Hearing is the last sense to fade in people before they die. With that in mind, researchers and clinicians encourage us to talk lovingly to our friends and family members in the final stages of their life.

A University of British Columbia study measured electrical activity in the brains of healthy control patients, hospice patients when conscious, and the same hospice patients when they became unresponsive.

The important findings, along with observations of long-time palliative care doctors and nurses, show:

• Brain activity supports the notion that a dying patient can hear.

• Even if awareness of sound cannot be communicated due to loss of motor responses, the value of verbal interactions is measurable and positive.

• Patients appear comforted by the sounds of their loved ones (in person and on the phone).

“In the last hours before an expected natural death, many people enter a period of unresponsiveness,” study lead author Elizabeth Blundon said.

“Our data shows that a dying brain can respond to sound, even in an unconscious state, up to the last hours of life.”

A carer told HelloCare how she looked after German woman name Greta at the end of life:

“When I greeted her, I would say, ‘Ich liebe dich, mein schöner Freund’, which translates to ‘I love you, my beautiful friend’. Her eyes would light up, reaching her arms out for a hug and repeating the phrase several times...

“A few nights back, I was sitting by her bedside, holding her hand, whispering, ‘Ich liebe dich, mein schöner Freund’. Her eyes opened, looking at me and giving me the biggest smile before falling asleep again.

“The scent of lavender filled the air with soft warmth, and lights were dimmed, with the melodic sound of Tyrolean folk music playing all around Greta. Even though she had no more words to give, I could see the look in her eyes that she heard me and was aware of the act of kindness and love.

“Greta passed away peacefully during the night with the vision of her beautiful family and the Fatherland on her mind.

“It is so important to talk to our loved ones in the final stages of their life, sending them off with love and joyful sounds.”

When a patient chooses to die comfortably at home under palliative care, how can you, as the primary caregiver, use this knowledge to provide meaningful final days?

A family in the United States who were confronted with this situation shared this experience: “The hospice nurse told us to keep talking to my brother even though he was not responsive.

“When his daughter in Australia called, we put the call on speaker. She told him she loved him and then sang a little song they shared when she was a child.

“He raised his eyebrow and twitched his lip, ever so slightly,” he said. “We all cried. He had heard her! This tiny act gave us all so much joy; he knew we loved him right until the end.”

Tips for communicating when a patient can’t respond include:

• Continue talking to them in a conversational way. Express your love for them. Share favourite memories.

• Touch them when you talk to them. Speak clearly and with enough volume yet use a gentle tone.

• Read to them. Consider reading notes from loved ones, religious texts, poems, or passages from their favourite books.

• Sing or play comforting music that is familiar and meaningful to them.

• Accept phone calls from far-away loved ones and let them briefly talk to them via speaker phone.

• Be willing to say goodbye and give them permission to do the same, releasing them from the guilt of “leaving you behind”. Say things like, “We love you and want you to know it’s okay to go when you are ready. You can be free of pain. We have had a wonderful life together.” 

• It’s normal and healthy to let your tears and emotions show; it communicates your love for them.

• Never say things that you do not intend for the dying person to hear, including scary health updates or stressful news. Talk about those topics outside of their room. Instruct others to do the same.

• Eliminate background noise such as televisions or side conversations.

Related reading: Heart to Heart Hospice, HelloCare