The Wonder of Music in Wings of Hope Hospice Care
Hospice patients, their loved ones and the staff that work with them often recognize a need for paths of communication and comfort care that go beyond the spoken word, the pharmaceutical and even the intellectual. Music may address some issues that become evident for hospice patients and their families.
Music is a language of the soul – a grand and moving gift of God. The wonderful gift of music is to the soul what words are to the mind. Music helps us express what means the most to us; sometimes in breathtaking ways.
Patient Preference is Essential
The music, of course, needs to be according to the patient’s preference. One of our current patients recently let her caregivers know that she liked certain hymns and would like to hear them again before her death. One of our staff members downloaded recordings of the patient’s beloved hymns and songs from a bygone era. Upon hearing her favorites, our patient had tears of delight.
I often sing to patients. I am not afraid to sing with feeling. I may even lay my head down on the pillow and sing softly next to the ear of a patient. One grandmother who had not responded in any way for several days opened her eyes when I began to sing. She worked hard to focus on me and maintain eye contact as I sang familiar hymns. She did not have strength to make a sound, but she mouthed the words with me ever so slightly.
Music affects us on many levels: spiritually, physically, mentally, emotionally, and socially. It can actually bring certain persons afflicted with dementia from a place of passivity to activity, from being very private to a place of entering into community.
Our patient in an assisted living facility could not remember her children’s names, whether her husband was still alive or whether she had triplets or twins though she was pretty sure she had one multiple birth. She was frustrated and tearful that she could not remember what was so important to her. She was sitting rather forlornly in her wheelchair. I asked if it was alright for me to sing. She said, “Oh yes, I used to sing in church all the time.” So I started with “Jesus Loves Me” and she sang out with a beautiful clear voice, remembering each lyric flawlessly. She said one of her favorites was “The Old Rugged Cross.” So we started to sing together. I forgot one of the lines and stopped singing but she never missed a beat, remembering every lyric in that song as well as several more. This previously despondent woman sang with a big smile on her face and with much joy and energy. When we got done singing, I asked her where she had raised her family. She got a confused look in her eye and said, “I think it was Battle Creek but it might have been Kalamazoo.” Interesting how the mind works. Or doesn’t. But her memory of old songs was a foundation for her happiness and social affinity as we sang together.
The philosopher Plato is quoted as saying, “Music is an art imbued with power to penetrate into the very depths of the soul.” A patient I’ll call Rosa* (a lifetime Lutheran) was seated in her living room rocking chair enduring Alzheimer’s. Her husband John*, son Scott* and I sat in other seats in the living room. They talked some about family memories at their cabin. We discussed Lutheran church history and hymnody. Rosa became agitated, demanding to be taken home (even though she was sitting in her own living room) and kicking her feet out in front, trying to get up out of her chair on her own. She got louder and louder while Scott tried to keep her from falling forward to the floor. He said she had been like this for weeks in the middle of the day for about 3 hours. I offered to sing some hymns that Rosa would know from her Lutheran hymnal and did so. The patient calmed down and sat back in her chair quietly, even after the singing was done. The men looked at me in wonder – and we resumed our conversation.
Many Genres of Music Speak to the Soul
One of our patients died in a hospital room with a recording of his son’s heavy metal rock band wailing in his ears. I didn’t think the musical style would bring much peace in the room, but the patient and family obviously were finding strength in the music because it was the music their family member had made.
I officiated one funeral that was full of the patient’s music. She had been one of the most difficult patients for me to have conversation with until she mentioned that she really liked 80’s rock. We had finally found a common interest and talked about memories associated with the various songs and groups. When she died, her children wanted some of her music played at the funeral. When I officiated at her funeral I felt more like a disc jockey playing 80’s rock. The lyrics and instruments of Lynyrd Skynyrd, Led Zeppelin, Blue Oyster Cult and Bob Seger filled the room. I had one prayer, one poem and 6 songs played over the funeral home’s sound system. I didn’t feel that the selections communicated much hope to the loved-ones, but then again, they found solace in hearing what had been meaningful to their loved-one. It was a part of her legacy and seemed to help with some emotional release.
A current patient is an outdoorsman. His eyes and voice come alive when singing songs from his youth. “I’ve Been Workin’ on the Railroad,” “Bicycle Built for Two,” “Home on the Range” and “You Are My Sunshine” are some of the many songs we now regularly enjoy singing together.
Another of our patients at the Wings Home loved Elvis. One of our Wings of Hope Hospice volunteers brought in a compact disc of Elvis’ greatest hits. Our patient Jill* had been depressed about her approaching death. But now, for the first time in days, she lit up the room with a broad smile in hearing her favorite music. She breathed more easily and experienced less pain while participating in the wonder of music.
The Internet offers a virtually unlimited range of opportunities to patients and families. Recently, a hospice patient relocated in Michigan from an African nation. During my visit, she downloaded worship music videos from her homeland in her native tongue. A choir of women robed in various vivid colors sang with flashing smiles and dance. This brought joy and strength to our patient’s heart.
A Special Gift That Brings Music to Others
One patient and her daughters asked that I play soothing hymns on their keyboard. Mother had been restless and agitated but focused on the hymns and returned to serenity each time I played. When Mother died, the daughters bought an identical keyboard for Wings of Hope so that I could use it to bring peace to other patients and families. I have used that topnotch keyboard all over southwest Michigan.
Just yesterday I was with a family that often sang together when the children were young. When on road trips, Dad would lead them for mile after mile, teaching them the faith through hymns. The daughters mentioned to me that their Mother (our patient) also enjoyed the organ at church. So I went to my car to bring in the keyboard which had a church pipe organ setting. I played hymns while the son and daughters sang together as they had when their Mother was raising them. This rehearsal of favorite music strengthened the bond between them that day and helped them think of eternal themes that touched each of them deeply. They didn’t want to stop – even after singing for over an hour. When we started Mom’s most favorite song, she responded physically: gently moving her head, raising her eyebrows and even moving arms and legs. Science shows us that music is conducive to movement by naturally activating motor centers even in people who are not otherwise responsive.
Lyrics can often be a spring board for conversation. One patient in a skilled nursing facility kept his cassette player playing hymns on his bedside stand. We would play a song then talk about the spiritual themes represented in the song.
Music is a significant part of most people’s being and soul. “Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.” Oliver Sacks, Musicolphilia.
Any of us can offer meaningful care for people by providing their kind of music – even if that means humming a tune close to their ear or playing a recording.
You can see many inspiring examples of the result of music by searching Youtube for keywords “music therapy dementia.” There is a moving example at https://www.youtube.com/watch?v=fyZQf0p73QM
Author: Greg Carlson, Spiritual Care Coordinator