End-of-life discussions benefit patients and caregivers
A study of 332 terminally ill cancer patients at the Dana-Farber Cancer Institute revealed that patients who said they did not discuss end-of-life issues received more aggressive medical care in their final week of life.

Such aggressive treatment was linked to lower quality of life for the patients and their caregivers, who also experienced feelings of regret and an increased risk of depression. Those who reported engaging in end-of-life discussions, on the other hand, were more likely to receive hospice services, and their loved ones reported a better quality of life during bereavement.

Doctor-patient discussions result in less aggressive treatment, lower costs
Meanwhile, the March 9 issue of the Archives of Internal Medicine included a report on a study of 603 terminally ill cancer patients, which was funded by the National Institute of Mental Health and the National Cancer Institute as part of the ongoing Coping With Cancer study.

According to the report, when doctors and patients talked about whether treatment should focus on prolonging life or controlling symptoms, patients were more likely to die at home and spend less time pursuing aggressive treatments. Researchers say these patients had a better quality of life and survived as long as those who did not discuss end-of-life options with their physicians.

The benefits of open communication between doctors and their dying patients include not only physical and emotional comfort, but also cost savings. The cost of providing health care in the last week of life was 36 percent lower for patients who reported having end-of-life discussions with their doctors, and researchers estimate that more than $76 million could be saved annually if just half of the people who die from cancer each year had those discussions with their physicians.

The timeless (but seemingly opposing) observations of both men continue to ring true in 21st century culture. Music arouses passion and awakens long-forgotten memories; leads soldiers into battle and celebrates their victories; whispers children to sleep at night and enlivens their play during the day. Nothing can rival music in its ability to capture the joys of new love – or the anguish of love lost.

Music and Grief
Music’s power to convey the full spectrum of emotions is a comfort to many people coping with bereavement following the death of a loved one. Perhaps a song will call to mind the person who died, or perhaps it will help the bereaved to express painful feelings when words simply fail. Some people may use music for meditation or relaxation as they try to cope with or take a break from the intense emotions of grief.

Joy Berger is a music therapist and the director of education and volunteers for Hosparus Inc., the community hospice of Louisville, Kentucky, southern Indiana and central Kentucky. In a recent lecture on Death, Dying and Bereavement, Berger spoke about the importance of music in bereavement.

In her address, Berger told her audience that music’s role in bereavement comes from the fact that music is “a universal language,” and that the music we listen to is “always autobiographical.” The unique memories evoked by certain songs help transform the “past into the present,” according Berger.

Quoted in Scientific American, renowned neurologist Oliver Sacks of Columbia University puts it another way: “(Music) really seems to be as important a part of human life and communication as language and gesture. . . It is a way of connecting one consciousness to another.”

And that communication and connectedness are the things that sustain bereaved listeners as they navigate through their grief.

The latter was the case for Kristy Davis and her dad. When Kristy’s terminally ill mother was discharged from the hospital and admitted to home hospice care, Kristy and her dad responded to the emotionally charged situation by staying busy. When the going got tough, they went shopping.

Shopping for an answer
Kristy’s dad purchased and upgraded gadgets and systems around the house to provide comfort and make life easier for his wife and her caregivers. When Kristy was besieged by feelings of sadness and helplessness over her mother’s suffering, she set up a laptop at her mom’s beside, “just in case she wanted to do any typing.”

In the days following her mother’s death, Kristy and her dad jumped into action planning the funeral. They purchased and configured components for their computer and sound systems, as well as an LCD projector to show the PowerPoint presentation created by Kristy’s sister for the funeral.

Even after the funeral, the shopping spree continued. Eventually Kristy realized that the buying and busy-ness were merely ways to avoid confronting the tremendous loss she and her father shared. When the money for electronic toys ran out, Kristy and her dad were forced to find another way to bond.

What now?
Their conversations were awkward, but they spent time together on long drives and over meals. Eventually they began to communicate via email, and they talked about the sorrow and loss they shared. Kristy’s dad, a retired Air Force colonel, was even able to tell his daughter of his enduring and unconditional love for her for the very first time.

The experience of Kristy and her dad isn’t unique – grief is hard work, and humans often rely on one or more defense mechanisms to help them get through. But in the end, as Kristy and her dad discovered, the only way out of grief is to go through it, and sharing helps to light the way.