There are times near the end of life when words become difficult. A person might be tired or have less energy for conversation. Illness can affect speech and concentration, while dementia or other cognitive changes can make it harder to find words, follow a conversation, or connect the present moment with the past. Sometimes a person simply reaches a point when talking requires more than they have to give.
Yet the need for connection doesn't disappear when conversation becomes harder. We still want to communicate love, reassurance, companionship, gratitude, or simply the message that someone is not alone. Sometimes another way of connecting begins with a song.
A few familiar notes can bring a smile or a change in expression. Someone who has been quiet might begin tapping a finger or humming. A hymn can evoke years of Sunday mornings; a love song can bring a spouse who died decades ago suddenly close in memory. A song from adolescence can carry echoes of friends, dancing, driving, protest, first love, heartbreak, or simply the person someone was becoming.
Music doesn't need to produce a dramatic response to matter. Its value isn't measured by whether someone suddenly remembers a name, sings every lyric, or has a movie-worthy moment of recognition. Sometimes music simply gives us another way to be together when conversation is no longer what it once was.
🎶 Music as Part of Our Life Story
Most of us have a kind of musical autobiography, even if we've never thought about it that way. Our lives collect music along with photographs, stories, possessions, relationships, and memories.
Think about the songs our parents played when we were children and the music we discovered when we were old enough to choose for ourselves. There are songs connected with falling in love, breaking up, getting married, raising children, working, traveling, worshiping, protesting, celebrating, grieving, or beginning again. Music also becomes associated with places: a childhood kitchen, a first apartment, a favorite bar, a church sanctuary, a dance floor, or a road traveled every summer on family vacation.
Research on music-evoked autobiographical memory helps us understand why some of these musical connections can be so powerful. Music can act as a cue for memories from our own lives, and familiar music appears particularly likely to evoke autobiographical memories. Music from adolescence and early adulthood can be particularly evocative as well. Memory researchers sometimes describe a reminiscence bump, in which memories from formative periods of life—often roughly ages 10 to 30—remain markedly prominent. Research specifically examining music has also found that songs associated with this period can be particularly powerful memory cues.
That gives families and caregivers an interesting place to begin. Instead of asking only, What is their favorite song?, we might ask, What did this person listen to when they were becoming themselves?
The answer could be a church hymn or gospel song. It could be Motown, mariachi, opera, jazz, country, disco, punk, Broadway musicals, the Grateful Dead, or a song everyone in the family groans about because Dad played it approximately four thousand times on road trips.
And that’s part of the point. The music belongs to the person.
🌿When Memory Begins to Change
Music can take on particular significance when someone is living with dementia or other cognitive changes. A systematic review of music-evoked autobiographical memory found that music can evoke autobiographical memories in several clinical populations and that these memories appear to be relatively well preserved in people with Alzheimer's disease. Other research has found that songs from the formative years can sometimes be remarkably effective memory cues for people with Alzheimer's.
The word sometimes matters.
We've probably all encountered videos in which someone with advanced dementia hears a familiar song and suddenly seems to "come back." Those moments can be moving, particularly for families who have watched someone's ability to communicate change over time. But they can also create an unrealistic expectation that the right piece of music will somehow unlock the person we remember.
One person might sing every word to a song while being unable to tell us what they ate for breakfast. Another could smile, close their eyes, tap a foot, or turn toward the sound. Someone else becomes calmer, while another person shows no outward response we can easily recognize. There isn't one correct or expected reaction.
We should be careful about describing music as proving that someone is "still in there." A person living with dementia hasn’t ceased to be a person and doesn't need to demonstrate recognition, memory, or responsiveness to establish their personhood. Music isn't a test we administer to see how much of someone remains.
Instead, music offers one more way of meeting someone where they are now. We can offer something familiar, pay attention to the response, and allow that response—or lack of one—to guide what happens next.
🌿When Words Are Hard
At the end of life, families can feel tremendous pressure to find the right words. We want to make sure we've said what matters. We might want to express love, gratitude, forgiveness, regret, reassurance, or goodbye. There can be a sense that time is running out and something important remains unsaid.
Sometimes those conversations happen, and they can be deeply meaningful. Sometimes they don't. The dying person might not want the conversation we have imagined or no longer have the energy or ability to participate in it. Some relationships also hold histories that words cannot neatly resolve.
Music can offer another language without requiring us to pretend that it solves what words cannot. You could sit beside someone and listen to a song you both love. A family might sing a familiar hymn together. Someone could hum quietly while providing care or hold a hand while a favorite album plays. A person who can no longer sustain a conversation might still seem to enjoy a rhythm, melody, or familiar voice.
None of this requires the dying person to perform a response for us. Companioning someone at the end of life isn't about continually asking them to demonstrate that they're present with us. Sometimes our work is simply to be present with them, and music can help create a space in which nothing else is required.
🎵 Music as Ritual
Music has accompanied human transitions for a very long time. We sing at weddings and funerals. We sing lullabies at the beginning of life and hymns near its end. Music accompanies worship, protest, celebration, mourning, storytelling, and remembrance. It helps communities mark moments that feel too large for ordinary speech.
At the bedside, music can become a kind of ritual even when no formal ritual has been planned. A family could play the song their parents danced to at their wedding. Someone might sing the hymn a grandmother taught them as a child. A friend could bring music from a concert they attended together forty years earlier. Children and grandchildren might create a playlist that traces different periods of someone's life.
Sometimes the music is sacred in a traditional religious sense. A prayer, chant, hymn, or piece of sacred music can connect a person with beliefs and practices that have accompanied them throughout their life. For someone else, the sacredness comes not from a religious tradition but from the relationship and memories held by the song.
In either case, music can carry things we struggle to express directly. It can say I remember you. I remember us. I am here with you. Your life matters to me. Near the very end, it can sometimes help carry another message as well: You can go. We will miss you, we will be okay, and we will carry you with us.
That doesn't mean every bedside needs a soundtrack or that music automatically turns dying into a sacred moment. Ritual is meaningful because of the people involved, not because we have successfully assembled the correct ingredients. A familiar song offered with attention can be meaningful, and so can turning it off.
🎵 Music Can Hold More Than Comfort
When we picture music at the end of life, it's easy to imagine something gentle and soothing playing quietly in the background. That might be exactly what someone wants. It also could bear absolutely no resemblance to the music that person has loved throughout their life.
People don't stop being themselves because they're dying. Someone who spent a lifetime loving loud rock music doesn't necessarily develop an interest in soft piano. The person who loved dancing might still want dancing music. Someone whose humor was gloriously irreverent can still enjoy the song that always made everyone laugh. A lifelong opera lover might want opera, while someone who has never willingly listened to classical music probably doesn't need it imposed on them now because it seems suitably dignified.
The same is true of religious music. Someone who has found comfort in hymns, chants, gospel music, or other sacred traditions might want those sounds nearby. Someone who has spent a lifetime wrestling with religion might not. We shouldn't assume that approaching death changes a person's spiritual identity, or gives us permission to choose one for them.
Music at the end of life can carry much more than comfort. It can hold lament, anger, longing, joy, defiance, sensuality, humor, faith, doubt, gratitude, belonging, and love. Sometimes a single song holds several of those things at once.
So rather than asking, What music is appropriate for dying?, a more person-centered question is: What music belongs to this person?
💛 Music, Grief, and the People Around the Bed
Music at the end of life isn't experienced only by the person who is dying. The people around the bed are listening, too.
A song can bring family members back to another time in their shared lives. Adult children might suddenly remember their parent dancing in the kitchen. A spouse hears the song that played at their wedding. A friend remembers a concert, a road trip, or an ordinary afternoon that didn't seem important when it happened.
These memories can bring comfort, but they can also bring grief very close. Sometimes the people around the bed cry when the dying person doesn't. Sometimes they laugh. A song can open a story: Do you remember when she used to...? In that way, music can begin the work of remembrance even before a death has occurred.
That doesn't make the bedside gathering about the family rather than the dying person. It simply recognizes that dying takes place within relationships. The people who love someone are also experiencing a transition, and music can give them a way to express what is difficult to put into words.
It can also become part of what they carry afterward. A song heard repeatedly during someone's final days might forever become connected with that period of life. For some people that connection becomes precious. For others, the song can be difficult to hear for a long time. Both responses make sense.
✨ Music Can Also Hurt
The connection between music and memory has another side. If a song can bring back a cherished memory, it can also bring back a painful one. Music can be associated with trauma, abuse, military service, the death of another person, a difficult religious experience, a relationship that ended badly, or a period of life someone doesn't want to revisit.
Even a beloved song can become overwhelming when someone is very ill, frightened, exhausted, or experiencing changes in sensory processing. This is one reason personalized music is different from simply turning on a playlist labeled "relaxing music." What sounds peaceful to us might not feel peaceful to the person hearing it, and familiarity itself doesn't guarantee comfort. Guidance from the Alzheimer's Society on music and difficult memories also reminds caregivers that familiar music can sometimes evoke traumatic or distressing memories.
Whenever possible, ask the person. If someone can tell us what they want, their preference should guide us rather than our ideas about what ought to be helpful.
When someone can no longer tell us easily, we can watch. Does their face soften or tighten? Does their breathing seem easier or more strained? Do they hum, tap, move toward the music, or settle into the bed? Do they become restless, grimace, pull away, or seem increasingly agitated?
We don't need to interpret every movement as a message, but we can remain attentive. If the music seems unwelcome, we can lower it, change it, or turn it off.
🎶 When Silence Is Music Someone Needs
Silence deserves as much respect as music.
Near the end of life, a person's tolerance for sound can change. Illness, medication, fatigue, pain, delirium, dementia, or simply the work of dying can make stimulation exhausting. A television playing, several people talking, medical equipment sounding, phones chiming, and music in the background can create an environment that feels very different from the peaceful bedside the family imagines. Even favorite music can eventually become too much.
Silence isn't a failure to create atmosphere, and it isn't an empty space we're obligated to fill. Quiet can allow someone to sleep, rest, hear the voice of someone sitting close by, or simply be without another demand for their attention.
Silence can be uncomfortable for those of us sitting beside a dying person. Without conversation, television, or music, we become more aware of what’s happening. We hear the breathing. We notice the pauses. We recognize that there might be nothing left for us to fix.
That discomfort can make us reach for music because we need something to do with the silence. There’s nothing wrong with acknowledging that. Families and caregivers have needs, too, and music can genuinely help them remain present, but it's worth asking whose need the music is meeting.
The goal isn't to create a meaningful moment. The goal is to accompany the person who is there. Sometimes that means music, sometimes conversation or prayer, sometimes holding a hand, and sometimes sitting together quietly.
💭 Creating a Music and Memory List Before You Need It
One of the gifts we can give the people who might someday care for us is information about what matters to us.
Advance-care planning understandably focuses on medical decisions. We can document who should make decisions for us, what kinds of treatments we would or wouldn't want, and where we hope to receive care. Those decisions matter enormously.
But end-of-life planning can also include information about who we are.
What helps you feel safe? Who do you want nearby? Are there spiritual or religious practices that matter to you? What brings comfort when you're frightened or in pain? What parts of your daily life would you want people to preserve for as long as possible?
Music belongs as part of that conversation.
Instead of creating a playlist of just favorite songs, think about the different roles music has played throughout your life. What did you hear as a child? What did you discover as a teenager or young adult? What music relates to people you love, places you've lived, or communities to which you've belonged? What makes you laugh? What helps when you're frightened, lonely, angry, or sad? Is there music connected with your faith or spiritual life? What music makes you feel most like yourself?
Then think specifically about serious illness and the end of life. Are there songs you imagine wanting nearby? Would you want music playing frequently, occasionally, or only when you request it? Would you rather have someone sing to you than hear a recording? Would live instrumental music feel comforting or intrusive?
And just as importantly, what don't you want played?
Don't assume your family and/or friends will know. The song everyone associates with you could carry a meaning they don't know about. Your favorite song might not be something you want to hear while dying. A religious song that comforts another person could make you uncomfortable. Or perhaps the music everyone assumes would be completely inappropriate for an end-of-life bedside is exactly what you want.
Recording those preferences is a small way of preserving your voice for a time when speaking for yourself becomes more difficult.
🌿 My Music & Memory List
I've created a free companion worksheet to help you begin recording the music that has shaped your life, the songs you might want during serious illness or at the end of life, and the music you would rather not hear. There’s also space to leave guidance for the people caring for you if you can no longer easily tell them whether the music is helping.
Download the free My Music & Memory List
🌿 A Playlist Is a Starting Point, Not a Prescription
There’s one more thing worth remembering if you create a music list ahead of time: you are allowed to change your mind.
The person you are when you make an advance-care plan is trying to help the person you could someday become. That's valuable, but a written preference shouldn't override the person who is actually present.
Perhaps you put a beloved album on your list ten years earlier, but when someone plays it during your illness, you grimace and turn away. Turn it off. Perhaps you wrote that you didn't care for hymns but unexpectedly seem soothed when someone quietly sings one you knew as a child. Pay attention to the person, not merely the paperwork.
The list gives caregivers clues. It isn't a set of instructions they must follow regardless of what they observe. That distinction is important in all person-centered end-of-life care. Planning helps us communicate our values and preferences, but good companioning also asks us to remain responsive to what is happening now.
💛 When Professional Music Therapy Can Help
There’s also an important distinction between thoughtfully using music at the bedside and professional music therapy.
Families, friends, doulas, chaplains, nurses, and caregivers can play familiar music, sing together, make playlists, and use music as part of ritual and remembrance. Music therapy, however, is a clinical practice in which a credentialed professional uses music interventions within a therapeutic relationship toward individualized goals. Music therapists use approaches such as listening, singing, songwriting, music and imagery, improvisation, or music-assisted relaxation depending upon the individual and setting.
Music therapy is used in hospice and palliative-care settings, and a recent systematic review of music therapy and other complementary approaches in palliative care found promising evidence for some outcomes while also emphasizing limitations in the research base. That distinction is useful: music therapy can offer meaningful support without requiring us to promise a particular result.
If a hospice program offers music therapy, families can ask whether it would be appropriate for their situation. A music therapist can be particularly helpful when there are complex emotional, communication, cognitive, spiritual, or symptom-related needs. The American Music Therapy Association's information on music therapy in hospice care describes ways board-certified music therapists work with patients and families around areas such as life review, spiritual support, communication, social connection, and bereavement.
But music doesn't need to become therapy to have value. A daughter singing the song her mother sang to her as a child isn't administering an intervention. Two old friends listening to an album they loved at twenty aren't providing treatment. Sometimes they’re simply sharing music, and sometimes that is enough.
🎵 Music, Memory, and Being Known
At the end of life, attention understandably turns toward the body. There can be medications to manage, symptoms to watch, changes in breathing, eating and sleeping, equipment to understand, and decisions about comfort and care. These things matter.
But the person in the bed has a history far larger than the illness that brought them there.
They loved and argued, worked and rested, danced and worried, celebrated and grieved. They belonged to families, friendships, neighborhoods, workplaces, congregations, cultures, and communities. They have had private jokes and embarrassing favorites. They have probably loved some songs that everyone around them hated.
They have a soundtrack.
Knowing someone's music can therefore be another way of knowing the person. This was the song Mom sang while cooking. They played this every summer when we drove to the lake. This is the hymn Grandpa always requested. She danced to this song with her wife. This was the album he played when he needed to think. This song always made them laugh.
Those details aren't incidental to end-of-life care. They’re pieces of a full life.
Music can help us remember the whole person rather than allowing illness to become the person's final identity. It can create opportunities for connection, memory, ritual, grief, laughter, companionship, or rest. And when music isn't what the person needs, turning it off can be an equally attentive act of care.
Near the end of life, we won't always know what to say. We won't always know whether the person beside us can understand our words or respond in ways we recognize. We don't have to turn that uncertainty into something we can solve.
We can listen, notice, and remember. We can offer a song and see whether it’s welcomed or sit quietly when silence seems kinder. In either case, what we are communicating is much the same: I know something of who you are. I remember the life you have lived. And I am here with you.
🕯️Making Music Part of Your End-of-Life Plan
At Life & Death Services, end-of-life planning and doula support can include more than medical decisions and practical arrangements. We can also explore the people, practices, stories, rituals, music, and other pieces of life that help you feel most like yourself—and how you would like those things honored if you become seriously ill or approach the end of life. Preparing these pieces ahead of time can give the people who love you another way to know how to accompany you when you can no longer easily tell them yourself.
