’ spiritual development

Abstract

This article focuses on the role of spiritual music in Finnish young adults’ spirituality formation. The research data consist of interviews (2013, N = 10) and questionnaire answers (2011, N = 278). Spiritual music refers to music that the young adults themselves experienced supportive for their spirituality. The article indicates that the spiritual music enhanced young adults’ spirituality formation as the music was well related to the young adults’ current life questions and to experiences of early life span. According to the data, music offered tools for constructing personal world view and was experienced to strengthen confidence on higher power or life itself. As a mental resource, music had an important role in coping with life. As entertainment, spiritual music enhanced experiencing life as satisfying. As a part of public spiritual life, music advanced spiritual connection with other people. The role of spiritual music in spirituality formation was related to questions of spiritual well-being.     

The Role of Popular Music in the Construction of Alternative Spiritual Identities and Ideologies

Setting its discussion in the wider context of the decline of institutional religion among young adults, the rise of alternative spiritualities, and the mediatization of religion, the article explores the significance of popular music in the development of alternative spiritual identities and ideologies. A summary is given of leading research conducted in this field by Christopher Partridge and Graham St. John. It is argued that they demonstrate the encoding of alternative spiritual symbols and ideologies into certain forms of popular music, they fail to give an adequate account of how audiences actively make use of this music to construct alternative spiritual identities or frameworks of meaning. The article concludes that researchers in the field of religion and popular music need to draw more on theories and methods developed in ethno-musicology and the sociology of music, and suggests that the work of Tia De Nora on music in everyday life raises important questions about the qualities and context of the act of listening to music that could generate more nuanced accounts of how popular music shapes alternative spiritual identities and ideologies.     

Women and Aging: Insights for Care from a Clinical Perspective

The purpose of this article is to generate pastoral clinical insights from the life experiences of three women entering the fourth quarter of life. The author considers how both physical, emotional, and spiritual resources as well as challenges can either enhance or disturb well-being. The author concludes that each of the women, having been in counseling for at least one year, has experienced an enhanced personal sense of well-being. Emerging from the clinical analysis, the author makes suggestions for helpful congregational pastoral care.     

The difficulties assessing spiritual distress in palliative care patients: a qualitative study

This paper reports on a focus group study aimed at exploring the difficulties that palliative care healthcare professionals encounter while assessing the spiritual distress of their patients. Three focus groups were conducted in a hospice (n = 15). Participants were all healthcare professionals working in the hospice in-patient unit. Interviews were taped and later transcribed. The data was analysed through content analysis. Emergent themes included: lack of vocabulary around spiritual issues, personal issues surrounding death and dying, training issues, fear of being unable to resolve spiritual problems, time constraints and difficulty separating spiritual and religious needs. Participants provided a number of recommendations for improving care. This pilot study has generated useful data in relation to how spiritual care of patients might be improved. Despite the abundance of academic publications and policies on spirituality, this area is not integrated well into palliative care.     

‘We Are All One,We Are All Gods’: Negotiating Spirituality in the Conscious Partying Movement

Research literature has been growing over the past five years which explores the religious significance of electronic dance music cultures. This article adds to this work by offering an analysis of spiritual discourses used within a particular underground dance scene in the UK, the ‘conscious partying’ movement. An ethnographic account is given of a typical dance night within this scene, which demonstrates how these spiritual discourses are embedded within a range of musical, artistic, therapeutic, and political networks and practices. The use and salience of spiritual discourses of oneness, energy, and immediatism within this scene are then analysed. It is argued that the conscious partying scene in the UK reflects spiritual ideas and practices within the wider global psy-trance music scene and that this study demonstrates the importance of ethnographic research for examining the complex ways in which such broader spiritual discourses may be negotiated within specific groups. The article concludes by identifying possible future research that explores in more depth the relationships between spiritual discourses, the aural properties of electronic dance music, and embodied practices of dance.     

The split professional identity of the chaplain as a spiritual caregiver in contemporary Dutch health care: are there implications for the United States?

The professional identity of the chaplain in Dutch health care institutions is in need of a new theoretical underpinning. The continued employment of the "spiritual caregiver," as the professional is called in the Netherlands, may be at stake. In former days, she or he was primarily a religious office holder fulfilling ecclesiastical functions. Against the background of secularization and individualization of religions and worldviews, the spiritual caregiver now turns more and more into an existential counselor, focusing on the search for meaning and life-orientation of all the clients/patients/residents, irrespective of their religion or philosophy of life. This brings along the need for a conceptualization of spiritual care. What is the spiritual caregiver's particular contribution to care and treatment, compared to that of, for instance, psychotherapists and social workers? What are the specific aims, methods, and key images of the profession? This brief communication sketches the specific context in which the Dutch spiritual caregiver has to work and the identity dilemmas he or she faces.     

Programmatic staff care in an outpatient setting

Traditionally, chaplains have provided care for staff through consultation, informal conversation, grief work, and more formal counsel and ritual. This article discusses four programmatic approaches to staff care created in response to particular assessed needs: "Finding Soul" addresses staff care needs to find meaning and joy in their work and to contribute to the "soul" of the institution. "Existential Expedition" helps staff both deal with their accumulated grief and provide better direct care around existential issues being faced by their patients. "After Book" provides a way for staff to have closure with parents/families and to provide holistic care to families after discharge from the system. "The Labyrinth Program" provides staff with an opportunity to de-stress and to attend to their emotional and spiritual well-being. Focused upon staff care, these programs also secondarily benefit both patients/families and the vision and mission of the institution.     

Utilizing hospice for visitation of comatose patients: field education for pastoral care students

This article provides a reflection on how three educational organizations utilized a hospice setting for field experience to provide spiritual care with comatose patients. It outlines how three students, who formed a collegial group, prepared for the experience, completed and documented assigned visits, summarized outcomes, and discussed some implications for ministry with terminally ill comatose patients.     

Deep hope: A song without words

Hope helps alleviate suffering. In the case of terminal illness, recent experience in palliative medicine has taught physicians that hope is durable and often thrives even in the face of imminent death. In this article, I examine the perspectives of philosophers, theologians, psychologists, clinicians, neuroscientists, and poets, and provide a series of observations, connections, and gestures about hope, particularly about what I call "deep hope." I end with some proposals about how such hope can be sustained and enhanced at the end of life. Studies of terminally ill patients have revealed clusters of personal and situational factors associated with enhancement or suppression of hope at the end of life. Interpersonal connectedness, attainable goals, spiritual beliefs and practices, personal attributes of determination, courage, and serenity, lightheartedness, uplifting memories, and affirmation of personal worth enhance hope, while uncontrollable pain and discomfort, abandonment and isolation, and devaluation of personhood suppress hope. I suggest that most of these factors can be modulated by good medical care, utilizing basic interpersonal techniques that demonstrate kindness, humanity, and respect.     

Sedation and care at the end of life

This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly at making a dying person unconscious, or is it only permissible to tolerate unconsciousness as an unintended side effect of treating specific symptoms? What role does the rule of double effect play in making such decisions? Does spiritual or psychological suffering ever justify sedation to unconsciousness? What are the theological and spiritual aspects of such care? This introduction describes how the authors in this special issue wrestle with such questions and shows how each essay relates to the author’s individual position on palliative sedation, as developed in greater detail within his contribution.     

Spiritual distress at life's end: finding meaning in the maelstrom

Recent trends in social research indicate a decline in church attendance and a corresponding increased interest in spirituality. With the aging of the population, attention to end of life care, with its corresponding spiritual concerns and distress, has become a prominent issue. Spiritual distress can be difficult to distinguish from psychological and physical distress and indicates the need for differential diagnostic markers to distinguish between genuine spiritual experience and psychosis related to the physical death process. Further, for hospice patients who are in genuine need of amelioration through pharmacologic suppression, the question of when and how to medicate becomes paramount as the distinction between spiritual process and physchosis becomes less evident. This article is an exploratory attempt to encourage dialogue across interdisciplinary lines and foster participation from alternative therapies representing the spiritual context of the patient. Anecdotal data from hospice professionals representing a variety of disciplines are presented to illustrate and emphasize the need for continued dialogue and research in this important area.     

Text and Tune,Speaking and Listening: Musical Resources in Pastoral Care

This article examines the power of music to help transform suffering. It draws on insights from the work of music theorist David Schwarz (1997) that bridges psychoanalysis, music, and culture; and from Daniel Levitin’s (2008) work on music and human nature, especially as it pertains to religion, ritual and songs. Schwarz describes listening to music as a process of retrospective fantasy and as a type of transference experience. If how we listen to music is shaped by traces of past experiences, then music as a resource in pastoral care has the potential to assist ministers in the process of guiding their parishioners to re-trace painful experiences in ways that “re-sound” with thoughts and feelings which have become an impediment to healing. A “case study” in which the author was a “player” (or more accurately performer) is briefly examined, and the role of music in the lives of Steve Lopez and Nathaniel Ayers (Lopez 2008) is explored to demonstrate how music—specifically religious music or song associated with religious ritual—is an overlooked resource for pastoral care. The article concludes with an illustration of how individuals’ personal associations with a hymn may have implications for pastoral care.     

A model for outpatient care

Chaplains have seriously discussed outpatient care for a number of years. This article describes a model of thorough and intentional outpatient care that is practiced in conjunction with an inpatient care to cancer populations. Rationales, values, institutional dynamics, and clinical care are discussed. Although the focus is on outpatient care where slightly more than 50% of personnel resources are invested, the care also occurs in the context of both inpatient care and follow-up care after discharge to home. A general model of spiritual and religious care and more specific models pertinent to hematopoietic stem cell transplant populations and general oncology populations are described. The models attend times of distress and times of "ordinary" and celebratory experiences, attend care of patient, caregiver, and staff.     

What Spirituality Means for Patients and Families in Health Care

This research focuses on the spiritual care experiences of patients and families at a hospital in Australia. Twenty-four patients and 10 family members were interviewed. Results indicate the importance of relatedness: being treated as a person, reminded of your capabilities and conversations about what matters. Maintaining contact with friends and family, sustaining religious and spiritual practices, music therapy and pet therapy were also significant and contact with the natural world and shared activities. The results indicate the importance of spirituality offered through pastoral care, and that all those involved in health care can contribute to the spiritually nurturing environment that reinforces healing.

     

What do Non-clergy Spiritual Care Providers Contribute to End of Life Care in Israel? A Qualitative Study

Spiritual care is an increasingly important component of end of life care. As it emerges in Israel, it is intentionally built on a nonclerical model. Based on interviews with spiritual care providers in Israel, we find that they help patients and families talk about death and say goodbyes. They encourage the wrapping up of unfinished business, offer diverse cultural resources that can provide meaning, and use presence and touch to produce connection. As spiritual care emerges in Israel, providers are working with patients at the end of life in ways they see as quite distinct from rabbis. They offer broad frames of meaning to which patients from a range of religious traditions can connect.     

Layers of engagement: Staff perceptions of spiritual care in residential aged care

ABSTRACT

Addressing the spiritual care needs of residents living in aged-care facilities should be an important dimension of quality care. We conducted semi-structured interviews with residential aged-care staff (including caregivers, nurses, managers, and chaplains) in New Zealand to explore how spiritual care is understood and operationalized. Many participants appeared to equate spiritual care with holistic care that respects the whole person. Participants discussed five types of spiritual care engagement requiring different skills, knowledge, and personal commitment, including information gathering, facilitation, companionship, end-of-life care, and counseling. Our findings suggest that the spiritual care that was offered by our participants, clergy and non-clergy alike, was predominantly informal and unplanned.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

Clinical pastoral education: a physician's experience and reflection on the meaning of spiritual care in palliative care

In this article a physician reflects on her experience as a chaplain intern and how this Clinical Pastoral Education experience led to a deeper understanding of spiritual care in the palliative setting.