Why I Sing to People Who Are Dying
Being a hospice chaplain can feel lonely at times, with people often wondering, “Isn’t that morbid to be doing that?” But with my front-row seat at Act Three, Scene Three of people’s lives, I get an intimate glimpse into what people are pondering, remembering, laughing about, and caring about at the end. Over the years, I have learned that one avenue to finding out what a person cares about the most at the moment is through singing to them. And sometimes singing is the only way to reach people at all when they have Alzheimer’s or dementia.
Music, as well as certain smells and sights, trigger emotions and memories. Hymns, being religious, trigger memories of one’s house of worship and the friends and family that were there. Other music triggers other memories. When dementia patients can no longer respond much to verbal input, it seems that music involves other parts of the brain, and perhaps those parts are more intact or remain more accessible. And music can certainly be a nostalgic, moving or emotional thing.
Singing is also an icebreaker: Offering my own singing rather than playing a video is like bringing along homemade cookies or a homemade greeting card; I am sharing something of myself and making myself vulnerable to their reactions.
This can work either way, but it usually brings comfort, warmth and even renewed energy. Take the Witfields. Mrs. Witfield was on hospice and in a nursing home and her husband shared the same room with her because of his own memory loss. It was one of the nicer rooms, with a couch to the left of the door and plenty of space for a mahogany bureau topped off with model airplanes and a picture of Mr. Witfield in a pilot’s uniform. Both had served as pilots in World War II.
Every time I came by, I had to go through the same ritual of Mr. Witfield’s questions because on some level I was a brand new face: “Where do you live? What religion are you?” Often he was mentally located in the past around World War II, and he would ask if I were a pilot too. I would always roll my eyes at that and say being a passenger was more than enough for me when it came to flying. He always took care to mention that Mrs. Witfield was a pilot too and that she was a WAC. So I sang out, “The WACS and the WAVES are winning the way, parlez-vous,” and they rewarded me with amused laughter. Even though the repetition of all this at each visit was annoying, I tried to think of it as a ritual worth going through that let me bask in their delight with the sheer pleasure they felt upon connecting with another friendly soul. (Related: Why I Hired A Comedian for My Mother with Alzheimer’s.)
A song can carry people back to happier times and places and make them comfortable enough to sometimes join in.
Another lovely thing that happens every so often is that patients join in singing or simply mouth the words along with me, even when it takes them considerable effort. This happened when I made a visit to an extremely devout Catholic family taking care of a woman named Mary in her apartment. She was close to turning one hundred and was very lucid. Mary’s home was swamped with ornate crosses, pictures of the Pope and other religious figures and decorations. The decorations echoed the hopeful and appreciative attitude of the family and of their numerous visitors coming and going. Taking my cue from the decor, I began to sing some hymns, such as “Swing Low, Sweet Chariot” and “Amazing Grace.” Mary felt like I was transporting her to church which she missed dearly. As the family harmonized with me, we created an instant if transient miniature choir.
But there are times when offering song can be a very bad idea. When someone cannot speak or even nod yes or no, I try to use my intuition as to whether singing would confuse or comfort a dementia patient. I first try gently singing in a low pitch to see if it is welcome. One time, as I was softly singing a hymn to a bedbound lady wearing a highly visible cross around her neck, she slowly started to rise in to a rigid sitting position, staring wide-eyed directly ahead, her cross sliding off center. Maybe she thought she heard the angels singing and that God was coming for her. I stopped, and she soon lay back down, her cross once again centered and at peace on her chest.
I don’t always know whether a patient will like my singing. But usually my songs carry people back to happier times and places and make them comfortable enough to sometimes join in. Singing is a powerful way to speed up closeness to strangers, revive soothing memories, and usher in comfort and peace.
Ordained in 1992, Rabbi Karen B. Kaplan is among the first 200 female rabbis worldwide. In 2007 she became a board-certified chaplain and has served hospices for 9 years. Currently she is a chaplain for Center for Hope Hospice in Elizabeth, NJ. She is the author of Encountering the Edge: What People Told Me Before They Died. You can read more of her writing on her blog, offbeatcompassion.com.