Hearing management

16 September 2020

Hearing persists at end of life, brain waves of hospice patients show

A study found that auditory responses of dying patients were similar to those of healthy people – even hours before death.

  • In their last hours, many people become unresponsive
  • However, EEG data indicated that their awareness of sounds was similar to healthy people
  • This suggests that they may still be aware of the presence of their loved ones, even though they seem unconscious  

Even if they appear unresponsive, dying people may still be able to hear.

That's the takeaway from a Canadian analysis of hospice patients in Vancouver.

Researchers compared electroencephalography (EEG) data – a measure of electrical activity in the brain – collected when patients were conscious and when they became unresponsive at the end of life. Those patients were compared to a healthy control group.

The study looked at brain response to various patterns of common and rare sounds that changed frequency, and found that responses of some of the dying patients were similar to those of healthy people – even hours before death.

Dying brain can respond to sound

"In the last hours before an expected natural death, many people enter a period of unresponsiveness," said lead author Elizabeth Blundon, a doctoral student in psychology at the University of British Columbia at the time of the study.

"Our data shows that a dying brain can respond to sound, even in an unconscious state, up to the last hours of life," she said in a university news release.

Co-author Lawrence Ward, a professor of psychology, said researchers were able to identify specific mental processes in both groups of participants.

"We had to look very carefully at the individual control participants' data, to see if each one of them showed a particular type of brain response before we felt confident that the unresponsive patient's brain reacted similarly," he said in the release.

The findings were recently published in the journal Scientific Reports.

Being present is meaningful

"This research gives credence to the fact that hospice nurses and physicians noticed that the sounds of loved ones helped comfort people when they were dying," said study co-author Dr Romayne Gallagher, a now-retired palliative care physician at St. John Hospice in Vancouver.

"And to me, it adds significant meaning to the last days and hours of life and shows that being present, in person or by phone, is meaningful," she said. "It is a comfort to be able to say goodbye and express love."

While the evidence of brain activity supports the idea that dying people might hear, it's not known if they're aware of what they're hearing, Blundon noted.

"Their brains responded to the auditory stimuli, but we can't possibly know if they're remembering, identifying voices, or understanding language," she said. "There are all these other questions that have yet to be answered. This first glimpse supports the idea that we have to keep talking to people when they are dying because something is happening in their brain."

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Ask the Expert

Hearing Expert

Minette Lister graduated with a Bachelor of Communication Pathology (Audiology) from the University of KwaZulu-Natal, Westville in 2015. Thereafter, she completed her compulsory year of community service at Phoenix Assessment and Therapy Centre in Durban. In 2017, Minette started working for Thompson and Hoffman Audiology Inc. She is passionate about working with children and adults to diagnose and manage hearing loss using state of the art technology. Minette offers hearing screening programmes for newborn and high-risk babies, as well as school-aged children, in order to decrease the incidence of late or unidentified hearing loss.

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