Innovation: Community singing for people with COPD

United Kingdom

AAI Domains:

• Participation in society (social connectedness)

• Independent, healthy and secure living (improving mental well-being, lifelong learning, physical exercise)

Chronic obstructive pulmonary disorder (COPD) is an umbrella term for a range of conditions, including chronic bronchitis and emphysema, that lead to an irreversible airflow obstruction. This can lead to severe breathlessness that greatly limits people’s ability to undertake the normal activities of daily life and this can lead to inactivity and social isolation. COPD is also associated with other health conditions such as heart disease, osteoporosis and depression that can greatly reduce quality of life.

There are more than 800,000 people in England who have been diagnosed with COPD but there are likely to be more than three million people living with the early stages of the condition. COPD is strongly associated with smoking and usually affects older people above the age of retirement but it does also affect adults of working age. In severe cases, people can be reliant on oxygen and the condition can lead to a ‘spiral of decline’ with people feeling depressed and having low self-esteem due to a condition without cure.

While the medical model of diagnosis, treatment and cure or management of the condition is valuable to people living with COPD, there is a strong case for social innovations that promote a sense of well-being informed by the salutogenic model of health. Good health is based on ‘resistance resources’ that form a ‘sense of coherence’ that is essentially a dynamic feeling of confidence that the challenges that life produces can be coped with and a sense of wellness be built and maintained.

The potential health and well-being benefits of community singing for people living with health conditions such as COPD but also mental health issues or dementia are becoming increasingly clear. The community singing for older people with COPD was established in six towns across the county of Kent (Ashford, Canterbury, Deal, Dover, Ramsgate and Whitstable) and met once a week with a ten month period of research to investigate physical and emotional changes that could feasibly be attributed to participation.

With funding of £130,000 from the Dunhill Medical Trust, older people with COPD at different stages of severity were invited to participate and take part in singing or the organisation of the community choir. The choirs were lead by a skilled musician and they met in suitable community centres for rehearsals with a baseline assessment of physical and emotional health taken at the start and after 10 months. The results indicated improvements in lung function and improved quality of life for participants who developed stronger social connections, many learned new skills associated with singing and reported improved mental well-being.

The groups in Kent are part of a wider movement that has seen community choirs established in the Royal Brompton and Harefield Hospital in London, Better Breathing singing groups established by the local health body in Brighton and Hove and a Singing for Breathing group in Folkestone. There is a developing body of academic literature that indicates that community choirs have positive health and well-being effects for people a range of health conditions that broadly coincides with the five ways to wellbeing devised by the New Economics Foundation, an independent think tank, based on connecting with people around you, being physically active, taking notice of the environment, the importance of learning and the value of giving to either a stranger or a friend.

In relation to the active ageing index, community singing for older people with COPD has potential promise to improve mental well-being through building social connectedness among a group of people who are at elevated risk of social isolation and depression due to the physical limitations of their condition. There is an element of lifelong learning for participants who can play a number of ‘behind the scenes’ roles if they are not able to fully take part in the singing. Singing is physical activity that is effectively a form of exercise for people who have a serious life-limiting condition such as COPD.