Comfort for the Dying

Front page of Laramie newspaper with article about a therapeutic musicianThe following article by Boomerang Staff Writer Karla Pomeroy appeared on the front page of the Laramie Boomerang newspaper on
Saturday, May 10, 2008.
A Hospice of Laramie patient in the "active" stage of dying begins to feel anxious and her heart rate becomes rapid. Therapeutic musician Alice Freeman sits next to the bedside and begins to play her harp, matching the rhythm of the person's heart rate, then starts to slow the rhythm of the music, watching as the patient's breathing slows to match the musical rhythm.

Freeman has been volunteering at Hospice of Laramie since September as a therapeutic musician. She said that seven years ago, she played her harp at her dying mother's bedside. She knew then that she wanted to provide the gift of music for the dying. In January, Freeman began online training with the International Healing Musician's Program and then contacted Laramie Care Center and Spring Wind Assisted Living Community to volunteer as an intern at the two facilities. 

She said that as a therapeutic musician, she will play for the dying, neo-natal patients, pre-surgery, post-surgery and Alzheimer's patients as a way of helping relieve pain and anxiety.

Care Center Administrator Ron Nelson said Freeman comes twice a week to the Care Center and plays for residents at the request of family members or Hospice of Laramie. While he didn't know a lot about therapeutic music programs, Nelson said he likes the program because music is truly therapeutic. He said the patients seem comforted by the music and the families are appreciative of the service.

Hospice of Laramie social worker and bereavement coordinator Angela Lavery-Benson said music can be used in so many ways to help hospice patients, especially if they are restless or anxious. "Our goal is peacefulness. We focus on quality of life and what brings them joy and peace," Lavery-Benson said.

Lavery-Benson said every volunteer must complete the hospice's two-day training course. She said she is excited about the additional training that Freeman is obtaining because it adds more to the program and allows her to let Freeman do her own assessment of the patients' needs in regard to frequency of visits and types of music.

Therapeutic Musician

Therapeutic musicians, also called clinical musicians, are not music therapists, Freeman explained. Like other therapies, such as occupational and physical, music therapy requires a college degree and focuses on actively involving the patient with a view to recover, she said. A therapeutic musician is also not a bedside entertainer. Freeman describes therapeutic care as music care with the intent to promote healing, not curing, by bringing the mind, body and spirit into balance.

When Hospice of Laramie contacts Freeman about a patient, she completes a referral request, finding out the patient's religious preference, musical interests and purpose for the referral, whether it is for pain, restlessness, anxiety or other reasons.

Freeman said each person has their own natural resonant tone and their own rhythm. Combining these elements, the therapeutic musician offers the patient their own personal musical journey to help them in emotional, mental, physical and spiritual healing. The musician starts this by entraining with the patient, matching the tempo of the music to the patient's breathing. Everyone responds unconsciously and automatically to external rhythmical stimuli. For example, she said, last Christmas, she was walking in Kmart as a Christmas carol began to play, and every person she saw was walking in time to the music.

To work with that natural resonance, Freeman said that in early visits with patients, she will play familiar music the patient enjoys. However, once the patient moves to the active phase of dying, she plays music that the patient is not familiar with because if someone is dying and hears familiar music, they may want to "hang on." During the actively dying process, she will play pieces that are arrhythmic with no specific tempo and with lots of pauses. "It is giving people permission to leave us," Freeman said.

She said she visits patients about once a week, but the visits will increase when the person reaches the active phase of dying if it is desired.

Therapeutic musicians must also be careful to make sure they take care of themselves physically, emotionally and spiritually, Freeman said. "You don't want to get overwhelmed or burnt out. My personal tension can easily come through in my harp playing," she said.

When a patient dies, Freeman has her own private ritual she conducts, lighting a votive candle, writing the name of the person on a piece of paper, burning the paper and putting the ashes in the candle. "It's my way of saying goodbye," she said.

Freeman said it is rewarding to see patients and caregivers relax and become happier while she plays. "Music is so powerful. The fact that I can successfully give people pleasure and comfort is by far the most rewarding part, for me," she said.

Her greatest challenge in being a therapeutic musician is learning music. She said that when she goes to a bedside, she does not want to use a music stand because it is like "putting up a wall" between her and the patient. "My challenge to myself is to memorize all of my music or to be able to play it by ear," she said.

She said she has had to learn a few new hymns since starting last fall. "It's one of the things I liked about my last job, the opportunity to learn new things. That's what keeps us going."

Although she wanted to play the harp as early as age 9, Freeman took her first lesson as an adult nearly 11 years ago from University of Wyoming harp instructor Connie Wallace. Freeman learned to play the piano at age 6 and began violin lessons at age 9. She has played the viola for 40 years and played the harp with the University of Wyoming Symphony Orchestra since 1999. She retired from UW as a computer software trainer for faculty and staff in 2007 which gives her more time to volunteer as a therapeutic musician and to do freelance work as a harpist.

"I love what I'm doing. I figure that I have a gift with music and now I'm working on extending the privilege of sharing that gift with other people. That in and of itself is very fulfilling. I always say that when I die, I want to know that I have made a difference in
peoples' lives."