When people learn that I play therapeutic harp for Hospicare’s patients, they are often surprised. Usually they imagine the music is a performance or entertainment. The truth is that the music I play at patients’ bedsides uses the latest understanding about how sound affects human physiology. Its purpose is to help patients cope with end-of-life physical and emotional distress. There are often no recognizable tunes. As I play, I tailor my playing to uniquely support each patient.
I am a certified harp therapist and a candidate for certification in music thanatology (music for the dying) with the Music Thanatology Association International. That means I have professional training in the special needs of the dying. I also follow a long tradition that has been implicitly understood by mothers the world over: music offered with love is a kind of human medicine.
Usually I visit patients in their houses, but I will also play in hospitals and skilled nursing facilities—and, of course, at the Hospicare Residence. Research has shown that the sound of the harp acts upon the human parasympathetic nervous systems. It can lower our heart rate, breathing rate, blood pressure and the level of a stress hormone called cortisol. When this happens for a dying patient, they become calmer and more restful. Often their physical symptoms, such as pain, restlessness, agitation, sleeplessness and labored breathing, improve.
When I’m playing, I use the elements of music to address certain symptoms. For instance, by working with tempo and rhythm I might ease distress of a patient who is having problems breathing. I determine what will help a patient from moment to moment as I play.
The sound of the harp can also help patients suffering from emotional or spiritual distress. That’s what happened with a patient named Debbie. Debbie had a lot of spiritual conflict that was causing her anxiety and fear. I played for her many times over the course of weeks, and each time she would become calm and contemplative as I played. Then Debbie’s health declined sharply, and her family called me in to play for her in her last hours. She had been unresponsive, yet as I entered the room, she smiled when they told her I was there.
I played while Debbie took her last breaths, then continued to play for her family members who were gathered. Her passing was calm, and her family members later told me they felt the music gave her permission to die. I don’t know what she really felt, but her family was sure the music helped her with the death process and eased her spiritual fears, and that helped them feel at peace, too.
Helping ease the distress of patients like Debbie and her family members is why I do this work. Playing for the dying is an amazing and often poignant journey. It is a very intimate, sacred experience, especially in the final hours. There’s a sense of time stopping at those moments. You’re not in the world’s time—you’re not where time is measured by appointments and all the other daily minutiae. Something mysterious is happening that’s not graspable, and we are following it, perhaps like a midwife might follow the delivery of a baby.
As a musician, working with the dying is some of the most profound work I do.
This article originally appeared in our Hospicare print newsletter in the spring of 2016.