Music Helps Hospice Patients

Twenty-four years ago, Kate Munger sang to her dear friend as he lay in a coma, nearing death after suffering from HIV and then AIDS. She used her love of music to comfort herself, and in turn realized she was comforting her friend as well.

Over time she began gathering more volunteers, singing for people as they approached death, which evolved, into the Threshold Choir in 2000. Now there are choirs in 120 cities across the country, including a group that sings to patients at the VNSNY Haven Hospice Specialty Care Unit at Bellevue Hospital.

Under the direction of Winnie Lee, a small group of volunteers met this past Saturday to sing to patients for an hour. Along the peaceful hallways of Haven Hospice, Lee led Marcia Picciotto, Rebecca Kaplan, and Carol Mannes in warming up their voices by singing harmonies to song phrases like “may I be an instrument of peace,” and “I will not leave you alone” before singing to the patients.

In an effort to keep the patients as comfortable as possible, Lee enters the first room alone to ask patients if they would like to hear songs from the choir. Once they agree, the other three women enter quietly, greeting patient Barbara Roberts and her family with warm smiles. Roberts happened to be celebrating her 72nd birthday; the room was filled with her family and friends.

The choir began by singing “This Little Light of Mine,” which inspired Roberts to start singing and clapping along to the melody. Her face lit up as she heard the familiar song, and soon the entire room was singing together in celebration of her birthday.

After a few more songs, the choir ended with several versions of the Birthday Song, leaving many in the room in tears. “These are happy tears,” a family member yelled out. “It’s just nice to be singing together.” The choir then said goodbye to Roberts and her family, leaving a joyful energy in the room and a smiling birthday girl.

“When we come out of the room we sometimes need to take a moment,” Picciotto explained. “It can be so emotional and we don’t want to break down in front of the patients so we try to collect ourselves before singing in the next room.”

All Threshold Choir volunteers are required to train for several months until they have learned the entire songbook. In training they also go over different ways to connect with the patients, and how to remain composed during such an emotional experience.

“The other thing that is important for our singers is blending, we want the different voices to blend into one sound,” Lee explained. “We also have to train our singers on how to sing quietly. They have always been told to project loudly, but here it is important to sing sweet and low due to the nature of the hospice setting.”

The volunteers have a range of musical experience, but all find inspiration in offering comfort to people in their days before death. After reading about the choir in a feature article in Real Simple magazine in 2007, Lee contacted them to get involved. With no singing experience outside of grade school chorus, she has committed enough time to become a choir leader. There is an average of 12 volunteers singing at VNSNY Haven Hospice Specialty care, working around everyone’s schedules to each sing at least once a week to patients.

“As we enter each room we hope our singing can offer a little comfort, just something soothing to the patients,” Lee said. “We’re here to give them a little brief break from their day, and if we’re lucky maybe sing them to sleep. Since illness and death are so out of our control, this is one small thing we can do.”

As the choir walked through the hallways singing to other rooms it became clear how they take the time to personalize the songs for each patient. Several patients felt too tired to have them in the room, so they sang quietly in the hallway to be less intrusive. For a Spanish-speaking woman, the choir sang traditional Spanish songs to inspire good memories from her childhood.

Jennifer Brown, a VNSNY nurse, approached the choir in the hallway to thank them for all that they do. Her first experience with the choir was when one of her patients had a brain tumor and was unresponsive. Her medical team saw some minor progress after adjusting her medications, but Brown explains she saw the biggest difference after the Threshold Choir sang to the patient.

“One of the first signs of major response was after the choir began singing to her and I started to see her sway with the music,” Brown said. “Her family visiting began to sing along with the choir and it was such a beautiful moment, especially after a few days of this patient not talking at all. To see her engage with the music and share that with their family was incredible.”