Songs in the key of Life

by Dr Oliver Minton @drol007
and Dr Mark Taubert @DrMarkTaubert



Artistic imagery to depict palliative care was the focus of a recent mysterious blog on the BMJ SPCare blog site, and generated much discussion on social media.  The theme of this week’s blog is music. A recent music and memory series on BBC Radio 3 reminded us of the link between music and our past experiences. A weekend of broadcasts from the Wellcome Collection in London  included the themes of music and memory, and how the former stimulates us to recall life events and experiences. There is a phenomenon called the ‘reminiscence bump’, where a previous generation will pass on a song to the next. An example: for fans of the Zeitgeist of the 1980’s, enjoyment may be had from watching Top of the Pops re-runs on BBC Four (hashtag #TOTP if you ever want to join the musings on Twitter on a Friday night).

Musical memory is also a core theme in radio features that encourage reflection on the past. Examples include the BBC’s  Desert Island Discs (where celebrities chose the music they would take a long to a desert island) or the Inheritance Tracks on BBC Saturday Live . One of the authors (OM) used to create genius mix tapes (they were the BEST, especially the one where he recorded the same Bros song three times in a row, so you didn’t have to hit rewind repeatedly). All this can now of course be done virtually through your choice of streaming service playlists.

What has this got to do with palliative and end of life care, we hear you ask? Music at the end of life and certainly funeral music choices are being increasingly discussed and seem to excite the popular media. The top 10 funeral songs contain some familiar tunes, although choices may have become more secular compared to previous years. The songs considered ‘appropriate’ for mourning still divide people, but it is certainly a conversation starter for that tricky Sunday lunch chat about whether Uncle Albert would want a cremation or a burial. Brahms or Bros at the end?

We have observed many patients, families and friends selecting music on their smartphone or tablet to play in the hospital or hospice room. In our experience, the tunes chosen in that sort of situation are often classical music, and also a lot of acoustic guitar ballads, but of course this will vary. It may be worth us all one day writing down the choices we’ve heard our hospital, community and hospice patients make, to see if there are themes. #SongsInTheKeyOfDeath perhaps?

If you have not seen it yet, consider looking at Playlist for Life, which aims to evoke certain memories, emotions and responses in its listeners. It is an app designed to stimulate memories in patients with dementia to achieve that “flashback feeling”. We’re not sure which member of the multidisciplinary team will volunteer to become musical detective for each specific patient, but current and future technology will surely allow for a familiar playlist to gently accompany someone in the last days of life. You may hear a patient’s relative or friend ask: “Are we ok to play her favourite Youtube Playlist in her hospice room?”.

Years ago, a palliative drugs bulletin board discussion focused in detail on the presence of certain types of music in the room, and how it was almost pathognomonic of dying. And perhaps as prognostically accurate as Oscar the cat.

Perhaps gone are the days of rainforest sounds, bagpipes or whale music, giving way to a more bespoke way of introducing music into end of life care. #TOTP for the hospice, anyone?

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