The role of music therapy in palliative and end-of-life care: a narrative review of psychosocial outcomes.

Background/Objectives: Music therapy has emerged as a valuable component of palliative and end-of-life care, addressing the physical, emotional, social, and spiritual needs of patients and their families. Despite growing clinical adoption, the mechanisms and breadth of psychosocial outcomes remain inconsistently synthesized. This narrative review aims to synthesize peer-reviewed evidence on music therapy's psychosocial outcomes in palliative settings, including mechanisms, populations, modalities, and evidence gaps. Methods: A systematic search was conducted in PubMed and the University of Alberta Library Primo discovery platform in May and June 2026, searching across PsycINFO, CINAHL, MEDLINE, Academic Search Complete, and additional databases. Primary search strings targeted music therapy in combination with palliative care, end-of-life care, and hospice settings. After screening for relevance and applying inclusion criteria, 33 peer-reviewed sources were included. Results: Evidence from randomized controlled trials, systematic reviews, and qualitative studies supports consistent improvements in pain, anxiety, mood, and subjective wellbeing. Biographical approaches involving personally meaningful songs and legacy work meaningfully enhance spiritual wellbeing and existential integration in dying patients. Music therapy benefits extend to family members and informal caregivers in the pre-bereavement phase. However, most studies are small, at high risk of bias, and heavily concentrated in Western, high-income settings. The non-Western palliative music therapy literature is critically sparse in English-language indexed databases, representing a gap in the evidence base rather than evidence of absence. Conclusions: Music therapy is a flexible, low-risk, and clinically meaningful adjunct in palliative care. Future research should prioritize large-scale, culturally sensitive trials, standardized outcome measures, and explicit investigation of music therapy across diverse religious and cultural contexts.