One Story of Music Therapy in Hospice – Singing Him Home

Written by Jodi McLaren 

hodlinghandsI’d like to share a story from my own experience as a music therapy intern working with hospice patients. Each person in hospice care is different and has different needs throughout his or her experience. However, we often help people with pain reduction, life review, relaxation, connecting with family and friends, and emotional issues. During this story, I had the honor of helping a man transition into death.

During the last week of my internship, I walked into the hospice unit of a hospital and checked in with the nurses there to see which patients might benefit from music therapy. The nurse suggested an older man with COPD (Chronic Obstructive Pulmonary Disease).

When I entered the room, the man was gasping heavily and rapidly. His eyes were wide open, staring at the ceiling, and there was a look of terror on his face. I felt that he may be close to death and was afraid, alone, and in distress. I felt a surge of urgency to help him find some peace in his final moments and so my first goal was to help ease his breathing. To begin, I played an improvised lullaby on my guitar first matching the rhythm of his breathing, and then slowing the rhythm to help him slow down with me. While this approach often helps people to soothe the autonomic nervous system, this time nothing was working.

I went back to the nurse and asked if he might need medication to help his breathing, apparent pain, and agitation. She responded that he has all the medication he needs right now and not to worry; that this was just the stage he was in. As I turned to re-enter the room, I became aware of my own panic. I had never seen someone in this much distress, even in hospice. I took a moment to dig deep into myself for a sense of calm, because I realized there was no way I’d be able to help this man calm down if I myself was full of anxiety, no matter what I played on my guitar. So, as I settled in next to him, I took some deep breaths and started again, this time singing a song that came to mind – “Peace is Flowing Like a River.”

When I started playing and singing, his breathing began to change. It slowed bit by bit. After a while, his eyes searched the room until they found mine. He held my gaze and shed a tear. His breathing gradually slowed more and more, until there were 10 seconds, 20 seconds, 60 seconds between each inhale. His face relaxed and he entered into a liminal space, just before dying, of breathing in once every minute or two. The nurse entered and thanked me for helping him with his transition. She let me know that this stage of dying could go for hours or minutes, depending on the person, but that my work was done in helping him return to a peaceful state. He died shortly after I left the room.

A member of the cleaning staff had entered the room when I was still singing to him. She paused to witness the moment and she said “You’re singing him home.” I believe people in their final moments have a sense of choosing who is with them, and whether or not they want to be alone or with loved ones when they go. I felt incredibly fortunate to be able to help this complete stranger in his final moments to find a place of calm.

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