The lamps are low, leaving soft gray afternoon light to filter through the large picture window. The house is quiet.

With a tender hand, Adair holds Allgire's wrist and counts his heart beats.

His heart is failing, and Allgire, 95, is in the last days of what has been a long, productive and happy life.

Adair takes her harp in hand, sitting close enough to Allgire that vibrations from the strings can wash over him.

If you feel like drowsing, go ahead, she says. Just like last time. If the tears come, let them, she says.

Adair plucks a single string, then another, filling the room with the lilting sound of an ancient melody. Now and again, she adds voice, in wordless harmony, to the music.

Allgire's eyes close. His breaths deepen. His head dips toward his chest. He drifts, lost for this hour in the harp's soothing sounds.

This is what Adair, a music thanatologist, hopes for: to give her patients a brief respite from physical suffering and emotional anxiety, and to ease the dying process.

Since September 2003, Adair has offered this service through CareSource, a Salt Lake-based hospice, home health and palliative care agency, which operates Utah's only freestanding hospice facility, The Residence.

A classically trained pianist and string bass musician, Adair was already tiring of the competitive world of symphonies and chamber orchestras when a car accident left her with a serious head injury. During her recovery, Adair, then living in Bend, Ore., volunteered at Hospice of Bend-La Pine and there learned of Therese Schroeder-Sheker's Chalice of Repose Project.

In 1972, Schroeder-Sheker developed the practice of "prescriptive music" - music designed to have a therapeutic effect on a person and deliver what she calls a "blessed or good or conscious death." She based her program on the contemplative practice of Benedictine monks.

"With great delicacy we help the dying set up the physical conditions in which they can enter into the depths of the entire process of dying," Schroeder-Sheker writes in a essay posted on the Web site of the Supportive Care of the Dying coalition.

All of that struck a chord with Adair. In 1996, she applied to and was accepted into Schroeder-Sheker's School of Music-Thanatology program, based at St. Patrick Hospital in Missoula, Mont. She stayed three years, studying anatomy, physiology, the history of death and dying as well as how to use music - both the harp and her voice - therapeutically.

Adair is one of about 60 music thanatologists practicing around the country, and one of four at work in Utah. Their numbers are likely to remain scarce, given the closure of St. Patrick's program in 2002.

The harp is the instrument of choice, not because it symbolizes ethereal worlds but because it is portable, and creates beautiful low tones and a full sound that can fill a room with vibrations.

"There is something about the size and length of the strings that gives a fullness of sound that seems to be very healing," she says.

Adair, like most music thanatologists, draws from a repertoire of ancient, Gregorian chants and lullabies when she plays. Familiar music might trigger an unhappy memory, she says.

"We use lullaby because it has a rocking, three-quarter time that is so soothing to everyone," says Adair. And Gregorian chant is "exquisitely beautiful and meter-less. I can take Gregorian chant and because it doesn't have a beat, I flow the music to the patient."

One of her first vigils was for a 45-year-old man who had Lou Gehrig's disease and could no longer speak. She has never forgotten the way his eyes filled with tears as she and two other harpists began to play and sing. Or the way he kept his eyes on his wife and daughter, letting the music speak for him.

"It was amazing to see those looks of love between them," she says.

Adair moved to Utah in 2002 and joined CareSource shortly thereafter. She plays for patients at The Residence as well as those still living in their homes or being cared for in other facilities. She may stay for as little as 15 minutes or as long as an hour, depending on a patient's situation and desires. Her longest vigil? Three hours, for an elderly man after he had been taken off a respirator.

Staff and family alert her when a particularly agitated patient needs soothing, and when death is imminent. She is often called to a bedside via a pager.

"I always try to utilize this as much as I can because music provides comfort and relaxation we aren't able to do with medical care," says Jamie Jones, a hospice nurse at CareSource. "It's good medicine for the soul as well as the body."

Gregory Miller, CareSource's medical director, admits he was a skeptic when he first heard of Adair and prescriptive music.

"Since she came, I've become a strong advocate based on the results I've seen," Miller says. "It increases comfort, decreases pain, stress and anxiety and has a calming effect on the family surrounding the patient.

"It just strikes a place that is very deep inside people and is soothing."

Miller says he has found Adair and her music blend into the emotional setting, rather than invading it.

Often, the music serves as an emotional conduit for family members maintaining a bedside vigil.

"Music creates a safe space that allows grief," Adair says. "It is not music therapy to cure and heal and get someone out of the hospital. We're using music to unwind and release."

On Monday, when she played for Vivian Pedersen, 94, at The Residence, Adair told her to "remember, it's not a concert, just music to rest with."

Vivian, who worked for years at the Murray Laundry before focusing all her energy on raising three sons, has congestive heart failure. Adair played for about half an hour as daughter-in-law Karen Pedersen stroked Vivian's forehead and held her hand.

"Nothing is more relaxing than beautiful music," Karen said afterward, when Vivian had drifted to sleep. "We know it does something to the body and soul."

Adair, who has played at nearly 1,500 vigils, also has seen her music break down emotional barriers among relatives, allowing them to cross divides sometimes years in the making.

"It's best if there is silence but there is room to say goodbye, to stroke a loved one or crawl in bed with them," she says.

When death is close, Adair's goal is to create a reverent space that is as holy as that surrounding birth.

"It really is birth, a birthing into another world," she says, and sometimes the musical interlude allows a dying person to relax enough to go gently.

Adair measures a patient's respirations and heartbeats before a session, and then adjusts her musical phrasing as she plays to calm or match a person's rhythms.

Dick Allgire went from 36 breaths a minute to 24, from 68 heart beats to 60, by the end of Adair's session.

"Nice, nice," he tells her.

And then: "It's totally relaxing.

"I think a little bit about playing a recorder with her," says Allgire, a writer and photographer for U.S. Steel and General Motors. He played for years as part of the local Eastwinds group. "But I'm not up to that now.

"You think when you drowse off you wouldn't hear it, but I'm still conscious of it," he says.

There are times, Adair says, when even a harp is too jarring and the music makes a patient more agitated - seen in a person's breathing and body movement.

"It doesn't happen very often, but I watch for it. If we're stimulating, I leave," Adair says. "Generally, with hospice patients we don't want to tax them."

That was certainly not the case that gray afternoon when Adair played for Allgire.

"Thanks for letting me come play for you," she tells him.

"Wonderful. Thank you," he says.

Dick Allgire died eight days later, on Feb. 3.

Music for the dying

Q. What is prescriptive music?

A. It is live music, using harp and voice, delivered at the bedside to provide palliative care and relief to a person with a terminal illness and, when death is near, ease that transition.

Q. How is it offered?

A. There are two types of referrals. The service is available for patients who are expected to live six months or less and who are receiving hospice care. Prescriptive music also may be provided when death is likely to occur within 48 hours.

Q. What are its benefits?

A. Prescriptive music can decrease pain, reduce physical and emotional anxiety and anger and deepen slumber. It can ease loneliness and help a person process grief. And it can comfort the spirit of the patient as well as family members. It is effective for patients with cancer, respiratory, infectious and degenerative diseases such as HIV/AIDS, dementia, Alzheimer's disease and multiple sclerosis.

- Source: Tristan Adair, music thanatologist at CareSource