On Music and Dying, Part 1

| Dec 15, 2016 |

Interview with Kristina Guevara

Part One

Many years ago I read Elizabeth Kubler Ross’s seminal work, On Death and Dying. It was, and probably is, considered to be one of the most important books on that subject. But until recently I had never connected the subject with music. That changed in October 2016 when I was at a party in Kansas City at the home of Marty Hackleman, horn professor at the University of Missouri Kansas City. There I met a trumpet player named Kristina Guevara, who told me she did music therapy for hospice patients. I was moved by her idealism and the way she was trying to help people at the end of their lives, and I asked if I could interview her. She graciously agreed, and what follows is the first of a two-part interview.

What path brought you to where you are today?

Before I entered middle school, my father bought me my first trumpet. At the time, my older brother had been playing the euphonium and was honestly quite talented; I guess you could say I wanted to follow in his footsteps. Once I was in the band, I never looked back. Whether it was joining jazz band, playing in chamber ensembles, or filling in on the not-so-French horn, I did it without hesitation. In no way did I feel obligated; making music felt completely natural to me.

After high school I went to college at Florida Gulf Coast University to pursue a Human Performance degree, determined to become a physical therapist in the future. However, I couldn’t pass Biology 101 to save my life. All through the heartbreak and confusion of that experience, music was there for me, and in fact its presence remained stronger than ever. With the help and encouragement of my colleagues, university band director, and college girlfriend (now fiancé), I made the successful switch to music education.

To complete my music degree, I was required to do a big project on any topic of my choosing. Back then, music therapy was a field that was just becoming established, and since I was a bit short on time due to procrastination, I opted to research and present on the topic of music therapy. Though my presentation was extremely overgeneralized, something about music therapy caught my attention. Thankfully, I had a friend finishing up her master’s in music therapy at the time. She shared her experiences and encouraged me to apply for a graduate program in the field. After a few applications, plane ticket purchases, and interviews, I was accepted into a program at the University of Missouri Kansas City. I moved halfway across the country to attend, and I will graduate with a Master of Arts in Music degree with an emphasis in Music Therapy.

What makes music therapy so meaningful to you?

To me, there is nothing more beautiful and rewarding than helping others. Also, I can’t imagine myself every becoming bored of this type of work. Each and every human being is unique and functions differently. Whether through building self-control, developing social skills, or promoting neurological rehabilitation, our priority in music therapy is to help our clients reach their goals. Therefore, each individual requires personalized treatment plans in order for the therapy to be effective. This challenges me both musically and creatively; it really keeps me on my toes!

In music therapy, we use an approach called the Iso Principle (where the therapist tries to match the emotional state of the patient/client through the music). Through this principle, we are able to meet the patients “where they are” and gently guide or redirect them toward a different emotional state using the music. In hospice work, this gives me the opportunity to address patients’ emotional, physical, psychological, cognitive, social, and spiritual needs—all common and important goal areas in end-of-life care. This opens up a channel of communication and meaningful conversation so we can talk about memories a song may trigger, validate emotions and feelings, or talk about death. We can even work on getting out their frustrations by improvising some lyrics over the twelve-bar blues. With some quick thinking and a touch of creativity, a music therapist can provide endless possibilities for hospice patients.

In previous clinical practicums, I’ve had the pleasure of working with older adults, children with emotional or behavioral disorders, and young adults with neurological disorders. Although I enjoy working with those populations, working in hospice has brought so much joy into my life. I know that may sound eerie, but there is something special about spending time with people at the end of life that words can’t fully explain. However, I can say this: spending my time with the sick and dying has given my life a sense of purpose.

Do you see this field expanding?

I firmly believe the field of music therapy in hospice will continue to grow; the older-adult and geriatric population is not getting any smaller. I am sure, for example, that there will come a day when adult diapers will outsell baby diapers (which I believe has happened in Japan already). Because these groups are growing, hospice care is a thriving business, which can potentially create more opportunities for highly trained board-certified music therapists.

End-of-life care is only one of the many areas in which music therapy services are both provided and growing! Because music therapists follow an evidence-based practice model, we combine the best available research, the therapist’s clinical expertise, and the patient’s values and needs in order to provide the best possible service for all ages. This has paved the way for music therapists to work in (but not be limited to) the following areas:

• Neurological disorders
• Substance abuse and addiction
• Emotional and behavioral disorders
• Survivors of domestic violence and abuse
• Traumatic brain injuries
• COPD (Chronic Obstructive Pulmonary Disorder)
• Mental illness
• Military populations
• Neurodegenerative diseases (Alzheimer’s, dementia, and Parkinson’s)
• Typically functioning people

What is fascinating is the continual growth of the research being conducted, even expanding to career fields outside of music therapy. Music interventions—actions and therapeutic devices utilized to alter the course of one’s cognitive processes—have been cited and used in research studies from a wide variety of disciplines, including neuroscience, physical therapy, sports medicine, speech therapy, and others. In all these disciplines we strive toward a common goal: to uncover the health benefits of music therapy and its effect on one’s well-being and quality of life.