Music therapist Anne Lacourse and massage therapist Julie Jobin radiate enthusiasm when they describe their therapeutic partnership in palliative care. After 7 years of combining their expertise in various settings such as cancer care clinics and oncology units at St. Mary’s Hospital, their dream of working together in a dedicated palliative care unit was realized when they teamed up at the 12-bed hospice, Maison St. Raphael, last year.
At Montreal’s Maison St Raphael, Anne and Julie have been able to accompany patients with compassion through the therapeutic use of music and massage. The goal of therapy is to provide a caring and pleasurable experience for the patient in order reduce “total pain” which includes physical, emotional and spiritual pain. So often patients at the end of life are rarely touched, or the touch they receive is painful as a result of treatment interventions. In contrast, massage therapy activates several brain chemicals, including endorphins which reduce pain and anxiety and promote a sense of wellbeing.
Anne and Julie have observed that something very special happens when music and massage as are used together. They report a synergistic effect where the massage functions to open the door to the experience of the music so that patients can rapidly enter into a more relaxed state where they experience multiple benefits such as reduced pain, less emotional distress, and a sense of safety and support.
In particular, Anne and Julie have noticed that the combination of massage and music therapy is an effective approach to reduce anxiety and help people manage difficult transitions and stresses, such as new losses of autonomy or treatment changes related to disease progression. Listen to recording
“Music and massage therapy is very effective in managing the stress associated with change, such as a new loss of autonomy. Every time there is stress associated with a transition or adaptation required, that’s when we can really help the person, whether that is physical or emotional. Touch and the music really support the person in transition. This is true accompaniment.”
Anne is a pianist first and foremost but she uses her voice and several instruments such as the harp, guitar and chimes in her work as a music therapist. Although she has a repertoire of songs available if patients have specific requests, her music is almost entirely improvised.
“I use many different instruments. But I especially use the harp which has a very soft sound. Just the first note is soothing. Also I sing and I improvise with my voice. And the voice goes well with the massage to hold and support the person. People often tell us that they are not used to feeling such tenderness.”
It is not just patients who benefit from this magical combination. At Maison St. Raphael, family members are often present with patients, COVID regulations permitting, and they enjoy this experience as well. When Anne and Julie arrive, family members often close their eyes and just listen to the music, knowing their loved ones are being touched and cared for.
Sessions are based more on intuition and “tuning in” than formal planning. Anne and Julie allow themselves to be guided by their sense of the patient, the patient’s breathing rhythm, and their desire to accompany the patient with as much compassion as possible. For Anne and Julie, it is the patient who is the “conductor of the orchestra” and they use their combined expertise to facilitate the patient’s experience.
“The beauty of this is that Julie is in tune with me and I am in tune with her. Most of the time the music I play is all improvised. I adapt my music to her massage movements and she does the same for me, and 90% of the time we do not have to look at each other and It’s like a dance we are creating with the patient. We finish at the same time. We work at the rhythm of the patient’s breathing. The music and the movement are connected.”
Anne and Julie credit their extraordinary relationship to the fact that they are on the same page, both professionally and personally. They share the same deep value system and the same desire to accompany people with compassionate presence. Both express confidence in the strength of each individual patient, and deeply appreciate helping people connect with the present moment to experience a sense of wellbeing, tenderness and dignity.
“People come into palliative care for their last months, last weeks of life; they know what is waiting for them. They come here to die. Nonetheless, you can have many very beautiful moments even at the end of life. Music and massage can help people experience of sense of wellbeing in the moment. I was just thinking of a man we accompanied recently. He said, “I don’t know what’s on the other side, but it’s really nice right here, right now.”
To see music therapist Anne Lacourse and massage therapist Julie Jobin at work with palliative care physician Dr. Benoit Deschamps: