When you are very near death, you may no longer be able to see or speak. But you can still hear voices… and music.
Experts say the sense of hearing is often the last sense that leaves a person. That’s why family members and medical staff should always act as if a dying person is aware of what’s being said.
It’s also the reason a music therapist is a valued member of the interdisciplinary group (IDG), the team that’s assembled to support each and every patient at Centrica Care Navigators. Music therapists meet regularly with patients at their request, at times playing live music for patients to listen to, and at other times using music to help the patient express themselves when other kinds of communication are difficult.
Music therapists work with patients at many stages of care — some are in the last days of their lives, but others are at home, and look forward to a visit from a Centrica Care Navigators music therapist to stay active.
“Music can get into memories the way conversation doesn’t,” says Centrica Care Navigators music therapist Tommy King. “A patient might not be able to tell you what the day is, but they can sing every word of a song.”
Making music theirs
When a patient first meets a music therapist, they’re meeting a lot of other people in the IDG too, like their hospice doctor, their nurse, and their social worker. Of course, they’re also dealing with an illness that can mean they only have a few months to live.
With all that confusion and extreme stress, why add a music therapist when it’s simpler and quicker to just turn on Spotify?
“Recorded music can be isolating because patients can’t control it,” says Marissa Kells, a Centrica Care Navigators music therapist. “They might like listening, or playing music themselves. I even had a couple who danced while I played ‘their song.’”
A music therapist has skills in working with care patients that performers don’t have. They help patients express their emotions and keep them physically active. They’re attentive to how patients are reacting to music, and use their abilities to build relationships with not only the patient but also their caregivers and families.
Playing music in person means the music therapist can watch how an individual is responding to the music and react to it. If the person is agitated and is having trouble breathing, for example, the music can slow to help them calm down.
“If someone is feeling depressed, we can work on mood elevation with our music choices,” King says. “There’s something about having someone else in a room to make a connection.”
The power of music
Angie Biehl, a music therapist with Centrica Care Navigators, plays guitar and sings, in addition to several other instruments (she is mainly a percussionist). When she meets some patients, she sings and they sing along. Other times, she changes the lyrics or the speed at which a song is played to support the way a patient is feeling.
“If a memory or emotion comes up from a piece of music, we help walk people through it,” Biehl says.
A recent patient was bed-bound — she has difficulty getting out of bed for even basic activities like using the toilet. For the patient, though, what might have been most challenging was realizing she couldn’t attend services at her beloved church. Biehl realized that, after singing a hymn which made the patient sad.
“I learned she was struggling because she can’t be with her church community,” Biehl says.
Biehl played music with another patient, and a family member of the patient would sometimes play along. After one session with the patient, a caregiver told her that it was the first time they saw their loved one smile since she started receiving hospice care.
One of the people King visits does more than smile while listening to music. She had been an English teacher for 40 years, and pays close attention to the lyrics of songs, taking note of interesting language choices. She asks to hear not just songs she knows, but songs that are brand new, too.
Patients and guests who are able to play music themselves sometimes join in with the music therapist. Playing something like a simple drum beat can help them stay active. It can also lead to a conversation about an instrument from a different culture, or about the opportunity to learn a new skill. Making sure patients are engaged and comfortable is a goal for music therapists.
Kells says she has a patient who enjoys mariachi music, which has definitely expanded her own musical horizons.
“He only wants songs in Spanish, so there’s a lot of Google Translate,” she says. “I’ve brought instruments like maracas and we play mariachi together.”
Popular with patients
What are patients listening to? It’s said that the music that you liked listening to when you were a teenager is always your favorite kind of music. Since the vast majority of Centrica Care Navigators guests and patients are in their 80s and 90s, that means a lot of big band and Frank Sinatra-style music. Others enjoy classic country singers like Johnny Cash and Glenn Campbell.
“For some reason, people in Mattawan want to hear Jimi Hendrix, which requires insane guitar playing,” Kells says. “We trade a lot of chord charts back and forth (between music therapists).”
Playing a favorite song might get the person talking about a happy memory connected to the song, maybe even a memory their loved ones never heard before. One guest at Centrica Adult Day, after hearing an Elvis Presley song, remembered that she had been at his last concert in Kalamazoo.
Religious music is important for a lot of patients, too. Our music therapists say they play hymns and inspirational music, or what’s sometimes referred to as “Contemporary Christian.”
Patients don’t need to hear their favorite songs to benefit from music therapy, though. Biehl says she’s played drums for a young boy, and brought a small drum for him to play along.
“Now anytime he sees someone with a Centrica shirt and a backpack, he asks, ‘Is that a drum for me?’” she says.