My Heart Will Go On: Caregiver Experiences of a Legacy Intervention in Acute Palliative Care.

Abstract

The Heartbeat Project (HBP) is a music therapist-led legacy intervention that incorporates patients' heartbeat recordings into personalized audio keepsakes. While anecdotally described as meaningful, few studies have explored caregiver outcomes after participation. To describe implementation characteristics and caregiver-reported outcomes of the HBP to understand caregiver perceptions and inform best practices in palliative care. This mixed-methods study documented song genre preferences at implementation. A 16-item survey assessed caregiver engagement, satisfaction, and perceived emotional impact. Descriptive statistics and thematic analysis were applied to survey responses and qualitative feedback. Patients receiving palliative care (n = 81) and caregivers (n = 29) were recruited from the University of Alabama at Birmingham's Palliative and Comfort Care Unit. Of 81 bereaved caregivers, 30 responded (36.7%), including both adult and pediatric caregivers. Most reported being very satisfied and described the keepsake as comforting, meaningful, and helpful during grief. Ratings for "comfort," "helpfulness," and "meaningfulness" were consistently high (mean scores: 9.14-9.96/10). Qualitative themes included emotional resonance, legacy preservation, and appreciation for personalized care. The HBP was highly acceptable to caregivers and perceived as emotionally supportive. Findings suggest that legacy-based music therapy interventions may enhance grief coping across diverse palliative care settings.