Giving Voice Initiative: Giving Voice to those with Alzheimer’s
It’s a Wednesday morning in Minneapolis. Outside Antonello Hall at the MacPhail Center for Music, there are the muffled but whimsical song lines of that Tin Pan Alley hit “Button Up Your Overcoat.” It could be one of hundreds of choruses rehearsing any day across America.
Open the doors and you’ll see a stage crowded with singers, mostly over the age of 55. Facing them is a director, emphatically reminding them that this song needs more—the word doesn’t come. So Jeanie Brindley-Barnett puts an “upbeat” swing into her shoulders and hips. The stage erupts in laughter. Then attention turns back to the music binders and Brindley-Barnett signals the accompanist; and once again, the chorus digs into the music. This time all 60 voices give it that upbeat panache along with some toe taps and finger snaps. It’s another one of the growing numbers of older-adult choruses in the country. No–it’s not!
This is Giving Voice Chorus, one of a few American choral ensembles for people with Alzheimer’s disease and their caregivers. Giving Voice Chorus (GVC) was founded in 2014 by Mary Lenard and Marge Ostroushko to focus on the arts and Alzheimer’s, a disease that currently affects more than 8 percent of the U.S. population over age-65. Two friends, Lenard and Ostroushko both had family experiences with Alzheimer’s and each brought complementary expertise to GVC. Lenard had spearheaded the Alzheimer’s Association MN-ND and helped launch a statewide initiative for dementia-friendly community groups. Ostroushko had spent an award-winning career in public broadcasting and music production.
The idea for GVC came from research from the fields of arts and aging that documented the value of lifelong arts participation. In 2014 and 2015, neuroscience studies reported that music (and specifically singing) stimulated a portion of the brain that is particularly resilient and last to be affected by Alzheimer’s. Additional research included a Finnish study that indicated group singing had social/emotional benefits for those with Alzheimer’s (e.g. reducing anxiety and depression, improving mood and even increasing some cognitive abilities). One stunning statistic about those living with Alzheimer’s: 70 percent live outside of memory-loss facilities or skilled nursing homes. Most people live in early-to-mid-stages of Alzheimer’s for eight or more years, often losing their social networks because of the public stigma surrounding the disease.
Yet the GVC concept actually “popped” when Lenard came across a four-month study out of UCSD where persons with Alzheimer’s sang familiar songs together like Broadway and Beatles tunes and showed marked improvement in mood, memory and focus… And the idea for Giving Voice Chorus was born!
The founders knew the key to GVC’s success would be finding the right choral director to lead the singers, and to create an appropriate learning curriculum and performance repertoire. More than those rudimentary requirements, the GVC music director would have to be comfortable engaging with older adults and, in particular, people with Alzheimer’s. Ostroushko had someone in mind: Jeanie Brindley-Barnett. A vivacious vocalist and respected teaching artist, Brindley-Barnett had co-founded the MacPhail Center’s Music for Life™ adult education program. Her response was enthusiastic and fortuitous.
Brindley-Barnett connected the GVC co-founders with MacPhail’s leadership team, which offered to collaborate on a nine-month pilot project to bring the GVC concept to life. GVC had access to Brindley-Barnett, a professional accompanist, MacPhail’s registration and box office services, as well as topnotch rehearsal and performance facilities.
In September 2014, GVC launched with 30 singers (15 singers with dementia and 15 caregivers) and a handful of volunteers to help those with AD fully participate. By 2015, GVC had grown to 90 singers and expanded to a second MacPhail-based chorus and year-round programming. A strong strategic alliance was formed between MacPhail and Giving Voice Initiative, a new nonprofit formed by Lenard and Ostroushko. Last fall, a third chorus launched in St. Paul sponsored by a collaboration of several social service organizations. GVC now serves a total of 150 singers.
So what makes Giving Voice Chorus different from other older-adult choruses or conventional music therapy programming for those with Alzheimer’s? As highlighted above, GVC’s target population is people living with Alzheimer’s at home, who can be very isolated and almost invisible. There’s also the level of GVC’s artistic purpose. This is not a “drop-in” activity or casual “sing-along.” Weekly rehearsals are geared to a clear artistic goal: a professionally-produced public performance of musical works that vary from folk songs to musicals and popular music from the singers’ lives. Beyond that, the singers assist in selecting repertoire. They also work with volunteers to create their own scripted introductions that personalize the concerts with funny, poignant, and compelling insights about the impact of music and Alzheimer’s in their lives. The artistic ownership, self-determination, and emotional investment have made a real difference to the singers and the musical outcome.
GVC accepts all singers, who want to be part of the weekly rehearsals. Some members have choral experience and were asked to leave choirs when their memory loss became a problem. Others have no formal choral background, may not read music, and yet share a love of singing. Curriculum combines best practices in vocal music and older adult education with emerging AD research to maximize the singers’ knowledge acquisition and retention, and minimize confusion and anxiety—common issues for those with the disease. Jeanie Bridnley-Barnett describes some of the many considerations in successfully leading this group:
The greatest challenge I’ve found in working with older adult choruses, including GVC (ages 25-80), is finding either published or public domain music that is accessible for the singers. Deciding a program theme and song content is not an issue. We all want to provide our singers with best practices and tools for a successful and purposeful experience. Most groups I work with are comprised of about half who read music and half who don’t as they’ve had little or no choral experience. With best intentions to support fellow composers, independent, and large music publishers, I, with my talented husband, arrange about two-thirds of the music for our library. I have found that if I carefully review tessitura and key, SAB arrangements can work well. I also use two parts and incorporate rounds and partner songs. There are many to choose that don’t infantilize, including some great jazz standards and Broadway tunes. For unification in unison singing, most often, the rhythm, notes, and chords of a basic piano/guitar/vocal score need correcting which may warrant a rewrite.
Preparation for a successful experience begins with singers receiving lyrics and/or music for each song. Lyrics work best with sans seraph font, minimum 18 pt. and written carefully to correspond with the printed music. Printed music in always enlarged to 8 ½” x 11”, sans seraph font, minimum 18 pt and whenever possible we adjust the form so that singers aren’t struggling back and forth to find the place where form symbols occur in the music. Lyrics and music are inserted into a three ring binder, reading as a book from left to right for less page turns. Colored, numbered, dividers which correspond with the Song Index are placed before each set of lyrics and music for easier access. Master rehearsal CD’s (S, A, B) are not only important for practice (repetition, repetition, repetition!), but serve as a prompt for some of our GVC singers as we’re told the CD’s bring calm and focus during times of anxiety.
Just as important to the preparation and logistics of the choir is the welcoming social environment. Each rehearsal is preceded and followed by a social hour with snacks. Volunteers spend time making sure that the singers engage in conversation and meet or reconnect with others as friends. GVC members include married couples, longtime friends, parents and children, siblings, even grandparents and grandchildren. People come early and stay late. Brindley-Barnett writes:
“There is no wrong in this room” is a phrase I use often. It has become a mantra in creating a safe and inviting environment. When our singers sing, the disease is disguised, so we only see engaged faces and hear beautiful voices. GVC singers are the most attentive I’ve ever worked with. I approach them as the professionals they are. With respect, I challenge them to be their very best. In return, they give me much more than I can imagine. They teach me to be present, to cherish the moment, to get “out of my head,” to be an open channel, so the music can move. We see our audiences moved to tears during performances. It may be during the music, or as singers share their personal relationship when they introduce a song. After a concert I heard “This was the best concert I’ve ever attended. I was touched more deeply than I’ve ever been.”
The Chorus has grown in reputation having performed a total of nine public concerts in the Twin Cities and attracting more than 2,400 people. Last December, almost 800 braved two snowstorms and Arctic temperatures to attend GVC concerts. GVC also has appeared as a guest ensemble for pre-concert and public programs of the Minnesota Orchestra, Minnesota History Center, Minnesota Public Radio and Twin Cities Public Television. The camaraderie and confidence of the singers are evident to audiences. A familiar refrain from family members: “We never knew he could sing let alone perform on stage.” Their friends and concertgoers say: “This was the most real choral concert we’ve ever attended.” Even nationally-known Choral Director Dale Warland remarked, “What you’ve done here is special and unique.”
GVC has a vision and a plan for how to share what they have learned. First is to inspire and equip Alzheimer’s choruses far beyond Minnesota and cultivating a movement to change how the public views dementia. A new website (GivingVoiceChorus.org) features a comprehensive toolkit that choral directors, organizations and communities can use to build their own Alzheimer’s community chorus. So far, the toolkit has informed the development and/or launch of choruses in communities such as Eau Claire, Wisconsin; Mankato, Minnesota; Chicago, Illinois; and Vancouver, British Columbia. GVC’s public awareness work has received coverage in local and national media. A local public television-produced GVC profile was posted nationally on the PBS Facebook homepage last July, prompting 20,000 likes and 5,000 shares in just one week.
Last year, GVC began working with Health Partners Center for Memory and Aging in St. Paul. The Center is conducting research on members of the St. Paul GVC to determine if GVC has impact on singers’ cognition and caregivers’ social/emotional well being. Lenard and Ostroushko hope that the study will help GVC and others provide evidence to the healthcare community that choral singing can make a very real difference in the well being of people with early-to-mid-stage Alzheimer’s and their caregivers.
But that difference is something GVC’s founders and Brindley-Barnett already know. They hear it in the singers’ laughter. They see it in their smiles. They feel it in applause of GVC friends and families; and in the weekly embrace of a caregiver. “You’ve saved my life,” says one GVC participant. No – choral singing is doing that!!