Hearing & Sound at End of Life
Hearing is the first sense we develop in life, and it is the last sense to go. We hear when we are sleeping, and even when we are otherwise non-responsive. Some sounds can be soothing, while others can be disruptive.
A patient does not need to be awake or responsive for music to be helpful to breathing and relaxation. A patient who has difficulty hearing voices may still be able to hear an instrument or feel the vibration of the music.
If you choose to play music, choose something that you feel might be supportive of the patient or whatever the patient might be requesting. When playing music for a patient, spend a few minutes watching him/her. Look for signs of increased relaxation or potential tension in the face, hands, extremities, or in breathing.
Some sounds that may once have been enjoyable to a patient can be startling or agitating near the end of life. We recommend cell phones be kept on the vibrate setting when visiting with a loved one, and phone calls should be made or received outside of the patient’s presence.
Television and radio might have been used daily to provide news, sports, entertainment, and distraction. This may not be needed at end of life. Offer your loved one the choice to have the TV on. It is empowering to let decisions be made by the patient if at all possible. While the TV is on, observe your loved one occasionally. Is he/she engaged and enjoying the programs? When leaving the room, ask your loved one if he/she would like the TV on/off.
The familiar sound of your voice can be of great comfort to your loved one, even if a patient is non-responsive. When entering a loved one’s room, announce your presence gently with voice and touch, so as not to startle him or her unnecessarily.
Speak words of love. Tell stories. Remember the times spent together. Come to closure. Speak even of the future. Let the individual know that he/she will be remembered. Understand there can sometimes be too much of a good thing. Observe your loved one to know when he/she may need you to be with them without speaking.
We often assume silence is bad and sound is good. We think in silence there is nothing, while sound provides at least something. Yet silence or quiet may be exactly what a patient needs to process his or her journey, and what we as loved ones may benefit from as well. Each patient, and each patient’s loved one, deserves the opportunity to process what is happening inside. Sometimes, silence provides that opportunity.
Information compiled from “The Breath of Sound,” a Casa de la Luz publication. “The Breath of Sound” was written by Carolyn Ancell, certified music practitioner.Back to Articles