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Hospice Stories

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Hospice Stories

 

On Healing Wings

Three stories about the power of music therapy, with other hospice disciplines, to create a sacred space

 

Eagle’s Wings

One day the chaplain and I were paged to come see a client we’ll call Janet, who was near death and experiencing agitation. The family was stressed by this. The chaplain and I, although coming from different directions pulled into the parking lot at the same time. As we have done many times before, and since, the chaplain and I chose to do a ceremony involving prayer, readings, music, and remembrances with family. Music can bring to mind memories. Sound is second only to smell in triggering past memories. The music is a way of sharing memories.

 

As soon as the chaplain spoke, with me playing instrumental music in the background, the client’s agitation began to reduce. Although she had been agitated, she had not otherwise responded or opened her eyes. During the prayers and readings she began to become more calm and alert at the same time. The family joined in the singing of the hymns. After singing the Hymn, “Just As I Am, Without One Plea”, the chaplain began to read the 23rd Psalm. Her eyes opened all the way. She looked at the chaplain, then myself, then each member of the family now gathered around her bed. After the 23rd Psalm was read, I began to play “On Eagle’s Wings” (Psalm 91). She continued to acknowledge and respond to her family members with her eyes. She smiled a very big smile. Just as “On Eagles Wings” came to the last note, an expression of complete calm came over her, she smiled again, closed her eyes, and released her last breath. The family was aware as well that death had just occurred. For at least two minutes there wasn’t a sound. No one moved or said anything. Finally a daughter of Janet’s, with tears streaming said, “I had no idea that death could be so beautiful”.

 

Under His Wings your refuge, His faithfulness your shield.”- Psalm 91, On Eagle’s Wings

 

Crow Guide

In a similar session the same chaplain and I came to do a ceremony with a woman who had a more earth-based spirituality. We had both seen this woman and her family before. We always respect the spirituality of our clients and their families and attempt to meet their spiritual needs with respect. The day before the final session I had seen this client for the first time. She and family had initially been unsure of the idea of music therapy, but the RN case manager strongly encouraged them to try. The client had terminal agitation, a restless or agitated state that can occur prior to death, and the nurse knew it would help. When I came the first day, the music calmed her a great deal. She had been calling out, and trying to move out of her bed, which had resulted in two falls that day. She responded very well to Native American flutes, one of several instruments I play. She was quite calm when I left.

 

Unfortunately later that day a minister from the community entered her room at the nursing home and said to she and her family that she would only reach heaven if she accepted Jesus. This was very disrespectful and hurtful. Without getting into my own theology too much, I can say after doing this work for over a decade, there is a place in the next life for all of us, whether we be Hindu, Christian, Jew, Muslim, or someone who shares Indigenous beliefs. The client became highly agitated after this and family was very hurt and upset.

 

The next morning the chaplain and I arrived. I, with a Native American drum, flutes, and rainstick, and the chaplain with several Native American readings. The client was still agitated and having labored breathing. I played a rhythm near her respiratory rate and gradually slowed it and her breathing slowed. The chaplain began to read the Native American readings. I then played the Native American flute and she became much calmer. We alternated readings, Native American prayers, the drum, the flute, and the rain stick. The family stated they felt it was bringing both their mother and them peace. They also shared memories and aspects of her spirituality. By the end of the session everyone seemed in a much better place. The client was resting much more comfortable with no agitation. At one point, a large crow appeared outside the client’s window. This was extremely significant as the crow had been this persons “animal guide” in her life. 20 minutes after the chaplain and I left, she passed peacefully. The family later said they knew this ceremony help calm her and “got her to the right place where she was at peace with her Creator”.

 

“You have made me cross the good road, and the road of suffering, and where those roads meet, that place is holy”- from Black Elk’s Prayer

 

Wings of a Dove

There is an old country song, "On The Wings of a Snow White Dove", by Ferlin Husky. I saw a woman, Dorothy, in hospice for several months. This song was her favorite song. Every session needed to start with this song. One day I asked her why this song was so important to her. She said, "It reminds me that no matter how bad things get, that God is always there". Dorothy shared with me the story of the death of her son when he was in his mid 40's. She said on the day he died a white dove appeared at her house many states away. She never saw the dove before and never saw it again. She said she felt it was her son coming to say good-bye. She told me when she died she had the image of doves coming to take her home.

The second required song in every session was, "How Great Thou Art" dedicated to her son John. He lived in Colorado and always loved the mountains and nature. He was buried in a cemetery on a mountain in Colorado. Dorothy said the song takes her to that place where she feels connected to her son.

The evening before she passed away, a hospice social worker entered her room at the nursing home. She noted that the client was looking up at the ceiling. The client appeared to be seeing something the social worker could not see. When the social worker asked what the client could see, she said, "I see the doves, they've come for me".

By the time I saw Dorothy the next morning she was unresponsive. Her respiration was rapid and she had some agitation. When I started the song, she opened her eyes and looked up, apparently seeing her doves. She then closed her eyes. When the care center nurse came to take vital signs, she talked the Dorothy and assured her, “It’s ok to go with the doves to heaven”. The nurse later told me she and Dorothy had also talked about her image of doves bringing her to heaven. On the second verse of "How Great Thou Art", Dorothy opened her eyes, sat up in bed, reached out her arms, and exclaimed, "John!" I asked her if John was there and she said nodded and said, "uh huh". Then she said the word, "home". She then sunk back in the bed with a smile on her face. She kept smiling through the rest of the visit and her breathing slowed down. When I touched her hand to say good-bye she grasped my hand and held it firmly. With closed eyes, she said, "Thank You".

A few minutes after I left the room Dorothy passed away peacefully.

Music helped these people along in their preparation for their final passage. It eased their restlessness and helped to keep their connection to family and of those who had passed before. It supported each of their journeys in a way that matched each of their own unique spiritualities. Experiences like this humble me, and reaffirm that there is love and beauty even in the face of suffering.

 

“When these things beset us, he doesn’t forget us, He sends down his love, on the wings of a dove.”- On the Wings of a Snow White Dove

 

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Through an Open Door

Finding a place away from pain, finding the doorway home

 

Frank was a 76 year old man with bone cancer. Frank had multiple fractures and bone tumors that were quite visible. He had pain that was very difficult to manage. He was on multiple pain medications, but they were only partially managing the pain. He said he was always in pain, that even breathing hurt him. When I first came to visit him, his preferred music styles did not seem to help. When I began to play the Native American flute, he closed his eyes. When I stopped after a few minutes, he said, “Please just keep playing. Don’t stop”. I matched phrasing and rhythm with his breathing and gradually it slowed. I continued to play for an hour, when I stopped, he said, “the music took me somewhere else completely… it was somewhere beautiful… so far from the pain… somewhere I felt no pain”.

 

In the next session I introduced guided imagery into the session: using music to create a relaxed state, and then guiding him through imagery experiences, and flowing with images the music elicited in him. He imagined a blooming meadow, surrounded by mountains where he felt completely calm and at peace. He said again that he felt “separated from the pain”. After a few sessions using guided imagery along with recorded and live music, Frank was able to find a calm place, where his pain felt reduced on his own. After this time, I would come and play the Native American flute and he would listen with his eyes closed.

 

One day Frank’s imagined a door that appeared in the middle of the meadow. When we discussed it further, he said he knew it was the doorway to his next life. He said he knew there would come a time for him to enter- soon, he said, but not yet. Frank’s pain over the next few days got much harder for him to bear. His disease was progressing and pain management was becoming increasingly difficult for him. I was called by the nurse to visit on an urgent basis one day. Frank said the music helped, and he obviously was calmed. When he went to his place he said the door was now open and he could see past it. “It was a beautiful place and I know now I have nothing to fear. It will be time soon”. A few hours after I left, Frank slipped into a comatose state. Even in that state the family later said his pain was very apparent. Frank had a CD of my music played on a CD player that could repeat. At one point his family said the CD didn’t repeat. He became more agitated again until the CD could resume.

 

I was unable to return the next day as I had left for a conference. About 24 hours after I saw Frank, he passed away. I often imagine him going through that door in the meadow to a place where his pain is no more.

 

“It’s not far, just close by, through an open door. Work all done, care laid by, going to roam no more” –Going Home, Traditional Spiritual

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The Unbroken Circle

In this story my practice as a music therapist crossed into my own health journey.

 

One day I was contacted by an RN who was caring for a dying patient who had recently returned home from Mayo Clinic, having been unresponsive for over a week. He had said his goodbyes to friends and families, but seemed to have a hard time letting go. She and the family thought that it would be beneficial to have me play some music to assist him in finding a feeling of peace and support him as he made his final transition.

 

As I entered his home I noticed his family was gathered around his bedside in his living room. His wife, brothers, sisters, children, grandchildren, and friends were all gathered. When I asked the type of music he liked the best, his family said, "Country, Johnny Cash is his favorite singer". They also explained that he had a strong Christian faith background. After searching my memory for an appropriate Johnny Cash song to play in this setting, I thought of the old Carter family song, “ Will the Circle Be Unbroken”. This is a song that deals with death and the next life.

 

I pulled up a chair next to the patient’s bedside, adjusted my guitar in my lap, quietly shared my name and that I was going to sing for him. With the family encircling the bed and his wife seated next to him holding his hand, I began to play the guitar and he began to move. At first he raised an eyebrow, then he moved his head slightly toward me. I looked down and noticed his feet move slightly. When I began to sing the song, the corner of his mouth raised into a small smile. Then his eyes opened and he began to look around to his family gathered around. He squeezed his wife's hand. When the second verse came, he began to move his mouth to the words and sing. After the second verse and refrain, he began to close his eyes again and lay back into his pillow. I sensed a change and repeated the first verse and refrain. We all observed him take his final peaceful breath as I played the last chord. Although this was a sad time, it was truly a surprise and miracle to all of us!

 

After paging the nurse to return, the family asked to sing "Amazing Grace" and a few other hymns. It was a privilege to be part of this special event and it was so affirming of how music and spirituality are so integrally connected, and such an integral part of life.

 

The family requested that I play "Will the Circle Be Unbroken" at the funeral. Afterward, they gave me a small plaque in appreciation of my performance. I'm not sure why, but I placed the plague in the visor of my van that day and forgot about it.

 

A year later, I had my own personal health crisis. After many tests in Minneapolis, my doctors decided that I needed to have inpatient testing and evaluation done at Mayo Clinic. I was quite worried about the process and possible outcome. I was afraid that I myself might die or end up with a serious disability. I arrived early in the morning and I parked in the monstrous parking ramp. I was anxiously searching for something before going in to be admitted. As I pulled down the visor, the plaque fell onto the passenger seat. At that moment I felt a sense of peace and assurance that I really needed. It was as if God had just put a comforting hand on my shoulder. I stopped and re-read that plaque right there:

 

I said a prayer for you today

And know God must have heard.

I felt the answer in my heart

Although he spoke no word

I asked for happiness for you

In all things great and small,

But it was for his loving care

I prayed the most of all.

 

I looked up and at that very moment the sun was rising.

I somehow knew in that moment that everything was going to be all right.

That plaque helped to give me strength and reminded me that I was not alone during my time there. I found it to be very reassuring to have it with me during this difficult time in my life. This experience serves as a reminder to me that the care we give in hospice means something far more than we can understand and that sometimes in life our own caring and compassion for others can be returned in unexpected ways. That is one circle will never be broken.

 

“To a better home a waiting, in the sky, Lord, in the sky”  -Will the Circle Be Unbroken, Carter Family

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Everybody’s Got The Blues- Jake’s Story

Music Therapy for bereavement with an angry child

 

Jake was an 8 year-old boy, who’s mom had terminal Liver Cancer. I met Jake for the first time a couple of weeks before his mother died. Jake was very angry the day I came to see his mother. He was lashing out verbally at relatives, throwing objects, and almost pushed a television over. It was a warm summer day and I asked Jake to come outside with me to talk. When we got outside, Jake started to yell about all of the things he was angry about. “My life sucks”, “my mom’s sick and she’s going to die”, “My dad left me when I was little”, “I’m going to be all alone when my mom dies”, “We family’s poor and I never have what other kids have- now I’m alone”, “I just feel like laying down right here and dying”. “Now this jerk comes here with a guitar and is supposed to make it all better- yeah right!” This child was in a lot of pain emotionally. I wanted to help, but he was angry at me too. He was angry at everything and everyone, including his mom for dying. He had no constructive means to express these feelings, let alone examine these feelings- it was just coming out as pure rage.

 

In a bit of a risk as a therapist, I began to improvise a blues song over a blues pattern I played on the guitar, using the words and phrases Jake was yelling. At first he gave me an angry look, then a small smile came, then he laughed, and then the tears came. He said, “boy I know more about the blues than almost anyone my age in the whole world.” We started to write down the song and Jake was able to make changes to lyrics and guide the music. After a while he was talking about his feelings. He said, “I feel sad, but it just comes out as mad”. Over the course of 3-4 sessions we wrote his “Blues Song”. The end result wasn’t so important as the fact that he was able to express his feelings of anger and his grief in a way that didn’t involve breaking televisions. He was able to take these feelings, give them structure, and deal with them.

 

After his mom died, Jake wouldn’t talk to anyone about his feelings. His grandmother described him as “angry all the time”. For several sessions after the death, Jake refused to talk to me about his mom’s death. Instead, we ended up making music with keyboards and drums. This seemed to engender more trust even though it didn’t initially seem things were progressing.

 

One day I entered the house with only a drum. He was arguing with his grandmother when I arrived. The three of us started talking about the anger. He said, “Sometimes I get so mad I just want to break something” I asked Jake how he would tell the drum how he feels. I gave him the mallet and he said, “What do I do?” I said, “Show the drum how you feel”. He warned, “I might break it.” I said, “I have more drums”. This model of Remo drum is almost indestructible- almost. I suggested he say something he was mad about and then hit the drum to show the feeling.

He wound up- “I’m mad because my mom died”. I held the drum far from me as he hit it very hard. “I’m mad because my dad left me” ---BOOM went the drum. “I’m mad because I’m all alone in the world” ---BOOM! “I’m mad at my friends for picking on me for being poor” --- BOOM! He went through a long list as my arm grew tired and my drum started coming apart. Then he ended by saying, “I’m mad at my mom” --- BOOM! “I’m mad at her leaving me”--- BOOM! “I’m mad at God for taking her away from me and making my life so hard”--- CRACK went the drumhead with the final swing. Then tears came again. We talked about letting feelings go instead of hiding them and that it was alright to feel sad, confused, or angry.

 

His overall anger at school and home was better after that point. We continue to meet from time to time and he is now open with his feelings. Jake faces many challenges in his life and has faced a lot of pain. This is the beginning of a very long healing process for him, but music therapy helped him get it started.

 

Here’s his blues song:

 

Everybody’s, everybody’s got the blues

I said, Everybody’s, everybody’s got the blues

I’m gonna lay down on the ground, lay right down and die

 

Even though I got the blues, I know my life’s been good.

Even though I got the blues, I know my life’s been good.

If you’ve never met the blues, someday you’ll get the blues too

 

My family’s gone away, so now I’m all alone

My family’s gone away, so now I’m all alone

So all I want is something that will make me happy

 

My pappy never let me play, and so he went away

My pappy never let me play, and then he went away

Now I only see him on some certain days

 

*My mom got sick and died, so now I’m mad and cry

My mom got sick and died, so all I do is cry

All I want to know is why, why, why?

 

When you’ve got the blues, you don’t know when it will go away

When you’ve got the blues, you don’t know when it will go away

Even though I’m sad I hope it will be gone some day.

 

Even though I got the blues, I know my life’s been good.

Even though I got the blues, one day my life will be good.

 

*verse written after mother’s death, the rest of the song was written before mom’s death.

 

“You’ve got to live the blues to play the blues” – B.B. King

 

You should be listening to one of Christian's recorded compositions, called Aurora (if your speakers have been turned up). To listen to more of Christian's music, visit his Streaming Music Page.

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