(Bronwyn Fryer is a writer, musician and certified death doula in Montpelier, Vermont. You can hear her winter solstice and lullaby albums at https://soundcloud.com/user-433976855/albums.)
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Diane had been in a coma for two weeks when the hospice team called me in. “She’s actively dying, and needs your music right now,” they said.
I found Diane lying in her bed, surrounded by her team. I don’t remember whether there were family members present, but everyone was very quiet, and no one was openly weeping. I could feel the caregivers’ deep compassion for Diane as if it were an electrical current in the room.
“What do you think she wants to hear?” I asked.
A few people shook their heads. “We don’t know.”
I started to strum my guitar, slowly, with a G chord. Then I began singing her name, over and over. “Diane, Diane, Diane.”
Then everyone gasped as the comatose patient slowly lifted her hand from the bed and began moving it in time to what I was singing. This went on for perhaps a minute, but it felt like an eternity. Then her hand drifted again to her side.
Ten minutes later, she had passed away.
This is an example of one of the many miracles that can occur during our last moments when music accompanies us on that journey. Why does this kind of thing happen, and what can it teach us?
First of all, our auditory sense is the last one to go. A 2020 study conducted by researchers from the University of British Columbia noted that even patients very close to death respond to sound. And since music is embedded into our lives – indeed, all human life, from the beginning of time – it is no wonder that patients like Diane feel it deeply, even at the very end.
I have found in singing and playing to patients suffering from Alzheimer’s disease that hearing a familiar piece of music can be immensely comforting. They appear to be less agitated and more focused, and to breathe more evenly. As an added benefit, family members have often told me how much the music I play helps calm them as well.
The use of music as a form of palliative and hospice care includes an area of formal study called “music thanatology,” or “prescriptive music.” Certified music thanatologists are harpists who have also demonstrated skill in music theory, anatomy, acute care, anthropology, and ethics. (I’m not entirely certain why the harp is the specifically preferred instrument, but I’m not a music thanatologist.)
What kinds of music do people want to hear as they are passing? As a certified death doula, I would say, “whatever they want.” The music doesn’t necessarily have to be instrumental, or even soft and gentle. Some patients prefer “Amazing Grace” while others want to hear something like James Taylor’s “Sweet Baby James.” (In fact, I think David Bowie’s “Starman” could serve for a Bowie fan, though no one has yet asked me to play that one.) I usually ask patients, if they are able to communicate their wishes, what they would like to hear; very often, the family will suggest the patient’s favorite songs (if I don’t know the song, I learn it).
When I am called to a patient, I feel deeply honored. I tell people that death is just like birth, only going in the opposite direction. And just as palliative care can ensure that the patient does not undergo pain, we death doulas offer a different kind of care.
For example, in addition to offering music, I can help the patient and family with advance planning (including helping to find legal assistance for advance directives, wills/estate planning, power of attorney, and organizing important documents for the family); compassionate listening to the patient’s and family’s concerns and planning for the end of life; organizing life celebrations and legacy projects, such as letters and books; support for medical assistance in dying; and emotional and physical support for the patient and family through the entire passing and grieving process.
I firmly believe that music at the death bed has innumerable positive effects for patients, families, and the care team. If you don’t know of a musician who can play live at the bedside, you can certainly stream pieces that the patient would enjoy hearing. I know that when I’m dying, I’ll want to hear Morten Lauridsen’s glorious “Lux Aeterna,” Pete Seeger’s sweet “To My Old Brown Earth” and “O, Had I A Golden Thread,” and yes, maybe I’ll rock out to “Starman” too.
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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
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I played the Hallelujah Chorus on my phone for my late husband during his last minutes. Then I called our priest to make an appointment to plan my husband’s Requiem Eucharist.