Academic journal article Canadian Journal of Music Therapy

Singing the Passage: Evaluating Volunteer Bedside Singing in a Palliative Care Unit /Chanter le Passage : éValuation De Musique Offerte Par Des Chanteurs Bénévoles Au Chevet Des Patients Sur Une Unité De Soins Palliatifs

Academic journal article Canadian Journal of Music Therapy

Singing the Passage: Evaluating Volunteer Bedside Singing in a Palliative Care Unit /Chanter le Passage : éValuation De Musique Offerte Par Des Chanteurs Bénévoles Au Chevet Des Patients Sur Une Unité De Soins Palliatifs

Article excerpt

Introduction

The bedside singing service was initiated in 2007 by a community group of volunteer singers called Songs of Passage (SOP), who had a special interest in offering support to seriously ill or dying patients through unaccompanied singing. This approach was adapted from that of the Threshold Choir network in the United States. The all-women Threshold Choirs "provide singing at the bedsides of patients in transition struggling with living or dying" (Munger, 2008). The unaccompanied voice is the only instrument used. Threshold Choir volunteers sing in pairs or small groups for patients in hospices, hospitals, nursing homes, and private homes when invited by family or caregivers. When the family is present, the music is provided for them as much as for the patient, and family members are invited to join in the singing or to listen. Choir members may visit once or multiple times depending on the patient's circumstances. The songs used are chosen to respond to a patient's musical taste, spiritual direction, and physical capacity. The Threshold Choir's repertoire includes rounds, chants, lullabies, hymns, spirituals, and choral music (Munger, 2008).

The bedside singing group was led by two dedicated volunteers who had extensive experience in choral singing, music education, hospital pastoral care, and hospice palliative care volunteering. Prior to and throughout the pilot project, the bedside singing volunteers (Bedside Singers) received musical training from their leaders through weekly group practices. They also received orientation to the Palliative Care Unit (PCU), and a full-day training seminar provided by PCU staff, familiarizing them with the physical and psychosocial needs of patients and families receiving palliative care. During the pilot project, the volunteer Bedside Singers provided service on the PCU for two hours weekly, in pairs. The Songs of Passage bedside singing service used a range of simple, gende, lullaby- type repertoire chosen from a broad spectrum of cultures. The songs used were spiritual but not religion-specific (Mary- Moon & Lamb, 2008). A comparison of music therapy and bedside singing interventions and approaches is found in Table 1.

The volunteer Bedside Singers offered bedside singing as a pilot project, under me supervision of the Music Therapist, on the PCU from August 2007 to May 2008. The PCU Music Therapist provided education regarding the respective roles of the music therapist and volunteer musicians, acted as a liaison between the Bedside Singers and the unit staff team, provided consultation regarding musical repertoire, provided patient referrals for each bedside singing shift, tracked and evaluated all visits documented, and audited random bedside singing visits to ensure appropriateness and quality of the service. The goal of the bedside singing project was to expand the range and accessibility of live music services offered to patients and families by volunteers, particularly during evenings and weekends. The evaluation was intended to gather information regarding patients', families', staffs', and PCU volunteers' responses to the bedside singing service, and to determine if the service was a beneficial adjunct to the music therapy services currently offered. The Hospice program also wished to gather information regarding patients', families', staff's, PCU volunteers', and Bedside Singers' responses to the service, in order to improve its service delivery and volunteer training.

Literature Review

Throughout history and across cultures, music has been used to facilitate life transitions, particularly birth and death. Music therapy research literature demonstrates that the systematic clinical application of music can address the physical, psychosocial, and spiritual needs of patients and families at end of life. For patients, music therapy interventions (including singing, instrument playing, song writing, improvisation, and listening) can be used in conjunction with pharmacological and other approaches to address acute and chronic pain symptoms (Magill-Levreault, 1993; Trauger-Querry & Haghighi, 1999). …

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