Approaching death can be a long descent into pain and fear. Proper drugs and social workers may ease these worries for some. But for others, the misery is so profound that little helps. Alternative medicine is increasingly accepted as part of palliative care and some studies show music is one method to ease pain and stress at the end of life. One of these methods includes live harp music, played at the bedside by a certified music practitioner.
Carol Joy Loeb, a former opera singer, is a certified music practitioner and registered nurse. When she arrives at a patient's bedside, she's prepared to alleviate misery.
"I use the music to bring a calmness to them," Loeb says. "It helps with pain and agitation. And in the case of those who are actively dying, it helps them to go peacefully."
She even uses the music to open communication between family members at the end of a person's life. Last year, she worked with a dying woman on Hospice care.
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"This was a woman in congestive heart failure, she was in acute distress," Loeb says. Just before she arrived, the patient had received a dose of morphine but didn't get the necessary relief. When Loeb started playing, the dying woman began to relax.
"Within 10 minutes her respirations were almost not there," Loeb recalls. "Her daughter was in the kitchen with the Hospice chaplain. I was there with the Hospice team. And we were so awestruck with what was happening we almost forgot to get the daughter! And when I realized what was happening, I said, 'Someone go get the daughter.' And she came in and took her mother's hand and she said, 'Mama, it's okay to go, go to God. Take the hand of God and go to God.' And within one minute, she was gone."
Some studies on palliative music show that harp music brings peace to patients, but others call for more research into its effects. And doctors may not agree that it's beneficial.
However, one former skeptic on Loeb's Hospice team changed her mind after seeing the harpist at work. Dr. Deborah Wertheimer, the medical director of Seasons Hospice in Baltimore, didn't oppose the bedside music. She reasoned that at least the music would be beautiful to hear. But Wertheimer was startled when she saw Loeb obtain dramatic results with one dying patient.
"This (patient), who had been so agitated and just all over the bed, on the floor occasionally, because we just couldn't keep her comfortable, quieted down," Wertheimer says, "and obviously was attentive to the music, even though I would have thought that it would have made somebody who was so afraid of dying, more afraid to hear harp music coming at her.
"This lady remained peaceful for some period of time. It was just a pleasure to see, because we clearly had not been able with traditional medicines to achieve that kind of comfort for her."
To become a certified music practitioner, students earn accreditation through the Music for the Healing and Transition Program. MHTP was founded 11 years ago to help palliative-care musicians serve the dying and the chronically ill.
During her internship and since receiving her certification, Loeb has played in private homes, emergency rooms, in hospital wings for ventilator patients and in assisted care centers.
Clients look forward to her arrival. One former client, Virginia Norman, said the music boosted the effectiveness of pain medication.
"The music helps the pain medicine work even better when I have it," Norman said before her death last year. "If I haven't had it in a while, it takes away a lot of the pain that is there. I go down usually about three levels, sometimes only two, but mostly three levels of pain, which is quite a bit."
Most people don't realize what a significant achievement this is, Norman had said. "People think of pain sometimes as just like stubbing a toe. It only lasts for awhile and goes away. But there is pain that does not go away."
Loeb recently returned from a conference of certified music practitioners. She continues to work with her Maryland clients and has established her own Web site, www.caroljoysings.com, to spread more information about her industry.