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Singing to Health: A Choir for People with Neurological Communication Disorders

Project Added:
27 January 2016
Last updated:
10 February 2016

Singing to Health: A Choir for People with Neurological Communication Disorders

Summary

The War Memorial Hospital (WMH) Waverley created a weekly social choir led by a volunteer music therapist, for outpatients with chronic communication impairments due to acquired and progressive neurological deficits. The choir supported the health of individuals, by building partnerships and facilitating continuity of care. 

This project was a finalist in the 2015 NSW Health Awards, Arts and Health category. Watch a video on this project (opens in new window).

Aim

To improve the quality of life and health of people with chronic and/or progressive communication impairments.

Benefits

  • Provides an opportunity for people with communication impairments to maintain purpose, show altruism and inspire others.
  • Increases awareness of communication impairments in the community.
  • Facilitates social interaction and boosts psychological wellbeing, leading to increased confidence and motivation.
  • Enhances therapeutic outcomes for many people.
  • Helps those with limited or no speech to improve their voice and quality of life in an understanding and supportive environment.
  • Reduces social isolation for those with communication impairments, with peer support and participation in normal daily activity.
  • Enhances collaboration between speech pathologists, music therapists, participants and carers.
  • Links to the National Arts and Health Framework by acknowledging the value and benefits of an arts and health practice.
  • The project is efficient, volunteer-led, resource light and independent of any one team member.

Background 

The Speech Pathology Department at WMH Waverley provides a broad range of intervention, education and support services for individuals and their carers. The majority of rehabilitation patients require management of acquired and progressive neurological impairments, including aphasia and Parkinson’s disease. It provides treatment and support across all stages of disease progression, from subacute rehabilitation to chronic stages.

Patients with chronic communication impairments are at great risk of social isolation and frequently have limited opportunities to express their opinions and tell their stories. Research demonstrates that singing has a number of rehabilitation benefits and can lead to positive changes in impairment activity, social interaction and quality of life, as well as reduced levels of psychological distress.

Song as a rehabilitation tool has been recognised and embraced by the medical community, thanks to well-known choirs including Melbourne-based ‘Stroke a Chord Choir’ and the Newcastle ‘Brainwaves Choir’. With no musical rehabilitation services in the South Eastern Sydney Local Health District (SESLHD), WMH Waverley chose to initiate a choir for patients with communication impairments.

Implementation

  • WMH Waverley secured a special purpose grant from Uniting to fund a music therapist that coordinated the choir program. Once the funding ended, a volunteer from the Uniting Volunteer Program continued this role. This volunteer was suitably trained and supported to perform a service in a safe, ethical manner in line with policy directives from the NSW Ministry of Health.
  • Choir sessions were held each week, with up to 10 participants in each session. Participants were WMH Waverley patients who had acquired aphasia due to stroke or had progressive neurodegenerative diseases.
  • Participation in the choir required a referral to outpatient speech pathology services, so that only appropriate patients were recruited.
  • The music therapist and volunteer prepared the materials for the choir, with the aim of increasing communication skills and providing psychosocial and peer support.
  • A speech pathologist acted in an advisory capacity, to ensure the method of communicating with participants was appropriate and the goals for the group were collaborative and achievable. They also ensured that any barriers to participation were removed, using evidence-based techniques and strategies.
  • Participants were encouraged to choose songs and get involved in the running of the choir.

Key dates

  • Project start: June 2015
  • Project end: December 2015
  • Performance for family and friends: 14 December 2015.

Project status

  • Sustained - the initiative has been implemented and is sustained via a volunteer music therapist. 

Partnerships

  • Uniting Volunteer Program

Implementation sites

  • Speech Pathology Department, WMH Waverley, SESLHD

Results

  • The choir became a small but valuable addition to the range of intervention services provided by the WMH Waverley speech pathology service.
  • Participants performed twice in front of patients and hospital staff during the project, at 6 weeks and 12 weeks post-implementation.
  • Analysis of semi-structured participant interviews following the 12-week block of choir sessions demonstrated positive outcomes including improved mood and social connectedness.
  • Feedback indicated that 100% of participants enjoyed performing and liked using the performance as a goal to work towards.
  • 88% of participants indicated that it was important to connect and communicate with other people and that singing supported these goals.
  • Positive participant comments were collated and evaluated qualitatively, including:
    • ‘The choice was excellent! I enjoyed performing!’
    • ‘[I valued coming to the choir] very much!’
    • ‘I would [like] the choir [to] continue.’
    • ‘When we sang [for the] concert, I felt really good and the atmosphere [was] really good in the room.
  • A satisfaction survey provided to participants’ family members indicated that 75% felt that attendance at the choir was valuable and important to both them and the participant. 75% also stated that they would encourage attendance if the choir was run again.
  • The choir project was formally documented and ongoing recruitment and evaluation processes have been established.

Awards

  • 2015 NSW Health Awards Finalist – Arts and Health 

Lessons Learnt

Six months was a long time for patients to stay motivated. Next time we will run it in shorter blocks of 8-10 weeks and have a performance at the end of each block as a goal to work towards.

Further reading

  • Alexander H. NSW government to explore how arts can be used to improve health (opens in new window). The Sydney Morning Herald. [Internet]. 2015 Nov 5.
  • NSW Health. Singing to health: a choir for people with neurological communication disorders (opens in a new window). [video on the Internet]. 2015 Oct 31.
  • Clift S, Hancox G, Morrison I et al. Choral singing and psychological wellbeing: quantitative and qualitative findings from English choirs in a cross-national survey. Journal of Applied Arts and Health 2010; 1(1): 19-34.
  • Davidson B, Worrall L & Hickson L. Identifying the communication activities of older people with aphasia: evidence from naturalistic observation. Aphasiology 2003; 17(3): 243-264.
  • Elman R & Bernstein-Ellis E. The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech, Language and Hearing Research 1999; 42(2): 411.
  • Tamplin J, Baker F, Grocke D et al. Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2013; 94(3): 426-434.

Contact

Alexis McMahon
Speech Pathologist
War Memorial Hospital Waverley
South Eastern Sydney Local Health District
Phone: 02 9369 0212
Alexis.mcmahon@health.nsw.gov.au

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