Music and Dying

NY Times Journal of Medicine (December 30, 2015)
Songs of Transition by Jennifer Hollis

"I am a music thanatologist, trained to offer music in a prescriptive way, to create a calm space for dying patients and their families. I focus on the patient’s breath as I play the harp and sing. With this rhythm as my guide, music can echo and reflect the dying process. The patient leads the music vigil with his or her breath, right in the middle of the hum of machines, the trill of cellphones, and the voices and nose-blowing of family. It often feels to me as if the room becomes larger, warmed by music and filled with the courage of families preparing to say goodbye."

Also see: The Hospice Flute. and Death Music.

This is the ultimate low-tech, high-touch intervention.

Book:  Music at the End of Life: Easing the pain and preparing the passage. by Jennifer Hollis (2010)

On Dying Alone in Prison

The United States incarcerates the largest number of people in the world.  Many would not be imprisoned elsewhere.  They are largely disenfranchised people who cannot afford lawyers to plead their cases.  This moving essay addresses the plight of individuals dying in the prison system.

When Dying Alone in Prison Is Too Harsh a Sentence by Rachael Bedard, M.D.

Japanese Death Poems

Although the consciousness of death is, in most cultures, very much a part of life, this is perhaps nowhere more true than in Japan, where the approach of death has given rise to a centuries-old tradition of writing jisei, or the "death poem." Such a poem is often written in the very last moments of the poet's life.

on a journey, ill:
my dream goes wandering
over withered fields   (Basho)

illness lingers on and on
till over Basho’s withered fields,
the moon    (Gimei)

Approaching death Shisui students asked him to write a death poem. Shisui “grasped his brush, painted a circle, cast the brush aside and died”.  This symbol is known as the enso which is prominent in Zen Buddhism and indicates the emptiness of all things.

 

Long Term Care Insurance, Part II

Long-Term Care Insurance Can Be Costly but Effective NY Times, December 26, 2015

“Long-term care insurance isn’t for everybody, but it can be useful for people who are interested in preserving their estate for their heirs and for families determined to provide high-quality home care or a superior nursing home for aging loved ones."

This is a helpful article on a complicated subject.

Also see Long Term Care Insurance Part I.

How Milennials Die

Friend Request (2010)  by Daniela Lamas, M.D.

“In the middle of my intern year, I became Facebook friends with a young man who was dying in the intensive-care unit. An investment banker in his mid-20s, he thought he was healthy until a fluttering in his chest and swollen ankles took him to a doctor. Now he was in the I.C.U. with a rare cardiac condition.  And his laptop. That’s the first thing I noticed the morning a group of us stood outside his room on rounds. He was shocked by his internal defibrillator three times the night before — died, that is, three times before being brought back with jolts of electricity. And this young man with a steroid-swollen face was surfing the Internet.

“Are you on Facebook?” he asked me. “I’ll friend you, and you can see the pictures.”

Ghosts in the Machine

Social Media Has Changed the Way We Mourn

In an essay they contributed to the ‘‘Handbook of Death and Dying,’’ the sociologists Wood and Williamson observe that people in the developed world have managed to banish death from their everyday lives — no small feat. ‘‘In the United States and Western Europe, dying is now primarily a private and often technical affair, hidden behind the closed doors of the hospital, the mortuary and the funeral home,’’ they write.

Proof enough of the change in our culture is that Facebook and other social-­media platforms have introduced procedures for handling profiles after their owners die. Families may decide whether to preserve a loved one’s old accounts; if they do, the accounts become memorials, designated places to lay a digital bouquet.

End of Life Discussions

Though most patients wish to discuss end-of-life (EOL) issues, doctors are reluctant to conduct end-of-life conversations. Little is known about the barriers doctors face in conducting effective EOL conversations with diverse patients. This mixed methods study was undertaken to empirically identify barriers faced by doctors (if any) in conducting effective EOL conversations with diverse patients and to determine if the doctors’ age, gender, ethnicity and medical sub-specialty influenced the barriers reported.

No Easy Talk: A Mixed Methods Study of Doctor ReportedBarriers to Conducting Effective End-of-Life Conversations with DiversePatients is a recent article that addresses this subject.