Bringing love and attention to the final stages of life

When Winifred Rudd, age 98, began receiving hospice care from Gundersen’s Hospice and Palliative Care Program in February 2023, her daughter, Linda Schmitz, was unsure what to expect. Linda hoped her mother would find some physical relief from the back pain that seemed to be getting progressively worse, but she was concerned about Winifred’s emotional well-being, too.

Later that month, Winifred was visited by Tracy Mangold, a certified music practitioner (CMP), and some of Linda’s worry was eased. 

“It was easy to see the joy in mom’s eyes as she clapped and sang along with the music,” remembers Linda. “Seeing that spark—knowing mom could still have moments of joy even in such a hard time—brought such comfort.”

Thanks in part to support from Gundersen Medical Foundation, Gundersen’s Hospice & Palliative Care Program has been able to offer therapeutic music to patients receiving hospice care like Winifred since 2022. These programs speak to Gundersen’s commitment to providing high-quality, compassionate care through the final phase of life.

“Gifts from our donors make it possible for the Foundation to support care initiatives at Gundersen that go above and beyond what most healthcare organizations offer,” explains Mandy Richardson, MPH, CFRE, director of Philanthropy in the Foundation. “Being able to add an extra level of compassion to the care already provided to hospice patients and their families is a perfect example of what Gundersen calls Love + Medicine.”

Providing love through music in Hospice & Palliative Care

Tracy Mangold and Charlene Elderkin became certified music practitioners in 2018 after completing the same Music for Healing and Transition Program. Charlene came from a musical family and has played instruments since she was 10 years old. When she decided to become a therapeutic musician, she also learned to play the harp. In addition to playing the harp, she is a certified vocalist. Tracy, who also came from a musical family and considers music an important part of her life, is certified as a vocalist and guitarist.

Regardless of their choice of musical instruments, both Tracy and Charlene are dedicated to adapting each session to meet each patient’s needs. Once a hospice nurse or doctor recognizes that a patient may benefit from therapeutic music, a referral is made. Then, one of the music practitioners will meet with the patient wherever the patient is receiving care—either in-home or at a care facility—to determine the patient’s interest and needs.

The sessions are patient-driven and completely individualized, which means the benefits can also vary. Some patients, like Winifred, find joy in music that can bring back memories and uplift their spirits. In some cases, family members who are present may be invited to join in, and the session can become a mixture of music and conversation with patients enjoying an opportunity to reflect or reminisce. In other sessions, Tracy or Charlene work one-on-one with patients, using music to promote relaxation and deep breathing.

“We come to each session with a plan, but we are constantly assessing and adjusting,” explains Tracy. “We watch closely to see how each patient responds, adapting elements like tempo or volume, to give each person what they need on any given day.”

While the physical, mental and emotional benefits of therapeutic music are well-established, Tracy and Charlene share that their visits often have a simpler, more profound impact. “It’s easy for a patient receiving end-of-life care to feel consumed by their medical situation,” explains Charlene. “But when we visit, they don’t have to talk about their condition or disease. They are just a person—a human who is worthy of love and attention. Our goal is to increase their quality of life, to give them love through music.”

The healing power of touch in the final stages of life

Soon after Gundersen added therapeutic music services, the option for massage therapy was added as well. Jennifer Vogel, licensed massage therapist (LMT), has been providing compassionate care to Gundersen patients receiving hospice care since March 2023.

In 2015, Jennifer attended an end-of-life doula training in Colorado; this experience helped her realize she wanted to support patients who were transitioning, so she earned a degree in massage therapy from Minnesota State College Southeast in Winona, Minn., and also received training in “healing touch,” a form of energy therapy.

“The end-of-life journey can be tumultuous,” says Jennifer, “but a calming presence with a soothing touch can make a profound impact on a patient’s physical and mental well-being, which also brings comfort to the patient’s family members.”

Just like therapeutic music, Jennifer’s relationship with a patient usually begins when a member of a patient’s hospice team sees a potential benefit and makes a referral. Jennifer meets with each patient to learn about their preferences and needs, so a relationship and a personalized plan can be developed.

Chelsea Rehman, RN, Hospice care coordinator, has made many such referrals because she has seen the value for patients. “Touch makes a world of difference to our patients, and to have someone with skilled hands who can help patients relax is so powerful,” she says.

According to Jennifer, some patients will benefit from a soft or moderate level of massage, which can ease muscle tension, contribute to pain relief or improve joint stiffness and mobility. Other patients experience a boost to their mental health through massage or healing touch, which can ease anxiety and promote better sleep. “Whatever the session looks like, there is something simple and beautiful about being able to connect so deeply with someone during such a fragile time,” explains Jennifer, “and I am proud to work for an organization that cares about their patients’ quality of life, even as they transition.”

Larry Skendzel, MD, works in the Hospice & Palliative Care Department at Gundersen’s La Crosse campus and has also observed the positive impact of massage therapy on patients. “Massage therapy brings a new dimension to our hospice care that decreases the need for pain medications, helps decrease anxiety in the patient and their family and provides space for new possibilities during
an important time in life,” he explains. “Our patients consistently view healing touch as something to look forward to during a challenging time.” 

While the therapeutic music and massage therapy programs for patients are still new, the feedback from patients and families—as well as the medical professionals who make the referrals—is overwhelmingly positive. Winifred, who later moved to an assisted living facility, continued to benefit from both therapeutic music and massage therapy sessions until she passed away in October 2023. Because she was dealing with a significant amount of pain that medication could not always resolve, the sessions were quieter and designed primarily to promote relaxation and rest. “Preparing to say goodbye was hard,” shares Linda, “but knowing mom was surrounded by attentive people who cared about her made a difference.”

Help support Hospice programming and services

You can help support quality and compassionate care in the final phases of life by donating to Gundersen Medical Foundation’s Hospice Endowment Fund. In addition to therapeutic music and massage therapy, the fund supports Hospice staff education, patient transportation, memory box supplies, rental of durable medical equipment and more. 

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