My Hospice Experience: A Member of the Orchestra

Carolyn Ancell, Certified Music Practitioner

I am a harpist. One part of my harp life is playing solo: for dinners, receptions, celebrations, services. But, the part of my harp life that is at the heart of the art is playing as a member of a sweet orchestra called hospice. In the hospice setting, my harp and I are part of an ensemble--medical, spiritual, social, familial, and administrative “instruments”--that creates a healing environment for those approaching the end of their lives.

Ten years ago, I read in PARABOLA magazine an ad for a national certification program called The Music for Healing and Transition Program. Two years later, after five intensive study modules and an internship at two local hospitals and Casa de la Luz Hospice’s Inpatient Unit (IPU) here in Tucson, I was officially a Certified Music Practitioner. Casa de la Luz hired me, and I began an amazing journey as a member of an “orchestra” that provides care, healing and support for terminally ill patients and their loved ones.

When I arrive for my shift at the IPU, I gather from the computer and from other members of the orchestra (nurses, CNAs, spiritual counselor, social worker) information about each of the admitted hospice patients (diagnosis, physical, emotional and mental condition, spirituality, relationships with family and friends). Armed with that information, I take my harp into the first room.

If the patient is awake and alert, he or she becomes a member of the orchestra! It gives me great joy when the patient says, “I would like music to help me sleep,” or “I like country western” or “classical.” And sometimes, after I begin playing, the patient will jump in and take the lead. For example, on Christmas Day, I began the first three patient visits with the same peaceful version of “Silent Night.” The first patient immediately began reminiscing and sharing her Christmas memories. I used my harp to support the mood of the patient’s memories throughout her storytelling.

In the second room, a Hispanic patient followed the song with tears in his eyes, then thanked me in Spanish, telling me he was feeling lonely this Christmas Day. So I shifted the direction of the music to “You’ll Never Walk Alone,” and then a few Spanish language songs.

In the third room, a patient’s family requested the harp music to soothe him while he slept. In the middle of “Silent Night,” the patient awoke and looked at me with surprise. I said, “I am not an angel, just a person, and I am here to play my harp for you because I love you.” He stared at me a few seconds longer, stated loudly and clearly, “Good!,” and went back to sleep. I shifted then to unfamiliar music to support his sleep without suggesting any particular images or memories.

Even when the patient is minimally- or non-responsive, he or she still indicates the choice and direction of my music. I sit close to the bed so I can watch and support, or help ease, the patient’s breath rhythm with the sound of the harp or soft vocal chanting. Often, the result is deeper, more relaxed breathing, a sigh, or other visible signs of relaxation.

If there are family members or friends present who ask for a particular song or kind of music for the patient, I try to find a way to include it appropriately, perhaps playing it slowly or softly, or stretching it to make it more arhythmic (which is helpful to a patient who is letting go of the regular rhythm of breath). Sometimes a family member or friend will begin to hum or sing along with the harp, joining the orchestra of love and support.

There are times as well that my harp music accompanies the patient to and through his or her final, fragile moments of life.

Even after the last harp tone is sounded, the orchestral work continues in charting or chronicling the visit, and perhaps leaving an in-house e-mail for the next day’s harpist.

It is an enormous privilege to be a member of the Casa de la Luz Hospice orchestra.

By Carolyn Ancell, Certified Music Practitioner