St Paul's Hospital -
Palliative Care Unit (PCU)

Vancouver Coastal Health Region

FUNDS REQUIRED

$22,000

“Music therapy has been an integral part of our multi-modal care for our patients with Palliative needs at St. Paul’s Hospital. Nothing brightens a day like a visit from Josh from Music Therapy – this goes not only for patients and families but also any staff that happen to be within earshot of his talents. I could not support a program any stronger than our Music Therapy Program spearheaded by Josh Denny-Keys. He is a true inspiration and exemplifies our multi-faceted approach to total care of our patients. We could not do the same job without him.”

David Williscroft

Palliative Medicine Physician at St Paul’s

Music Therapy at St Paul’s is patient-centred and patients can choose how they engage with music therapy – such as requesting their favourite songs or engaging in legacy work (writing, singing and/or recording songs for loved ones and family to listen to after they’re gone). Overall, music therapy aims to increase comfort and reduce pain of palliative patients as they progress towards end of life.

Music Heals donor funding helped sustain the palliative music therapy program during COVID-19, while also allowing the facility to increase the number of hours of music therapy from 18.75 hours to 21 hours per week at Providence Health Care (PHC) over the last year. Music Therapist Josh was also able to provide more 1-1 therapy at patient’s bedsides for over 100 patients.

Demographic

As a major hospital in Vancouver, St Paul’s services deeply marginalized populations including patients from the Downtown Eastside. Although they predominantly serve patients from Vancouver Coastal Health, people in rural and remote areas who do not have access to palliative services are flown into St Paul’s Palliative Care Unit.

Ages

Early 20’s – 100’s (avg 70’s)

Music Therapist Josh was also able to reach more family members of palliative patients this year. Involving family in palliative patient’s music therapy is particularly impactful for both families and patients.

End of life is often a challenging time for the mental health, relationships, patience and the wellbeing of everyone involved. End of life can be what brings people together after being estranged for years, and the simple fact of being in each other’s presence can be difficult to navigate. Estranged families often don’t know how to communicate with each other, and close-knit families can equally be unsure how to speak to a dying loved one.

In these instances, music therapy is instrumental in holding the space and allowing patients, family and friends to simply be together without the added pressure of talking about the past, present and future. It allows people to focus on the music and moment, alleviating anxiety and calming the environment – improving mental health of all involved.

Navigating The Ongoing COVID-19 Pandemic

The nature of palliative care is a challenging program for staff, and these challenges were exacerbated by the ongoing COVID-19 pandemic. New procedures and policies were implemented at PHC in anticipation of overflow from the hospital’s COVID units, which led to the relocation of the Palliative Care Unit (PCU). This was particularly distressing for PCU staff, patients and families, who [at times] felt their unique area of care was secondary to the urgency of the pandemic. Furthermore, the relocation of the PCU into a shared unit with Acute Geriatric Care meant the healing and peaceful atmosphere PCU staff endeavour to create for patients was superseded by the physically smaller and urgent environment of acute care. While music therapy was able to continue throughout the pandemic, sessions were often interrupted due to sharing a space with acute care. Patients, staff and families could be anxious in this unsettling environment. Music therapy became vital to the mental health of the PCU team and patients; Josh’s music would fill the halls and relieve the tension felt by the new environment, in addition to soothing people at the end of life.

Since the onset of the pandemic, many new procedures have had to be implemented within St. Paul’s Hospital palliative care music therapy program in order to minimize infection risks and ensure the safety of those they serve. These include reducing the size of music therapy groups, thoroughly sanitizing instruments and equipment between every use, adoption of rigorous PPE and hand hygiene routines as well as more frequent meetings to update on hospital COVID-19 surge preparations and updates.

All of this takes more time and as a result they have increased the number of hours a week they offer the palliative music therapy program in order to sustain the number of patients and music therapy sessions they are currently able to provide, while also working more with patient families.

Adopting this program would allow St Paul’s to continue with the additional 9 hours of music therapy a week that was added last year. Combined with other philanthropic contributions which also support the program, this will allow for the palliative music therapy program to sustain their current 21 hours a week.

The extra hours also enable Josh to continue mentoring a practicum student of Music Therapy. Having the student as part of the team helps the unit deliver more music therapy sessions for patients, who have been more isolated, anxious and have had less to keep them occupied during the ongoing COVID-19 pandemic.

Risha was admitted to the Palliative Care Unit at St. Paul’s Hospital to receive end of life care for pancreatic cancer. Her and her partner Geraldine’s two young children wanted to hold a symbolic wedding ceremony for their parents who had never had a wedding. The ceremony took place in the patient lounge on the Palliative Care Unit, and the children had a beautiful vision of how this would look.They brought in flameless candles, an arch and flowers – the only thing missing was the perfect live music to accompany this event and enrich this meaningful experience. They requested support from MusicTherapist Josh to play Risha and Geraldine’s favourite song, “Lover” by Taylor Swift. Because of how quickly things were evolving, Joshua ended up only have a few minutes to learn the song. He quickly learned the music while the children finished setting up the ceremony space. While Risha and Geraldine shared their first kiss as newlyweds and held each other, Josh played the song with ease, beauty and intention. As a music therapist, Josh understood that this was more than a performance.

It was a moment to remember, to celebrate, but also to grieve.

Together Risha and Geraldine swayed from side to side, dancing to the music, before then reaching for their children and dancing as a family. Eventually their extended family and friends that were in attendance also got up and they all danced together, singing the lyrics, sharing tears and smiles and creating a perfect lifelong memory. Music therapy played an integral role in supplementing this beautiful moment and enhancing the emotion, connection and beauty of the experience.

Joshua Denny-Keys

Joshua Denny-Keys is an Accredited Music Therapist who has been part of the Providence Health Care Palliative Care Team since March 2017 and the Dr. Peter Centre since November 2017. Throughout his career, Josh has worked with many diverse populations including acute mental health, long-term care, acute palliative care and HIV/AIDS care. Josh believes in patient-directed care and in meeting those he works with where they are at coming in. He then builds goals and the therapeutic relationship from there.

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