What’s Music Thanatology’s Role in End-of-Life Care?


Contrary to what you might think, music thanatology is a form of palliative care that brings together music, voice, and medicine to help a dying person’s transition from life to death. Music thanatology in particular uses the harp and voice to usher in death in a smoother fashion.

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It is a soothing way to provide spiritual peace to both the person who's dying, the family, and to the caregivers. The combination of the different types of treatment serves the patient from a medical, emotional, and spiritual standpoint.

Music thanatology is a prescriptive form of spiritual care for the dying. By using sound and soft music, it helps to ease any emotional and spiritual pain a dying person may feel as the end of their life nears.

Music thanatology also works together with medicine, by playing music when a person is dying is a way of healing and helping with the transition from life to death. Read on to learn more about this unique form of palliative care.

What’s a Music Thanatologist?

A music thanatologist is a person who’s skilled and learned in the field of music first and foremost. The “thanatology” portion comes from the specific field of study in death and dying. A “music thanatologist” as such, is a person who has studied and mastered the harp, and has also studied death and dying.

In order to become a certified music thanatologist, a person must hold a varying degree of competencies that include not only the appropriate educational background, but also competencies in the following areas: personal, musical, medical, clinical, thanatological, and professional competencies that include the harp and voice.

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Difference between a music thanatologist and a music therapist

The main differences between a music thanatologist and a music therapist is that a music thanatologist uses harp and voice to tend to the physical, emotional, and spiritual needs of the dying.  A music therapist specializes in using music to heal individuals with physical and mental health issues, those who are rehabilitating or who have special needs. 

A music therapist is held to a higher educational standard but is not necessarily trained as a music thanatologist. Most are not. The requirements to become a music therapist include holding a bachelor’s degree in music therapy with a clinical training internship, a master’s or doctoral degree in music therapy. 

A music thanatologist may also undergo a 900-hour training curriculum in order to become certified in their field of specialty. However, their musical background is specific to the harp and voice in providing their care and treatment to those who are dying. There’s no defined advanced degree required in becoming a music thanatologist.

What’s the Difference Between a Music Thanatologist and a Music Therapist?

Music thanatology refers to the music and its playing method for individuals facing the end of life, and grief professionals typically referred to it as prescriptive music. A musician specially trained in this type of music therapy uses the sounds of harp and their voice to adapt the music to the breathing rhythms of a dying individual. As the physiology of a dying patient shifts, so does the tempo of the music. The music thanatologist's role is to mimic these natural rhythms to bring peace and comfort to the dying patient. 

In contrast, a music therapist uses music to relieve the physical and psychological symptoms of a person's illness. In some instances, music helps to reduce the physical and emotional pain a person experiences throughout different stages of their medical journey through injury or disease. Both of these disciplines provide music for the dying but at different levels and chosen modalities. 

A significant difference between these two disciplines is the level of participation affected by the patient. The prescriptive music offered by a music thanatologist requires no involvement of the dying individual. On the other hand, a music therapist can encourage the patient to take on an active role with the music whenever possible.

A patient can benefit from singing along or playing an instrument if they can do so without much inconvenience to themselves. Active participation helps a patient remove themselves psychologically from their illness and revisit happier times.

Music therapy also helps individuals facing mental health issues, trauma, and both physical and emotional disabilities. The families of patients facing their end of life and those suffering from illness or disability can also benefit from prescriptive music and music therapy.

The sound benefits carry forth to everyone within the listening range. Loved ones can also participate in music therapy sessions along with their loved ones receiving treatment. 

What Does a Music Thanatologist Do?

A music thanatologist’s main work consists of ushering the dying through the death process. They help with the transition from life to death, and bring comfort, peace, and spiritual care to those faced with death, their families, and caregivers. They have other important duties and roles within the overall care of the patient. 

A music thanatologist can be responsible for many of the following:

  • Providing palliative care that brings together music and medicine in end-of-life care
  • Using the harp and voice
  • Using music prescriptively to ease a patient’s symptoms 
  • Helping alleviate pain
  • Calming agitation
  • Easing restlessness
  • Helping with sleeplessness
  • Regulating breathing
  • Helping control the experiencing of emotions such as anger, fear, sadness, and grief

In addition, their most common tasks can include unique vocal sounds and harp melodies to make this integral moment easier to manage. Below are some of the following specific duties they may perform.

1. Tending to the needs of the dying

Music thanatologists provide palliative medical care in the form of prescriptive music. They use the harp and voice to tend to the needs of the dying during their last moments of life. They also help the families and caregivers cope with loss and alleviate the anxiety associated with the dying process. The music is used deliberately like medicine in providing care to those undergoing this experience. 

The harp is an instrument of choice, but not the only one used. It is the chosen type of instrument because a harp can deliver multiple notes simultaneously, similarly to a piano or organ. By contrast, other instruments such as a flute or oboe can only deliver one note at a time.

In order to deliver end-of-life prescriptive music, the instrument must be capable of sounding multiple notes at the same time. Because the harp is easy to transport and has the required capabilities, it’s the one most often used in providing this type of therapy.

The use of voice in conjunction with the harp helps mimic the patient’s dying rhythms. A music thanatologist might incorporate a low-decibel humming to the harp’s music, a methodological use of vocal rhythm, or staccato to soothe the dying. 

2. Providing comfort care

A music thanatologist provides comfort care in tending to the needs of the dying. Music vigils for the benefit of the patient and their family are held during the last moments of life. A music vigil is a cycle of prescriptive music delivered to the bedside of the dying patient. 

Usually, one or two music thanatologists will work together to provide nonstop musical care during the last hours of a dying person’s life. There are different types of grief that a person experiences as they are reaching the end of their life. Prescriptive music helps ease the stress and anxiety brought on by these feelings of grief and sorrow. 

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3. Playing to the rhythm of the dying  

A unique feature of music thanatology is to play musical tones to the rhythm of the dying person’s breath instead of familiar music played for entertainment. The prescriptive portion of the music thanatologist’s job is to match the rhythms and flow of the patient’s breath in order to bring peace and calm to the dying and their families. The music changes as the breathing changes. 

4. Ushering in death

One of the most significant duties of a music thanatologist is to help the dying patient usher in death. This is done through the use of musical vigil as described above where a concentrated effort is made at the last moments of life to bring peace and calm to the dying person, their family, and caregivers.

The vigil tends to decrease elevated emotions of anxiety, fear, anger, grief, and sadness. It also helps the family to say goodbye to a dying loved one

When Do People Typically Hire Music Thanatologists?

You and your loved one who might be facing a terminal condition can benefit from the services of a music thanatologist early on in your loved one's illness diagnosis. A music thanatologist offers palliative care to individuals facing the end of life, but that transition can sometimes take several months.

You don't have to wait for the last few days of your loved one's life to hire one of these professionals. The hiring of a music thanatologist can come at anytime you and your family think is the right time for this type of musical intervention. Some choose to include prescriptive music when their loved one enters a nursing home or long-term-care facility. 

The transition into a residential care facility usually signals the final transition in life for many individuals. They know and understand that their condition has advanced to needing specialized care and that they're unlikely to ever return to their private homes.

Knowing this can create a lot of fear and anxiety in many nursing home residents. Prescriptive music can alleviate some of these emotional and psychological experiences by helping soothe an individual's psyche. Other residents within earshot can also benefit from the beautiful sounds emanating from the harp and the thanatologist's voice. 

Beyond nursing home or long-term care settings, there is, of course, palliative and hospice care. When a patient graduates from a specialized level of care to palliative care, it usually means that there's no hope for recovery, and their doctors have given only a limited time left to live.

Receiving this news can have a significant negative impact on both the patient and their family. Prescriptive music becomes ever so more important during this time to help soothe the pain of the anticipated loss. The healing power of music helps the dying patient transition to death and their family heal from their suffering. 

How Do You Become a Music Thanatologist?

Becoming a music thanatologist is much the same as becoming a grief counselor with the added component of musical competencies. One of the first requirements is to have a love and appreciation of human life and the dying process. Being comfortable around death and dying is a must in this field. You must also have a strong constitution and not become squeamish or afraid of the dying. 

Once you recognize yourself as a good candidate as a thanatologist, the next steps are to seek education and licensure through a training program specifically geared toward the professional training of persons with an interest in serving the needs of the dying with prescriptive music. You can obtain training for Music-Thanatology is the continuing education program for Music-Thanatology at Lane Community College in Eugene, Oregon, or with the Art of Dying Institute in New York City.

Once your training is complete, you can seek certification through the Music-Thanatology Association International (MTAI).

The general guidelines for becoming a music thanatologist can be found below:

Step 1: Enter into a training program

A typical course of training for a music thanatologist consists of a one to two-year training program such as the Chalice of Repose Project, of which many current music-thanatologists have graduated from. Other schools will offer modalities in music-thanatology as part of a continued education program in music.

Not all training programs require an academic degree. You will, however, have to demonstrate a mastery of your musical instrument and other competencies related to the field of thanatology.

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Step 2: Master the harp

The musical instrument of choice in the musical thanatology programs offered is the harp. The instrument is chosen because of its ability to deliver multiple tones of music to mimic the differing sounds of approaching death. 

Most programs will test your skill and knowledge prior to accepting you into a certification program. If you have yet to master this instrument, the chances of being accepted into any of the programs are slim unless you’re entering into an area of study focused mainly on musical theory versus performance.

Step 3: Learn about death and dying

Being an expert harpist is not enough to garner you the title of music thanatologist. You will need to undergo an in-depth study of death and dying in any of the accredited thanatology programs available.

If you are new to this field, start with obtaining a basic understanding of what it means to be a thanatologist. From there you can participate in any one of the seminars presented by associations such as the Art of Dying Institute, the International Harp Therapy Program, or Music Thanatology Association International. 

Step 4: Get certified

The widely recognized Music-Thanatology Association International certification program requires extensive study and knowledge of the end-of-life process and experience.

There’s no undergraduate degree required, but it’s encouraged in most of the programs offered. You should expect to undergo 600 hours of classroom training, 300 hours of clinical practice, fieldwork, and internship, followed by a minimum of 50 supervised vigils.

Music as Palliative Care 

Music thanatology brings together all aspects of palliative care to provide comfort care to those who are dying, their families, and caregivers.

Understanding the dying process and how music can alleviate the stress and anxiety associated with this transition will make this experience easier to undergo for those suffering the onset of death. 

  1. Hollis, Jennifer. “For the Dying, Music Can Be Magic.” Health, Next Avenue, 22 October 2018, nextavenue.org/music-dying.
  2. “Art of Dying Institute: Integrative Thanatology Certificate – A Death Education Program.” New York Open Center, New York Open Center, opencenter.org/thanatology.
  3. “Certification.” Music-Thanatology Association International. mtai.org/certification.
  4. “Our Motto.” About, The International Harp Therapy Association - USA Affiliate, harptherapyusa.com/about.html.
  5. “Overview of Offerings.” Chalice of Repose Project, Inc. 23 May 2017. chaliceofrepose.org/ed-overview.

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