The Healing Arts in Palliative Care

YOU MAY HAVE HEARD that art can be therapeutic for those grappling with cancer or its aftermath. But what kinds of art can have these benefits, and how can patients and survivors decide which forms to pursue? What instruction and other help do they need?

A recent conference in New York City offered a glimpse of some art forms that can be part of a palliative care plan designed to reduce suffering and improve quality of life. During the June 7, all-day palliative art conference sponsored by End of Life Choices New York and the Fordham University Graduate School of Social Service, presenters demonstrated how their art therapy programs help patients and their loved ones — no matter where they are in their cancer journeys.

At the heart of the palliative arts concept is the belief that engaging in purposeful activity can enrich and add meaning to life, even during treatment for a serious illness.

That’s the principle behind the Oncology Support Program at HealthAlliance Hospital in Kingston, New York. Its founder, Barbara Sarah, kicked off the conference by explaining how the program uses arts-based palliative care activities to help patients confront anxiety and fear, from diagnosis through the progression of the illness.

Patients choose from a variety of options. Some write memoirs or poetry and share them with other patients. In creative arts workshops, participants draw, paint, make jewelry or explore collage, and their artwork is displayed on the walls of hospital rooms in the oncology unit. For those drawn to the stage, the program offers improvisational theater and a singing group that performs for hospital inpatients. One concert featured an oratorio about breast cancer.

At the Louis Armstrong Center for Music and Medicine at Beth Israel Medical Center, music therapy helps terminally ill patients celebrate their lives and fosters their acceptance of death and ability to die with dignity, comfort and a sense of lasting legacy. Founding Director Joanne Loewy told conference attendees that, because music can be used to reduce anxiety, live musicians play in the lobby of one hospital where she works.

Both music and poetry were found to lessen pain and depression in patients with cancer, researchers reported in a clinical study in the Journal of Palliative Medicine in 2016. Poetry stimulates the expression of feelings and concerns, creating a reflective or meditative space.

Jack Coulehan, M.D., a physician and medical educator whose writing has been nominated for a Pulitzer Prize, has been involved in a weekly program led by physician poets, which encourages those in an inpatient oncology unit to read, discuss and write poetry. During the conference, Coulehan discussed how poetry can not only relieve the suffering of patients, but also help heal the wounds of caregivers.

Dance and movement therapists, who help patients understand themselves better through enhanced awareness of mind-body connections, offer another option for palliative care. Susan Orkand, a professor and the education clinical coordinator in the graduate dance/movement therapy department at Sarah Lawrence College, led the audience through interactive movement experiences and described how attention to breath, gesture and movement can lead to further exploration of meaningful thoughts and feelings. She explained how guided-movement improvisation and kinesthetic empathy — experiencing the feelings expressed by another person’s movements — can be integrated into palliative care.

To facilitate difficult discussions regarding advancedcare planning and end-of-life care, one useful technique involves writing, drawing and reading comic books and graphic novels, according to MK Czerwiec, RN, M.A., the artist-in-residence at Northwestern Feinberg Medical School. In comics, words and pictures can be combined to communicate more effectively than either alone, and, for some people, may be more accessible than books. Comics tend to generate good feelings, even when they tackle challenging subjects, she said.

More than 100 graphic novels deal with medical topics, ranging from cancer and pain management to Parkinson’s disease and dementia. Czerwiec’s graphic memoir, “Taking Turns: Stories from HIV/AIDS Care Unit 371,” documents her experiences as a nurse at the peak of the AIDS crisis.

Filmmaker Carolyn Jones shared excerpts from her new documentary, “Defining Hope,” which follows patients dealing with life-threatening illness as they move between intensive care units, operating rooms, hospice care and home. During their journeys, they face death, embrace hope and ultimately redefine what makes life worth living.

If you think you might benefit from one or more palliative art techniques, you can use the directory at https:// getpalliativecare.org/providers to search for a program near you. Your health insurance may cover this care; check with your provider.

Keep in mind that palliative care programs vary significantly in size and scope, so be sure to ask what’s included. Some offer only the services of a palliative care specialist, while others offer a full team consisting of a doctor, a nurse, a social worker, a chaplain and an arts therapist.