The Beat Goes On: Exploring Heartbeat Recordings in Hospice Care
By Sarah McInnis, Music Therapist at Valley Hospice
This May, I had the opportunity to attend the 2025 Canadian Association of Music Therapists (CAMT) Conference in Halifax, where I participated in a compelling session titled “The Beat Goes On – Heartbeat Recordings as a Therapeutic Tool in Hospice” led by Victoria Di Giovanni. As a music therapist working in hospice care, I found this session both inspiring and practical. It offered a meaningful way to support individuals and families facing end-of-life through personalized, creative, and deeply human musical experiences.
What Are Heartbeat Recordings?
Heartbeat recordings—more formally known as Amplified Cardio Pulmonary Recordings (ACPRs)—are audio captures of a person’s heartbeat that are often used in therapeutic settings, particularly in palliative care and neonatal intensive care units (NICUs). These recordings serve as a sonic reminder of presence and connection. Research, including a study by Andrews et al. (2020), shows that heartbeat recordings (HBRs) can be incredibly supportive in the grieving process, offering comfort, legacy, and a sense of ongoing closeness to a loved one who has passed.
The Technology Behind It
Creating a heartbeat recording is more accessible than you might think. The setup can include technology like the Littmann CORE Digital Stethoscope, an iPad with a recording app, a USB microphone with an adapter, and headphones. The stethoscope connects to the iPad via Bluetooth using the HIPAA-compliant Eko App. The process starts with recording the heartbeat, which is then exported as a WAV file from the Eko desktop app and imported into GarageBand for editing.
Placement is key—recordings are often clearest when the stethoscope is placed on an artery in the stomach or leg with direction from nursing staff, especially if chest sounds are weak or compromised.
Creating a Musical Legacy
Once the heartbeat is looped and edited in GarageBand, it becomes the foundation for a custom musical piece. This can be approached in a few different ways:
1. Custom Compositions: A new song is created to match the natural tempo of the recorded heartbeat.
2. Pre-Recorded Songs: A meaningful, familiar song is re-recorded to match the tempo of the heartbeat—or vice versa.
3. Participatory Recording: The individual may sing or speak over their own heartbeat, allowing them to be an active part of the creation process.
4. Sonic Collages: Family members can contribute voice notes, memories, or sound bites, which are then edited together into a musical keepsake.
There’s something incredibly powerful about hearing a familiar heartbeat woven into a song. For families, this can become a cherished auditory memento—a way to remember, to connect, and to feel held even after loss. The final product is typically ready within 1–2 weeks and showing an example to families ahead of time can help them visualize the potential impact of the project.
Applications in Hospice
In hospice care, where the focus is on comfort, meaning, and emotional support, heartbeat recordings offer a tangible and heartfelt way to honour the life and legacy of a loved one. These recordings can support anticipatory grief, facilitate memory-making, and give families something they can return to again and again. Whether it’s a gentle song underscored by a loved one’s heartbeat or a collage of voices and stories, this tool becomes not just a therapeutic intervention, but a deeply personal gift.
As we continue to explore innovative ways to support individuals and families at end-of-life, heartbeat recordings stand out as a beautiful blend of clinical practice and creative expression. I’m excited to integrate this work into my own practice at Valley Hospice and to share the therapeutic potential of something as simple—and profound—as a heartbeat.