Seven Considerations for Live Music in Hospice Settings

Categories: Care.

The presence of live music in hospice settings can be of enormous value to dying people, their families and their caregivers. It can provide comfort, encourage reminiscence, and facilitate meaningful shared moments of beauty, creating lasting memories of final moments with a loved one. However, music being a powerful agent in people’s lives, it has the potential to do harm when not used with caution.

Here are 7 considerations when inviting live performers into your care space:

1) Always Ask: get consent from the people within earshot of the live music if they would be amenable to a live musician playing close by. If they consent, make it clear that they can ask if the music stop if it is bothering them. Having the musicians ask for consent themselves can be a great way for them to establish relationships with people in the care space.

2) Go Organic: instruments made of organic materials – ie. violin, guitar, voice/singing, flute, cello, piano, etc. – are more likely to produce a sound that will support a healing environment for people. There are certainly exceptions to this, but as a general guideline try to limit amplification or use of music-technology tools when possible, to ensure the music remains at a “human” level.

3) Limit Numbers: sometimes, musicians from large choirs or orchestras volunteer to perform. Keeping these groups small is a good guideline. In intimate care spaces, smaller ensembles of musicians will ensure that the volume of the music – as well as the number of “strangers” entering personal, sensitive space – be kept within reasonable limits. Try to encourage ensembles of 3 or less.

4) Be Flexible: suggest to the musicians that they prepare to be flexible with their musical choices. Classical music can be pleasing “background” music for many, but displeasing for others, and so musicians should be prepared to change their “plan.” Also, some might want to ask for “requests.” Can musicians prepare an array of pieces? Consider offering musical suggestions in advance – of particular songs, styles, or periods of music – that are meaningful to the care receivers.

5) Watch Breathing: musicians can gauge a lot about the impact of their music by watching the breathing of their listeners. Use the breath for information: if playing for a person who is non-responsive, try using their breath as a metronome and see how it impacts the music, and the listener.

6) Prepare for Triggers: some songs will inevitably bring up emotions for some people, particularly in the sensitive moments at the end of someone’s life. There is no sure way of knowing in advance how certain music may trigger someone, but keep aware of this possibility. If a certain song brings someone to tears, it is best to ask: “would you like us to stop?” The tears may be a welcome release for some, or an unwanted trigger for others. When in doubt, just ask.

7) Use the 20 – Minute Rule: 20 minutes is a safe amount of time to have live music in a clinical setting where people are “captive audiences”. If the musicians are moving through a facility, going to individual rooms or different units, suggest keeping the performances to this time-frame.

When offered with care and respect, live music can be an incredible gift to a hospice environment. Many orchestras, chamber ensembles, choirs, and professional solo musicians have mandates of volunteerism. See if you can reach out to musicians in your community to invite them to your hospice setting. It can be a life-changing experience for even the most seasoned musician!