A Musical Response for When a Senior Says, “I Just Want to Die”

I just read an article on how a caregiver can respond to a senior who is saying, “I just want to die.” I appreciate the advice given by Margaret Sherlock, M.A., Clinical Director of the Behavioral Health Program & Assessment Program Services at the Visiting Nurse Service of New York, which includes not ignoring the statements and being realistic about a senior’s need to talk about death and dying, while still setting limits on such heavy discussions and monitoring for signs of clinical depression in both the senior and in yourself. You can read all of her advice here.

This is sound advice, but I do think there is one important piece missing: you must think about how to deal with all of the emotions you and your loved one are both feeling. In fact, this kind of conversation can be so emotional for both the senior and the caregiver that it can be difficult to tell who is feeling what. You might think, is this person feeling depressed? Or is he just ready to die? Or is this person saying she wants to die because she wants to make me upset or get more attention from me? Or am I interpreting all of this wrong because I am the one who is feeling sad, or tired, or frustrated? Or maybe it’s a mixture of all of the above feelings, and I’m not really sure how to put words to it?

Even just trying to identify these feelings is difficult. No wonder these emotional conversations can wear you out! As Ms. Sherlock advised, though, you can’t just sweep the difficult feelings under the rug: they’ll just build up and create bigger problems for you and the senior later on. That’s why I’m usually not a fan of just changing the topic or putting on happy music to avoid the conversation.

When someone says, “I just want to die,” you need to acknowledge their emotional expression and honor your own.

A great way to do this is by allowing a song to be the container for that emotion. Musicians for generations have been putting these kinds of feelings into music, and you can let their songs hold your feelings, too. There are hundreds of songs that could work well as containers for difficult emotions. Here are some examples, with significant lyrics:

Fire And Rain – James Taylor (Folk/Rock)

“I’ve seen fire and I’ve seen rain
I’ve seen sunny days that I thought would never end
I’ve seen lonely times when I could not find a friend
But I always thought that I’d see you again”

Help Me Make It Through The Night – Kris Kristofferson (Country Ballad)

“Yesterday is dead and gone
And tomorrow’s out of sight.
Lord, it’s bad to be alone.
Help me make it through the night.”

Peace In The Valley – Thomas Dorsey (Gospel)

“There will be peace in the valley for me, some day
There will be peace in the valley for me, oh Lord I pray
There’ll be no sadness, no sorrow
No trouble, trouble I see
There will be peace in the valley for me, for me”

I’ll Be Seeing You – Sammy Fain/Irving Kahal (Jazz Standard)

“I’ll be seeing you
In all the old familiar places
That this heart of mine embraces
All day through”

Each of these songs addresses loss and end of life in a different way, with a focus on a different emotional aspect, but each one can be a container for the difficult emotions that might otherwise be suppressed or allowed to overflow in a way that is unhealthy for you and for your relationship with the senior.

If you want a song to be part of the conversation about death and dying, consider these ideas:

  • Choose a song that expresses how you feel, how you imagine your loved one might feel, or both.
  • Introduce the song, maybe by saying why you chose it. For example, say, “Grandma, I heard this song and I wondered if you feel the same way that this singer does.” Or just, “Dad, I want to listen to this song with you.”
  • Listen actively, paying attention to the senior’s reactions as well as your own. If something feels off or totally uncomfortable, it’s okay to stop the music.
  • Talk about the song afterwards. Identify how you thought certain feelings or ideas in the song matched your own.
  • Or, don’t talk about the song afterwards. Sometimes, the song can hold all of the feelings and ideas, and when it’s over, you can move on.

It’s important to have conversations about death, but when words aren’t working, you just might be able to meet your loved one in a song.

This is a musical experience that you can use on your own with your favorite senior, but there are times when music therapists or other mental health professionals might be needed. Here are my words of caution: 

  • Music can bring up very strong emotions, sometimes in ways that surprise you. Please know that you can contact a music therapist or another health care professional to help you work through these feelings in a way that will bring about better health for you and your favorite senior.
  • Use caution with seniors who have dementia. Sharing songs can be a great way to validate the underlying emotions for a person who has dementia, but attempting to talk about the song and death and dying issues may be confusing and agitating to the person with dementia. A music therapist can help you navigate this in a way that is emotionally-validating but not confusing.
  • Talking about the end of life as an approaching reality is different than contemplating suicide. If your loved one is suicidal or you’re just not sure what they are thinking, contact a mental health professional.

Have you ever allowed a song to be a container for difficult feelings? What songs would work for you and your loved ones? Please share your experiences in the comments section below.

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26 thoughts on “A Musical Response for When a Senior Says, “I Just Want to Die”

  1. Faith Halverson-Ramos says:

    Some other songs that I use as “emotional containers” in my hospice work are: “One Day at a Time,” “Wings of a Dove,” and “I’m So Lonesome I Could Cry.”

    Personally, I like to use songs that validate a person’s difficult emotions, yet also contain lyrics that offer some additional reassurance or hope. Because if that person doesn’t want to (or isn’t able to) verbally process their emotional experience of the music, I don’t want them to feel like they’re being left in this dark place, and sometimes it’s difficult to know how to do that effectively by segueing into a different song.

    On the other hand, sometimes just being a present witness to their feelings, like you wrote above, can be beneficial in allowing someone to know that they aren’t alone in having to hold those emotions.

    Actually, now that I think about it more, even the universal “You Are My Sunshine” contains lyrics that express longing and a fear of loss…

    • soundscapemusictherapy says:

      Faith, you make an excellent point. I do try to choose songs that leave room for hope or reassurance (which is why I rarely choose “I’m So Lonesome I Could Cry.”) That makes this experience more accessible for people who aren’t therapists, too. Thank you!

      P.S. The other songs you mentioned are all great examples for this purpose, too.

      • Faith Halverson-Ramos says:

        Yes, “I’m So Lonesome I Could Cry” is one I use sparingly as well. (Even though I love singing it for my own plaintive pleasure!)

        As you also wrote about actively listening, sometimes I have to check in with myself to see if the discomfort I may be feeling in that moment is my own or the patient. You know, is it my unwillingness to “go there” or the patient’s?

        Such an interesting dynamic interplay. Seriously, I think we’ve got the best jobs in the world. 🙂

      • soundscapemusictherapy says:

        That is an interesting aspect, monitoring our own feelings when listening to a song with a client. Caregivers can (and should) check in with themselves, too, and try to answer some of those questions about why their loved one is saying what they are saying.

        And yes, we do have the best jobs in the world! 🙂

  2. Laura Cousins says:

    An excellent post – one that, to my mind, explains the whole reason behind using music as a therapy. Speech may be the language of thought, but music is the language of emotion.

  3. cfukushima says:

    Rachelle,

    An excellent post addressing a very difficult and emotional subject. Your point is very well articulated as many of us in the health care profession forget the power of music. I have seen music have a powerful effect on both provider and patient alike. For me personally, certain songs immediately take me back to a time in my life and brings alive emotions and memories in a way that no other medium can.

    A song that contains some very powerful lyrics is “Goodnight” written by Scott Alan and performed by Liz Callaway. I play it on occasion and it fills me with memories of three very dear friends that I have lost.

    Thanks again for your timely thoughts.

    • soundscapemusictherapy says:

      Hi Craig,

      Thank you so much for your feedback! You’re right – music can bring back memories and emotions that other media cannot.

      I’ll have to check out the song “Goodnight.” I’m glad that you can use that song to remember your friends.

  4. Ann Becker-Schutte (@DrBeckerSchutte) says:

    Rachelle,

    This is a subject near and dear to my heart. I really like the idea of using music as a frame for both the older person and their caregiver. Conversations about dying are important, and can be really rewarding for both parties, but they are also tough. I’m a huge fan of any tool that makes it a bit easier. And I appreciated your reminder that it’s okay to get extra help–for the caregiver or the elderly person–if the emotions get too intense.

    Warmly,
    Ann

    • soundscapemusictherapy says:

      Ann,

      I really appreciate your feedback! Yes, we have so many musical tools that folks can use, even without the intervention of a music therapist. The structure of a song – the frame or the container – really does help to create a safe space for a tough conversation.

  5. Stephanie says:

    This was a wonderful article! I’ve never had a client say this to me, but your thoughts apply perfectly to the work I do with clients who have aphasia as a result of a stroke. Music is such a powerful tool to work on language while also providing opportunities to acknowledge the incredible sense of loss many people (and their caregivers) feel post-stroke. I definitely think it’s very important to leave room for hope in the music, as several people said before. Thanks for the insight!

    • soundscapemusictherapy says:

      Thanks for your insight, too, Stephanie! I know that choosing a song to listen to can be a way to communicate to a loved one when speech isn’t available due to aphasia, and I know the loss many people feel after a stroke is profound. That’s another great application of active listening for caregivers!

  6. Karen Hensel says:

    My husband, John, liked the Beatles and we listened to “In My Life” several times while he was in hospice care. He really liked the message of that song.

  7. Janea says:

    When My dad died Allison Krauss’ “A Hundred Miles or More” meant so much to me. My Dad couldn’t talk because he had a brain injury (tumor) but that song felt like his good-bye to us. I played it over and over again and it helped me move through the grief. Some of the lyrics are “Baby, dry your eyes. There’s no need to cry. I’ll be seeing you again. Until then, you must understand, I am just a way down the river, a hundred miles or more. Crossing over Jordan to the other shore. I’ll be standing waiting with those who’ve gone before. I am just a way down the river a hundred miles or more.” I also love Hilary Weeks “Just Let me Cry” which speaks to the loss of a loved one. Both songs were great containers for the feelings that emerged from that loss. Thanks for the post!

    • soundscapemusictherapy says:

      Hi Janea,

      Thank you so much for sharing those songs. I’m glad that these songs helped you to get through such a difficult time in your life. I hope your suggestions will be able to help others, too!

  8. Carolyn Stone says:

    Rachelle,
    The way you describe this is so helpful. I imagine listening to one of the songs you recommend in this situation being so validating to elder and caregiver. These interactions are so hard, but to avoid them robs the elder and the caregiver of richness in the relationship.
    Thanks.
    Carolyn

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