Author: voicesofaphasia

We are very fortunate to receive funding from the St John’s Foundation which has secured the future of our choir for the next three years. We were recently asked for an update about the impact the funding has had on our group, and it was a great opportunity to reflect on everything we’ve achieved over the last few months!

 

Here are some extracts from the report we sent to the St John’s Foundation:

 

The choir has continued to develop very positively sing the start of our funding from the St John’s Foundation. To mark the start of our funding term we held a relaunch event at the Chapel of St Michael’s Within. Thanks to PR support from the Stroke Association this event attracted press coverage from the Bath Chronicle and coverage on BBC Radio Bristol, who sent a reporter to record our rehearsal and interview some of the members.

 

We have been able to guarantee to choir members that weekly term time rehearsals will be held for the next three years and given them certainty that an important part of their (sometimes limited) social life will be maintained. We have continued to attract new members as we are certain that there will be rehearsals for them to attend. Some new members have had a stroke and developed aphasia quite recently, while others are further into their recovery.

 

We used some of the funding to purchase a new projector and screen which has been invaluable in allowing members to clearly see the words and pictures we use to display song lyrics and warmups in an aphasia friendly manner. Our old projector was not fit for purpose in our rehearsal venue and participants have commented on how effective the new projector is and how much easier it is for them to see and understand the lyrics.

 

We also purchased a new electric piano which a Music Therapy student plays to accompany the choir. The keyboard has a strong and authentic piano sound and a transpose feature which allows us to easily sing in keys which are most comfortable for our members. As a result of our funding we have been able to arrange for the placement student to be paid to continue to accompany the choir once her placement ends, allowing the strong relationships she has already built with choir members to continue and ensure that the choir are supported by a talented and flexible accompanist.

 

We have been able to continue the use of carefully selected vocal warmups and voice strengthening exercises taken from evidence based Music Therapy literature. Members have remarked that they feel their voices have become stronger and they are more confident in singing without damaging their voice, and external listeners have commented on how strong and rich the sound of the choirs’ singing has become.

 

The social aspect of the choir has become vitally important to its success, as members are able to make friends and support their peers within a supportive environment where everyone understands the impact of stroke and aphasia and there is no pressure to use complex language. As some of our members have experienced difficulties in their health and within their personal lives, the choir members have supported and uplifted each other through bad and good times.

 

Members of the choir who wish to take part in performances have had the opportunity to do so at an afternoon concert at the Chapel of St Michael’s Within, and at the Stroke Association Christmas lunch. Many members also sang in Southgate before Christmas in order to raise money for the Stroke Association which will be put towards running costs of the choir. We are also due to perform at the Pump Rooms as part of Party In The City in May 2019 and we are planning a concert in the summer.

 

Music Therapist Laura Cook and Speech and Language Therapist Emma Richards (who helped to set up the choir initially) were accepted to present a poster about the choir and its origins as a Music Therapy student placement at the British Aphasiology Society conference in 2018. The presentation included video footage of the choir and examples of our aphasia friendly lyrics. The poster was voted by delegates as the best poster at the conference and many Speech and Language Therapists who saw the poster have expressed an interest in starting aphasia choirs in their areas, using the Bath choir as a model.

 

We have used the funding to purchase and print Stroke Association leaflets and posters with details about the choir, and we are about to start distributing these to GP surgeries, hospitals and other appropriate locations around Bath in order to attract new members.

 

At our final meeting before Christmas 2018 the choir visited St Martin’s Hospital in Bath and held an open rehearsal for patients on the rehabilitation ward. Friends and family of choir members also attended. This was particularly special for the choir as one of our founding members had unfortunately had a further stroke a few weeks prior to this and was a patient on the ward. He had been very low in mood and unable to attend the choir so it was a privilege to be able to take the choir to him, and for his friends from choir to see him and offer their support at a difficult time. Some of the other inpatients in the ward had survived strokes and been newly diagnosed with aphasia, while other patients were living with dementia and were able to join in the music and singing at a time of the year when being in hospital can be particularly difficult.

 

A testimonial from Catherine, whose husband Tim has aphasia and has attended the choir since its inception:

 

‘Tim has been attending he Aphasia Choir since its inception, and he really enjoys it, as do others. The session is very friendly, supportive and stimulating, and everyone has a lot of fun. Many of our friends have commented on how Tim’s speech has improved since he has been attending choir, and I too feel that it has.

Tim’s voice is still very strong when he is singing, and I think this helps to boost his self-esteem. He has aphasia but can read, and so can sing confidently when the words are in front of him, as they are at choir, up on a screen in front.  This facility would not be available to him at any other choir.

Attending the aphasia choir gives him an enjoyable opportunity to engage in an activity which takes him out of his disability and doesn’t remind him of it. We are very grateful for the hard work put into the choir by all the organisers and leaders.’

 

Laura Cook – Choir Leader

As part of my second year clinical placement I was tasked with leading a choir for people with aphasia and their loved ones in Bath. The group had previously been run as a short term pilot project, led by two music therapists. The choir was the joint brainchild of Speech and Language Therapist Emma Richards, then part of the Virgin Care Bath and North East Somerset Community Stroke and Neuro Service, and Liz Jeggo, the local Stroke Association Stroke Communication Support Coordinator who is passionate about developing a local aphasia community and giving voice to stroke survivors with communication challenges. The project was very well received but ultimately too expensive to fund as an ongoing group.

 

Emma (a keen singer member of two choirs!) approached UWE Bristol and offered to supervise a UWE music therapy student in order to get the choir back up and running after many pleas from people who had been part of the pilot project in Bath. During my first year of training I had volunteered at the UWE ReVoice aphasia choir and had developed an interest in neurorehabilitation and the potential for singing to help people with aphasia, but had never led a choir myself. I was daunted but excited about the placement, particularly after meeting a very enthusiastic Emma and Liz and finding out about the singers I would be working with.

 

Emma taught me about the various subtypes of aphasia, techniques for using supported conversations in order to support the communication of people with aphasia, and how to make written and musical resources accessible through the use of layout, highlighting key words and using carefully chosen images. The initial rehearsals were a crash course in conducting, aphasia friendly communication and managing volunteers but I was encouraged by the enthusiasm and commitment of the participants. Musical supervision was provided by Dr Cathy Warner, Programme Leader for the UWE training.

 

During rehearsals I lead careful breathing and vocal warmups in order to safeguard voices which may be rarely used for speech, and focused on posture and diaphragmatic support. The choir sings a variety of traditional and pop songs, chosen either by the choir members or for their musical and lyrical content. We project aphasia friendly lyrics onto a screen to support both posture and comprehension.

 

Throughout my six month placement I developed my own abilities but more importantly witnessed a dramatic increase in the confidence and tonal quality of the choir. We were lucky to have some talented members, including a former musical director and local amateur dramatics star, and were able to welcome experienced singers who had been unable to participate in local choirs since their stroke. The placement concluded with a feedback session, including the use of an adaption of the AIQ-21 scale designed to make research accessible to those with aphasia (Swinburn et al., 2018). The choir members unanimously agreed that they had fun at choir, felt more confident singing and had more energy after the rehearsals. Members gave encouraging feedback such as “when I sing its perfect my words….I cannot do this when I speak” and “la, la, la perfect really…good I think”, while carers responded that “having words to sing takes away the stress of having to find the right words” and “choir gives him the opportunity to do something he is good at”.

 

A personal highlight was leading the choir in a performance at the Colston Hall as part of the UWE Festival of Sound in a joint performance with ReVoice – to my knowledge the first and only time two aphasia choirs have joined forces! I also felt a strong alliance and relationship building with the choir members and have cherished the opportunity to get to know them and their families. The work led to a lot of reflection and discussion around the links between ‘traditional’ music therapy, community music therapy approaches and speech and language therapy (Pavlecevic and Ansdell, 2004).

 

At the end of my placement the choir was continuing to grow in numbers and confidence and no one wanted it to come to an end. Emma successfully applied for startup funding from the Virgin Care Feel The Difference fund which allowed me to be employed as the choir leader and continue the valuable work of the group.

 

We knew that this funding would only be a short term solution and set about planning concerts and fundraising events. With the help of an experienced fundraiser, who is a friend of a couple who have sung with the choir since its inception, Liz and I applied for a funding grant from the St John’s Foundation who fund community projects in Bath. Thanks to the feedback and enthusiasm of our members we have now been awarded funding for the next three years and can now focus on growing the choir and reaching even more people with aphasia.

 

We hope that the growing trend of aphasia choirs continue to give voice to more people with aphasia and that music therapists and speech and language therapists can work collaboratively to ensure that such groups are truly accessible, participant-led and therapeutic.