In the growing field of music thanatology, research finds that a patient’s final days can be made easier with music.
When aggressive treatments and heroic measures fail, caregivers are left wondering how to minimize loved ones’ suffering. The answer, experts say, may be music. Indeed, a growing number of patient care centers are calling on music thanatologists (thanatology means the study of death) to ease the transition into the next dimension.
Unlike music therapy, which uses music to address peoples’ physical, emotional, and cognitive needs, music thanatology comforts dying patients with the soothing notes of a harp and vocal music.
“Rather than playing familiar songs or tunes from an era when patients were young, we assess each person’s heart rate, respiration, and vital signs to create a ‘musical prescription,’ tailoring the rhythm, harmony, and melody to what’s happening with the patient physically and emotionally,” explains Jennifer Hollis, certified music thanatologist at Lahey Hospital & Medical Center in Burlington, Massachusetts.
And the effects are dramatic.
Music as Medicine
With music, patients require fewer pain medications, they experience improved mood, and they benefit from a slower respiratory rate, reduced agitation, and increased spirituality.
In a 2012 study published in the Journal of Hospice & Palliative Nursing, investigators concluded that prescriptive music played during bedside vigils helps accompany patients in their transition from life to death. While a nostalgic playlist tends to keep people anchored on earth and attached to their life memories, music that is soothing but unfamiliar helps us let go of the earthly plane. A second study, published in the American Journal of Hospice & Palliative Medicine in 2006, found a significant reduction in wakefulness and agitation among 65 patients who received a music thanatology prescription. Patients’ respiration also indicated a calmer state at the end of the vigil.
There are anecdotal accounts of the power of music thanatology, too. Dr. Martha L. Twaddle, medical director of the Midwest Palliative and Hospice CareCenter in Glenview, Illinois, discovered a 75 percent drop in the use of sedation medication for agitated delirium on her inpatient floors in 2003, the same year she hired two music thanatologists to work on the unit.
“We had data on our use of sedation therapy beginning in 1995. It was steady at 12 cases a year until 2003, when it dropped to three,” says Twaddle, who credits music for the results. “Patients are so quickly calmed by the music, they never get to the point where sedation is necessary.”
Music thanatologists achieve these dramatic results with only a harp and their voices. Both are portable and have a wide range, from glistening high tones to deep bass notes. The harp also has a loud sound box, which allows for complicated sounds and big vibrations. “Even when people can’t hear well, the harp is still discernible,” says Twaddle.
Creating a Sacred Space
Hospitals are sterile, isolating biomedical facilities that may provide quality patient care but often neglect patients’ emotional and spiritual needs.
“People are really bereft of beauty in a hospital setting,” says Hollis. The calming sounds of the harp and voice help create a sacred space right in the middle of all of the beeping machines, intricate monitoring devices, and IV drips.
“It’s medicine that you give the whole family,” says Twaddle. “The music creates a space for grief, but it also connects families on a deep level.”
With music thanatology, patients not only experience the beauty of the music reverberating into their souls, but they also gain a sense of intimacy. Parents sing lullabies to babies because it’s comforting and connecting, but most adults haven’t had the experience of someone singing directly to them.
“When someone offers their voice as a resonant instrument, it can be very comforting,” says Hollis.
The field of music thanatology is small but growing—there are roughly 60 practitioners nationwide, compared to 31 just 10 years ago—and the work they do is life altering, not only for people who are nearing the end of life but also for those they leave behind.
“Even when doctors have exhausted medical treatment options, there’s still much we can do to ease the distress around dying and support patients and families,” says Twaddle. “The experience can be something families look back on with comfort and peace.”
Originally published as "Playing on Heartstrings" in Spirituality & Health Nov/Dec 2013 issue.