Learn about the Inspiring Work of Certified Music Practitioners

‘Where words fail, music speaks.’
Hans Christian Andersen

EDITOR’s NOTE: As the worldwide pandemic has risen and fallen in 2021, we are receiving more columns from writers around the world about the challenges of aging, caregiving and the end of life. This week’s story comes from Lori Brady-Neuman, a retired school social worker who has been using her life-long skills, especially her talents as a musician, to bring music to hospice patients. That kind of work by Certified Music Practitioners has been growing nationwide, including at major teaching hospitals. In her story, Lori explains how she got involved in this work, which is distinctly different than the profession of music therapy—and she tells us how her music has touched the lives of families she has met.

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By LORI BRADY-NEUMAN
Contributing Writer

Looking back over the years, I recall that I have known loss and grief in many capacities. My Dad left our home when I was 8. My husband of 20 years left the marriage, and friends of mine have struggled with many loss issues. I realize that I have walked alongside grief in many aspects of my life, so choosing to sing to the dying became the ultimate way of befriending loss.

One set of experiences that led me along the path toward working in hospice was planning and singing at various funerals over the years. I remember a significant funeral in which I sang for a dear friend, Elizabeth who was in her thirties. The night before her death, I was at her hospital bed where we shared memories and prayer and Holy Communion.

Since my hands were both involved in playing the guitar, she reached out for my knee in a desire to touch me. I introduced her to a new piece of music, “The Lights of the City,” which she loved—and then asked me to sing it at the wake, the night before the funeral.

At the memorial service, I shared the story of having sung this song to Elizabeth the night before her death. I shared what she loved about the song, and that she wanted me to sing it as the final song because she wanted her friends and family to leave the service on a happy note. I told this story just before singing it. At the end of the song, no one moved. I walked over to Elizabeth’s mother who shared a comment Elizabeth might have made if she could: “That was really cool.” I quickly returned to the microphone and shared this comment with the mourners who knew those would indeed be her words. A chuckle ensued, and then they were able to let go of their frozen stance. It was an extremely moving moment. I knew then I wanted to sing to people as they left this world.

Certified Music Practitioners: Music for Healing and Transition

I learned from a friend, who knew about my desire to sing to the dying, about the organization, Music for Healing and Transition (MHTP). I applied and was accepted. (If you care to learn more about MHTP’s work and certification of music practitioners, here is a very helpful page you’ll want to read within the MHTP website that answers questions including the distinction between a CMP and a music therapist.)

I completed my training and earned my certification as a Certified Music Practitioner through The Music for Healing and Transition Program. My training included teaching presentations by staff, background on paradigms of healing, required reading, repertoire development along with extensive internship and supervised practicum. I was assigned a mentor and, at the end of the entire process, I took an extensive exam and was required to submit a vocal recording that demonstrated my knowledge of which categories of music to use for patients in situations such as chronically ill, critically ill or actively dying.

Within the overall program, I chose hospice as my practicum. I will never forget an exercise during my hospice training that was focused on the various aspects of “letting go.” One of my assignments was to think of a final person I couldn’t bear to leave. I have three children, and I was asked to choose one child from among the three, as the final person to say “good-bye” to. I can recall quietly crying and not wanting to finish the exercise—but I had to complete this writing assignment as part of my program. Even though it was an exercise in my training, the process still was wrenching. The experience was designed to help me understand a little better the agony that a dying person could be experiencing.

During my training, I also was surprised at the breadth of music I was encouraged to prepare. As I started this process, I had prepared spiritual music, assuming from my own personal preferences that I would want spiritual music during my dying days. However, I quickly learned that we only sing spiritual songs if the patient or family asks for that type of music. This was so startling to me, at first, that I considered leaving the program for a moment.

Then, I began to understand. Not everyone loves spiritual music. For many individuals and families, other kinds of music are far more meaningful. As my trainer explained this, I decided to stay and to broaden my repertoire. I am so glad I made that choice!

My next hurdle was dealing with the question: Do I have enough musical talent? Can I remember the words and chords to all the music I wanted to share? None of this detoured me. I was determined. Eventually, I realized that the music I most commonly play falls into three general groups: spiritual music and hymns; popular and folk songs, especially music like John Denver or traditional tunes like Shenandoah; and then music that actually is new to people but that winds up closely paralleling their journey. While that’s a lot of music, my son has loaded all of my guitar chords and lyrics onto an iPad for me, so my repertoire is very portable now.

One event that vividly stands out occurred during my internship. I had sung to a woman who had COPD. She had been struggling for some time, and was experiencing labored breathing. The nurses indicated she had been trying to let go for several days but just became so anxious and rigid that she couldn’t let the process unfold. Her son asked me to sing to her that day as he was aware that I had done so the day before, and that it had gone well.

The patient was using oxygen. She was breathing extremely hard, so much so that her false teeth had fallen out of her mouth. During my studies I learned the importance of mirroring the patient’s breathing musically as a sign of respect, which is what I did. And then to immediately transition the beat to a normal heartbeat pattern, 60 to 80 beats a minute. Her breathing entrained to my normal heartbeat and then her process of letting go began. While sharing music with her, her breathing diminished to 30 breaths a minute, to 20 breaths a minute, then 10, then her actual last breath. I followed her until there was no breath at all. Her son and her sister who came from Australia were in the room. Her son was holding her hand.

During the final 5 to 10 minutes, I was playing arrhymic music, often just a chord, or I plucked a string, no singing, only following her breath. It was a gentle, slow letting go that her body was trying to achieve. As an intern, the whole event was scary and awesome at the same moment. It was amazing to be able to help the patient unbind in her own time and manner and as she was ready.

The Benefits of Music for Patients

Live therapeutic music at the bedside has been shown to reduce a patient’s anxiety, fear, pain, anticipatory grief and restlessness and offer them a sense of calm, comfort and peace.

In doing a little research for this article, I found a log, which we were required to submit to our mentor and supervisor after visiting with each patient. It references a COPD patient, age 90, who had declined all medications, even Tylenol. This is the first time I had been with a patient who was suffering so. I felt enormously helpless. At one point I thought she didn’t want music, but a nurse came in and said to share the music anyway. She needed water and I summoned the hospice nurse for that.

At one point she started moaning: “Please save my soul.”

I responded by singing those words in a chant-like melody that I improvised. It seemed like she responded favorably to this. She definitely wanted me to sing and play. She was hallucinating, however, most of the time, so it was difficult to tell. I also sang a song and inserted her name in it. She noticed even though she was hard of hearing. I spent a long time with this patient trying to see what was right for her and trying to help her relax and
hopefully she would be able to sleep. When I was ready to leave her room, she seemed more relaxed, and even had closed her eyes.

I am reminded of another vignette of a family that I had been allowed to accompany on his final journey. I was  singing to a man in his seventies. He was pretty alert. His daughter was in the room with us. I started to sing “Swing Low, Sweet Chariot.” I invited the patient and his daughter to join if they wished. The patient, who died the following week, chose to sing with me. His daughter grabbed her smart phone and video taped the moment. It was truly special.

A week later, I received a call from the daughter letting me know her father had died and wanted my permission to show the video at his memorial service. I said: Yes, of course. It was well received and exactly what the family wanted.

Over the years, I have discovered that presence is more of a gift than musical excellence. I now understand this important gift. I experience the importance of presence every day that I volunteer at Capital Caring, Adler Center, in Aldie, Virginia, one day a week for the past 6 years.

Creating a healing environment through music

My goal as a music practitioner is to create a healing environment, a musical massage if you will. My ultimate goal is to help a person in transition as they unbind. The reason live music is more effective than recorded music is that the musician is able to make adjustments during the session depending on the patient’s mood, condition and breath.

Therapeutic music during the dying process is very effective at regulating breathing (as the person goes through the transitional stages of breathing until there is no breath), supporting relaxation, diminishing fear and anxiety, bringing family and loved ones closer together as they sit vigil, and adding a potent spiritual dimension to the event, regardless of religious affiliation. Music can help people relax and the voice can communicate a sense of healing and comfort. Since music is pure vibration, whether it’s from my voice or my guitar, it affects the body inside and out, mind and spirit.

I also find that the music has the potential of reducing feelings of isolation and fear. Music has the power to bring a fullness that words alone can’t create. I have seen the power of music reach deep inside of family members as they transform experiences of suffering into meaning.

I am also aware that the simple act of a stranger holding guitar and offering to share music, I am telling the person and family that someone is willing to sit with them for 30 to 60 minutes and share in their sorrow and feelings of loss. I am always aware that, even if the family chooses not to have me sing, they are always grateful that I offered to sing.

Before I begin each visit at Adler, I center myself. I ask God to work through me to help bring a sense of peace, comfort and calm. My intent is to be of service, not to entertain. I
am humbled and privileged to do this meaningful work. I often feel that I receive a greater gift than I give. While some Certified Music Practitioners are paid, I do all my work as a volunteer.

We play our music for those suffering with pain, anxiety and dementia to bring them comfort and a sense of belonging. The music can help release fears and attachments. It can provide us with beauty, warmth, light and hints that we are not alone. Music can help relieve stress and tension.

We also play our music for the dying because of our love and appreciation for life. The music provides a voice for this love. It is our hope that the music can accompany and journey with the person who is dying to ease their fears and surround them with a sense of beauty and blessing. The music conveys a sense of serenity and consolation that can be profoundly soothing.

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Care to read more?

A dozen writers from around the world came together to create a resource for families who suddenly discover they are facing aging issues—and immediately need a helpful orientation to the new challenges opening up around them.

It’s called Now What? A Guide to the Gifts and Challenges of Aging.

Co-sponsored by a long list of nonprofit groups that work with aging Americans, this new resource book has chapters on issues that include:

• Successful aging in place, which includes making our homes safe for us as we encounter physical changes.
• Tips for smart dressing and accessories to make life easier.
• Tips for new careers and also meaningful service we can provide to our communities as we age.
• An introduction to services including financial planning and hospice.

“An amazing feature of this volume is its ability to address both caregivers and those in need of support, fellowship and aid to improve quality of life,” Robert J. Wicks, the author of many books about resilience, writes about this new book. “You will be so much better prepared to live a full life more sagely and enjoyably with less unnecessary worry, and guide others in the process as well.”