Comforting Melodies

Johanna Guntner of Camarillo sleeps so soundly that her hospice nurse doesn’t wake her by checking her vital signs and rolling her over to look at her back.

But then the nurse, Cynthia Fiacco, begins singing the hymn “Shall We Gather at the River?” and the wisp of a woman slowly comes to life. Guntner’s mouth begins quivering and her eyes open slightly.

“We’ll . . . gather with the saints at the river that flows by the throne of God,” Fiacco sings in a strong soprano voice, laying her hand tenderly at the dying woman’s side.

At the end of the song, Guntner, an Alzheimer’s patient, mumbles something. Fiacco moves closer and asks her to repeat it.

“By the throne of God,” whispers the 96-year-old.

Fiacco knows she has reached her.

“That’s the only way I reach some of the patients, because they won’t speak to me,” she said.

Fiacco is one of a small but growing number of caregivers using music to soothe those facing death. Sound Covenant, a nonprofit organization started in Ojai two years ago, presents lectures to instruct church volunteers, hospice workers and medical personnel how to bring music to a patient’s bedside.

The Chalice of Repose Project in Montana offers a two-year graduate program that trains people to play harp at patients’ bedsides. And a similar Music for Healing and Transition program in New York certifies people to use a variety of live and recorded music.

Sound Covenant founder James Schaller, certified as a music practitioner by Music for Healing, lectured employees and volunteers at Livingston Memorial Visiting Nurse Assn. of Ventura and Camarillo Hospice a year ago. He moved his organization to Pennsylvania in October, but is set to return to Ventura County in July to provide additional training for Camarillo Hospice.

Despite such formal training, people like Fiacco are often guided only by their love of music and desire to help the dying. As a cantor at St. Maximilian Kolbe Catholic Church in Thousand Oaks, it seemed natural for Fiacco to incorporate music into her job with Assisted Home Hospice in Ventura.

Carole Wadsworth, director of counseling services at Camarillo Hospice, studied music therapy with her husband 20 years ago, when it was used primarily to connect with the emotionally disturbed.

Last year, at the request of her supervisor, the Wadsworths played the flute and guitar for a cancer patient who was in pain. Each week for three months until the woman died, the Wadsworths played a variety of Celtic, classical and pop music, including songs that sparked memories of happier times for the woman and her husband. The patient told Wadsworth the music eased her pain.

Schaller said research shows that music can reduce patients’ need for pain medication, a welcome benefit for people wanting to be as alert as possible during their final days. Studies also reveal that music can distract people from worry and relax them, lowering blood pressure and respiration rates and slowing the heartbeat, Schaller and Wadsworth said.

“It brings such great benefits and it’s noninvasive. It’s not a drug,” Schaller said.

Schaller and others tell of patients who seemed to be struggling to hang on to life for so long and then die soon after a musical session or two.

Patients facing death near the holidays often have a particularly hard time letting go, Fiacco said. So Fiacco sings Christmas songs and celebrates the holiday with them, even if the holiday is days or weeks away.

“To relax and let go they have this need to know it’s Christmas,” said Fiacco.

Fiacco of Camarillo believes singing is the only way she can connect with some of her patients. She couldn’t reach Guntner at all before an employee at Marriott Brighton Gardens of Camarillo told her that the woman responded to hearing hymns. Guntner hardly ever talks to her nurse, but she will sing to her, often in German.

“Some days she perks up so much she says, ‘Let’s go for a walk,’ and we walk to the piano and sing,” Fiacco said. “It’s just amazing.”

Different music reaches different patients. Fiacco said that while Guntner does not know where she is, she does remember the German version of “O Tannenbaum.” Church hymns are popular with many patients, probably because people have sung these songs since childhood and feel a particularly strong connection to them as they prepare to die, Fiacco said.

One of Fiacco’s patients enjoyed having her sing romantic Italian arias to him and his wife. Another patient insisted on Broadway show tunes. Another, battling depression, always requested “Bought Me a Cat,” complete with animal sounds.

“Some patients don’t want to be calmed down,” Fiacco said. “They want to be diverted from what’s happening in their lives.”

Some of Fiacco’s patients have asked friends to attend their mini-concerts. One woman invited her Bible study group to hear Fiacco sing and requested songs by pointing to a play list she had compiled for her nurse.

For other patients, the musical sessions are a private and tender time. One patient wrote a special song and sang it to the nurse.

“It’s very intimate when you sing with a patient who is dying,” Fiacco said.

The first patient Schaller played for was an acquaintance he had heard was suffering from a respiratory disease and living in a nursing home in Ojai. When Schaller arrived with his guitar, he thought he saw the fear of death in the elderly man’s eyes. As he played, it disappeared.

“He just sort of relaxed and leaned back in his bed. His breathing gradually got slower and easier. His face muscles relaxed,” Schaller said. “He talked a little, reminiscing.”

The man died a couple of days later.

“I just knew that my going at that point had made a very big difference,” Schaller said. “And at that point I was changed. I just had to continue doing this.”