Music care at end of life brings many benefits

Sounds of music may be most profound at the end of life when all other senses are shutting down and the melodies are not only distinguishable but spiritually sustaining. That’s what Jane Twohey experienced when she visited her friend George at the Lakeridge Hospital last Fall. Jane wanted to give him something comforting and help him find meaning in his suffering. She could see he was fragile and barely able to see. On her next visit, Jane brought George an iPod and earbuds, loaded with spiritual readings, and comforting music. The response was immediate: he began to sing. Jane joined him. The bond between them was deep and certain.

Music connects people through shared experiences like this one. That’s why there are psychosocial benefits in using music in palliative and end of life care. Dr. Amy Clements-Cortes, Senior Music Therapist at Baycrest Hospital says that dying patients are looking for assistance with issues other than physical pain alone. She completed a study on how music therapy helps people complete relationships, both intra-personally and interpersonally.

Completing relationships with others is a task for people who are dying, describes palliative doctor Ira Byock. In his book Four Things That Matter Most, Byock share that relationship completion involves expressing certain sentiments: I love you, thank you, will you forgive me?/I forgive you, good-bye.  The task is not always easy. Words can fail us, or at end of life, so can our strength. Medication may prevent us from thinking lucidly or verbal communication. Sometimes, we simply don’t know what to say.

In spite of these hurdles, songs may help us complete relationships because they connect us to life. They connect us to ourselves and to each other. They become our words and express how we feel, the sentiment we want to convey, sentiments of love, cherishing, gratitude. i.e. “you needed me”, “you raise me up”, “you’re always on my mind”, “you’re still the one”, “you’ve got a friend in me”, “there never seems to be enough time to do things we want to do once we find them”.

When my loved one was dying, there was an album we played over and over.  One of the songs, Wind Beneath My Wings allowed us to thank her and say good-bye. This was an unspoken acknowledgement confirmed by gently stroking her hand and forehead. The song helped us express and communicate our feelings. We were present, close, connected and communicating.

Music provides emotional support not only for the one who is dying, but also for loved ones and caregivers. Palliative music therapist Deborah Salmon talks about the idea of containment. She says music becomes a place for people to express their feelings and a place for people to contain their feelings, whether it’s anger, loneliness, fear, sorrow or thankfulness.

Music is able to give intra-personal support. Certain kinds of music may help to regulate breathing, or promote sleep. Music may assist in pain distraction. It may bring comfort and peace and help deal with larger questions surrounding death and dying. It may help create meaning out of suffering. Music may be a part of the spiritual practice of the one who is dying and help strengthen faith, courage and hope.

Evidence suggests that music can improve quality of life and help people embrace living in dying. One example is the Room 217 Foundation’s R2R program which is taking place in more than 40 Canadian hospice and palliative care programs. With the generous support of the GlaxoSmithKline Foundation, Room 217 music care resources are bundled and used in a variety ways with people who are dying and their loved ones. “We are very pleased with the response towards the music” says R2R Program Facilitator Debbie Devitt. “It is clear that the music is bringing support to people who are at end of life, their loved ones and caregivers.” Phase one of the program ends this spring and has demonstrated benefits in:

• ·         Release, closure and comfort

• ·         Reminiscence and enhanced communication

• ·         Soothing relaxation

• ·         Companionship

• ·         Program support i.e. bathing

• ·         De-stressing caregivers

• ·         Regulated breathing

• ·         Reflection and meditation

• ·         Sleep promotion

• ·         Distraction

Music is unique in that it has the capacity to follow someone through a diagnosis, treatment, palliation, end of life, imminent death and crossing over. And that very same music may provide care, comfort and sustained connection afterwards to caregivers and loved ones. It’s that shared bond, both profound and transcendent, the connection Jane and George discovered, that makes music a valuable part of end of life care.