Healing music at the end of life

Throughout human history, we have always had a deep connection with music. It has the ability to provoke strong emotions, recall long-forgotten memories and affect us in profound ways. The music we most associate with the end of life are funeral hymns after a person has died, but music can also provide comfort for people at the end of their lives.

It might sound strange, but the art of music thanatology aims to bring peace and comfort to patients nearing the end of their lives through live music. The word ‘thanatology’ comes from Thanatos, the Greek god of death, and refers to the study of how we think about and deal with death. Music thanatology is based on the idea that a person’s passage into death can be made less painful and less traumatic with the use of live music, usually performed with a harp and vocals.

Jennifer L. Hollis describes the effects of these special performances in her book ‘Music at the End of Life’: “During these music vigils patients report relief of suffering from physical, emotional and spiritual pain. Their family members may find an opportunity for rest, relaxation, and expression of deep emotions, which in some cases they have never had an opportunity to release.”

Music thanatology is a relatively young field of medicine, founded in the 1970s by a musician and clinician called Therese Schroeder-Sheker. She believes that playing the harp and singing for patients can bring them peace and comfort in their final hours. Indeed, patients often respond both emotionally and physically to the music vigil. In many cases their heartbeat slows, their breathing becomes easier, and they are able to say goodbye to their loved ones.

What does it involve?

Music thanatologists usually perform for a patient at their bedside in the final hours of their life. This service may be provided by some hospices or care homes, or you might choose to contact a thanatologist directly.

They normally perform live music by singing and playing the harp. Although the harp is sometimes associated with heaven, this is not why they choose it as their instrument. The harp allows several notes to be played at once (unlike instruments such as flutes or clarinets), creating harmonies which are important for the sound of the music. Many types of harp are also easy and convenient to transport, and are not too loud when played in close proximity to a patient.

A music vigil can last between half an hour to an hour, depending on the patient’s needs. The patient and their family are encouraged to react to the music in any way they see fit, whether it be crying, laughing or embracing each other.

A musical dialogue

However, music thanatology is not about performing a set song or routine. Practitioners emphasise the vital importance of tailoring each vigil to meet the needs of the patient. They will monitor the patient’s heart rate and breathing, as well as reading their body language and the environment around them, in order to sense what kind of music will work best for them. They can adjust the melody, key and rhythm of the music as the vigil progresses – whatever best eases the patient’s pain and allows them to contemplate any emotional or spiritual issues.

Suzanne Cerddeu describes music thanatology as a “dialogue between music thanatologists and patients”. Even though they often do not speak to each other at all, they are constantly communicating “through body language, facial expression, physical states such as respiratory patterns, and the music of harp and voice.”

The end goal of this “dialogue” is to allow the patient to move towards the end of their life in peace and acceptance, rather than struggling through pain and confusion. Apart from easing physical and emotional pain, a big part of music thanatology is preparing the patient for their own death. Practitioners often refer to this as ‘Transitus’, the movement from life into death. Although the word has its origins in Christianity, it needn’t be a religious occasion, but rather a way of mentally and emotionally preparing for the end.

As Cerddeu puts it: “The patient may be reliving a lifetime of experience or, within a liminal state, be creating a dialogue with eternity. We know we can witness this and support it.”

Families whose loved ones have benefitted from music thanatology often report experiencing profound emotions as they witness the music vigil. They may also find a deep sense of calm and understanding as their loved one’s pain is eased. It can be a powerful moment for the patient and their family, in which deep emotions are expressed and important goodbyes are said.

A place in palliative care

The benefits of music thanatology are still widely unknown or disregarded, despite several scientific studies and research papers showing its positive effects. Patients and their relatives may not know that this is an option as part of end of life care.

Ultimately, music thanatology is not meant to replace medical care and attention, but rather complement it. Palliative care organisations such as Marie Curie, the NCPC and Dying Matters are increasingly promoting the importance of end of life care that addresses physical, emotional and spiritual needs on an individual basis. Music thanatology could be an important part of this compassionate care, bringing peace and resolution to patients and families alike.

Further reading

Suzanne Cerddeu, ‘Music Thanatology As Narrative Practice’, 2009

Helen Cox and Peter Roberts, ‘From music into silence: An exploration of music-thanatology vigils at end of life’, 2007

Helen Cox and Peter Roberts, ‘The Harp and the Ferryman’, 2013

Jennifer L. Hollis, ‘Music at the End of Life: Easing the pain and preparing the passage’, 2010

Lindsay Freeman, Michael Caserta et al, ‘Music thanatology: Prescriptive harp music as palliative care for the dying patient’, 2006