Hearing persists at end of life

Date:
July 8, 2020
Source:
University of British Columbia
Summary:
Hearing is widely thought to be the last sense to go in the
dying process. Now, the first study to investigate hearing in
palliative care patients who are close to death provides evidence
that some may still be able to hear while in an unresponsive
state. Electroencephalography (EEG) was used to measure the dying
brain's response to sound. The findings may help family and friends
bring comfort to a person in their final moments.



FULL STORY ========================================================================== Hearing is widely thought to be the last sense to go in the dying
process. Now UBC researchers have evidence that some people may still
be able to hear while in an unresponsive state at the end of their life.


==========================================================================
This research, published recently in Scientific Reports, is the first
to investigate hearing in humans when they are close to death.

Using electroencephalography (EEG), which measures electrical activity in
the brain, the researchers analyzed data collected from healthy control participants, from hospice patients when they were conscious, and from
the same hospice patients when they became unresponsive. The patients
were receiving palliative care at St. John Hospice in Vancouver.

"In the last hours before an expected natural death, many people enter a
period of unresponsiveness," says study lead author Elizabeth Blundon,
who was a PhD student in the department of psychology 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." This new
insight into the dying brain's response to sound can help family and
friends bring comfort to a person in their final moments.

The researchers introduced study participants to various patterns of
common and rare sounds that changed frequency. When the rare tone pattern occurred, both groups responded by giving a pre-arranged signal.



==========================================================================
The researchers monitored the brain's response to those tones using EEG
and found that some dying patients responded similarly to the young,
healthy controls -- even when they were hours away from death.

"We were able to identify specific cognitive processes from the
neuro-typical participants as well as the hospice patients," says Lawrence Ward, a professor in the department of psychology at UBC. "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."
This study was adapted from a European study that explored brain responses
to sound in individual healthy participants, and in minimally conscious
and unresponsive brain-injured patients. The UBC researchers applied a
similar paradigm to actively dying unresponsive patients.

Blundon and Ward collaborated with Dr. Romayne Gallagher, a palliative
care physician at St. John Hospice who has since retired. The research
required patients to give their consent in advance. Thirteen families participated and brain recordings were obtained from five patients when
they were unresponsive.

In Gallagher's 30 years of treating dying patients, she has witnessed
positive reactions in people when loved ones spoke to them in their
final moments.

Gallagher and her colleagues often wondered if hearing was the last
sense to go. She contacted Ward to see if this theory could be proven.

"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," says Gallagher. "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. It is a comfort to be able to
say goodbye and express love." Blundon says what while the evidence of
brain activity supports the idea that a dying person might be hearing,
they can't confirm whether people are aware of what they're hearing.

"Their brains responded to the auditory stimuli, but we can't possibly
know if they're remembering, identifying voices, or understanding
language," says Blundon. "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."

========================================================================== Story Source: Materials provided by University_of_British_Columbia. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Elizabeth G. Blundon, Romayne E. Gallagher, Lawrence M. Ward.

Electrophysiological evidence of preserved hearing at the end
of life.

Scientific Reports, 2020; 10 (1) DOI: 10.1038/s41598-020-67234-9 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200708105935.htm

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