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Interview: Choir Magic


Kirstin Robertson-Gillam

Kirstin Robertson-Gillam

People who live in residential care settings typically lead passive and receptive lives. But the work of researcher Kirstin Robertson-Gillam and others suggests this does not have to be.

Robertson-Gillam is a music psychotherapist and owner of Creative Horizons Counselling and Therapy Services in the Blue Mountains, near Sydney, Australia. She is currently enrolled in the PhD program at the University of Western Sydney.

In a recent study, Robertson-Gillam investigated the potential for choir work to enhance the lives of older adults living in residential care settings. Participants were residents of Hammond Care’s residential facility in Sydney. They included 18 females and 11 males. Their average age was 80 years. Two-thirds of the residents had dementia and the other third did not.

The pilot study revealed choir participation enhanced quality of life for older adults with dementia. It also reduced their chances of becoming depressed.

The findings were published in Ageing, Disability and Spirituality: Addressing the Challenge of Disability in Later Life (Jessica Kingsley Publishers).

AHB reached Kirstin Robertson-Gillam at her office in the Blue Mountains, near Sydney.

Ruth Dempsey: What gave you the idea of starting a choir?

Kirstin Robertson-Gillam: For my first choir, I will have to go back a bit. I was doing some work at a home for older people and looking for ways to engage the residents in meaningful activities. I started a choir, which we called the Blue Jays.

The Blue Jays travelled up and down the mountains, performing in nursing homes and at local jazz festivals and religious events. A wonderful family of singers was born. We celebrated birthdays with cake and tea. When a choir member or someone in the family died, we prayed together and sometimes sang at the funeral. We became a close community. And I was hooked.

That experience led to the pilot study described in Aging, Disability and Spirituality. We had up to 30 people coming to our weekly choir practice. They came from eight different areas of Hammond Care’s large residential facility. Some members of the Hammond Village Choir had severe dementia; others lived independently in their own apartments in the facility.

The staff was not enthusiastic about the choir at first. But this changed as participants developed a sense of camaraderie and showed improved physical capabilities and heightened motivation.

RD: How did the older people respond initially?

KRG: They were quite reticent. A popular comment when invited to join the choir was, “I can’t sing.” My reply was always the same: “You can talk so you can sing.”

Their voices improved markedly over time as they learnt the discipline of rhythm, speech intonation, melody and memory retrieval. Best of all, they relaxed and began to experience the sheer joy of singing with others.

RD: The group met once a week for 20 weeks. Is that right? How long was each session?

KRG: That’s right. Each session lasted 60 minutes, a long time for people with dementia. The amazing thing was that one could not tell who had dementia and who did not. They started to talk to each other and began to make new friends – something, which, in the normal life of the home, would have been out of the question.

RD: How did you choose the music?

KRG: Good question. Good quality music is a must. The repertoire included jazz, popular music, religious, spiritual and folk. As well, individuals shared songs from their different cultures. Many choir members were keen to learn classical as well as popular and religious songs. I found they were able to remember and sing the lyrics with fairly high levels of accuracy.

Not surprisingly, some songs triggered memories of relationships and past experiences. This encouraged participants to explore their inner lives and share stories from their past with other choir members.

RD: I am interested in the techniques you used with the choir.

KRG: First, I believe that people need to be actively and meaningfully engaged in life up to their last breath, regardless of illness or disability. So my primary goal was to create a genuine person-centred experience and to build interpersonal relationships.

Mainly, I used four techniques:

1. I began each choir practice with a short period of silence. This helped to focus people’s attention, reduce stress and provide a contrast with the noise and bustle of the home.

2. After that, I did relaxation exercises to help build their self-confidence. And I used deep breathing exercises to loosen up muscles in the throat, chest and shoulders.

3. To tune up, we used a variety of exercises, including games. Singing vowels to imitate the sounds of animals, for example. These were great fun and helped the choir to relax. Many older people harbor dissatisfaction with their voice quality because most were told to avoid singing when they were young.

4. I also used vocal improvisation to facilitate spontaneity and explore a range of voices. Members were encouraged to express their emotions and interact with each other.

Choir work involves learning a new skill. So it can be both challenging and deeply satisfying.

RD: I was very touched by Jim’s story. He had Parkinson’s disease and could not swallow.

KRG: Well, Jim was one very special man. He could only whisper when I first met him. Jim began to attend vocal therapy as well as the choir. And over a period of 18 months, he increased his vocal range by six notes. This increased his confidence and self-esteem and gave him more control over his life. He became more socially interactive, which was a great boost for his family and carers.

RD: What did you learn from the study? Any surprises?
KRG: I think I can sum it up in three points:

1. People maintain their essential personhood regardless of disability or disease.

2. I was surprised by the high levels of awareness and engagement that grew out of the weekly choir sessions and how this spilled over into other areas of life, enriching them.

3. Participants became involved in the choir in ways that care workers did not imagine or deem possible. One woman with severe dementia told me, she went up the hill to sing yesterday. Another woman, also with dementia, said, “I need to sing in order to be understood.” Yet another told me, “You’ve kept a breath in me that I’ve not had before.”

I realized the choir had tapped into the spiritual essence of each person.

RD: In fact, the Hammond Village Choir became quite the hit . . .

KRG: Absolutely. I chose to establish a choir rather than do a simple sing-along because older adults want to be engaged in life: to feel the sense of something new and unexpected in the air. And they want to contribute.

After completing the study, I worked with the choir for another two years. The Hammond Village Choir gave eight performances throughout the year at a variety of festivals and events. Some even sung solo parts. They attracted enthusiastic audiences, including other residents and their families. And the Hammond Village Choir performed for the Aged Care TV Channel Program, garnering media interest and boosting the choir’s profile.

RD: It must please you to see positive results.

KRG: Since then, I have replicated the pilot project at another Hammond Care site. This time, the choir was made up entirely of people with dementia. Depression scores decreased dramatically over the period of the study.

In both studies, the choir provided an opportunity for older adults with dementia to broaden their horizons and discover personal meaning and purpose. But they did the rest. They sparked the “magic”. (For more information, contact Kirstin Robertson-Gillam at kirstin @