The Science of Hearing Near the End of Life

Many people have heard that hearing is the last sense to go. Families often wonder whether to keep talking to someone who can no longer respond. A small study has begun to give an answer. This article explains what it found and what it did not.

What did the study do?

It recorded brain responses to sounds in dying patients. The University of British Columbia researchers worked with a palliative care physician at St. John Hospice in Vancouver. The Canadian Press reports that eight hospice patients did a hearing task while still responsive, and five repeated it after they became unconscious. Seventeen young, healthy people served as a comparison group. The work was done between 2013 and 2017. CTV News adds that patients had to give consent ahead of time, and that recordings were collected from five once they were unresponsive.

What did it find?

That the brains of unresponsive patients still reacted to sound. The study’s abstract says that most unresponsive patients showed a brain response to changes in tone, and some showed further responses to changes in a pattern of tones. It concluded that their auditory systems were responding much like those of healthy young people only hours from the end of life. The Canadian Press says this was seen in one case six hours before death.

What does it not show?

Whether the person understood what they heard. Lead author Elizabeth Blundon says the brain activity supports the idea that a dying person might be hearing, but that the team cannot confirm that people are aware of what they hear. The Canadian Press quotes her saying that she cannot tell anybody whether a loved one understands them or knows who is speaking. The study was also small, and similar work has been done in Europe on patients with brain injuries.

Why do palliative care teams encourage talking?

Because of what they see at the bedside. Dr. Romayne Gallagher, the hospice physician who inspired the research, says she has seen positive reactions in dying patients when loved ones spoke to them, over 30 years. She says that being present, in person or by phone, is meaningful, and that it is a comfort to say goodbye and express love. Blundon’s view is that the findings support continuing to talk to people when they are dying.

What can families do?

Speak to the person, say what you wish to say, and ask the care team what to expect. See What to Expect in the Final Hours, What Is Hospice?, and The Science Behind the Death Rattle.