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Harp provides therapy at end of life for patients,
Music calms agitation, regulates breathing
At the end of life, there often comes a point when there's nothing more, clinically, that can be done. That's when the music starts for some patients.
"There is therapeutic value in music when someone is actively dying," according to Donalyn Gross, PhD, LCSW, CMP, a Longmeadow, MA, social worker and thanatologist who provides therapeutic harp music to dying patients.
Gross has been a counselor to the dying and their families for three decades, but a few years ago she heard a therapeutic harpist playing at the bedside of a patient.
"I knew that's what I wanted to do," she says. A lifelong musician, Gross became a certified music practitioner through the Music for Healing and Transition Program in Hillsdale, NY (www.mhtp.org). As the acceptance of music therapy in health care gains acceptance, industry-wide protocols are being developed for training and certification of music therapists.
Jewish Geriatric Services, a Springfield, MA, nursing facility, received a grant in late 2006 to provide music to the terminally ill in their last hours of life. When a patient is actively dying, Gross is paged and family members are offered her services.
Often, they are the primary recipients of Gross's therapy. She plays for about 45 minutes on a portable harp designed to be easily moved and used in confined spaces.
"I would say a majority of patients aren't aware I'm there," says Gross. But as she plays — usually unrecognizable melodies in low tones — the patient's breathing regulates and slows, and agitation wanes.
"A big part of it is for the families. Sometimes they just need a break and they know someone is there to calm [the patient]," she says. "Sometimes they stay, and the music soothes them. It just makes the atmosphere very peaceful and comfortable."
The results of a study conducted by researchers at the University of Utah Center on Aging, published in 2006 in the American Journal of Hospice and Palliative Medicine,1 indicate that harp vigils at the bedside of dying patients could have a positive influence on both the agitation and wakefulness of the patients. The reasons for this, researchers speculate, could be that hearing is the sensory ability that usually functions until the end of life, and that music "can influence the heart and brain on a physiological and psychological level simultaneously."
Harp music seems particularly effective, the Utah researchers found, a point agreed to by Gross and associations that promote music for end of life. Maybe because harp music is associated subconsciously with angels and death, Gross suggests; however, while harps are the most common, music therapists have reported similarly positive effects with other instruments.
"The important thing is, when you play music for the dying, you don't want to play recognizable music, because you don't want to bring that person back," Gross explains. "You play in low tones, in certain rhythms, and you try to match the patient's breathing, to calm them down."
If Gross receives a page she can't answer, hospice staff can play a CD she recorded of some of her music; other good substitutes are new age music (no lyrics) or recordings of nature sounds (waterfalls, rainforest, ocean sounds).
"We have had other [nursing home] residents wheel up to the door and listen while I'm playing for someone who is dying," she recounts. "It is very relaxing and reduces stress. A couple of hospitals, I've heard, have harps in the operating room."
1. Freeman L, Caserta M, Lund D, et al. Music thanatology: Prescriptive harp music as a palliative care for the dying patient. Am J Hosp Palliat Care 2006; 23;100.