PERRYSBURG - Week by week. Day into day. Hour upon hour.
|Amey Raihala, one of the members of the Hospice "Threshold Choir", poses for a portrait outside the hospice in Perrysburg. (Photo: Shane Hughes/Sentinel-Tribune)
For each of us, life's span has a predetermined length, and how we spend our final weeks, days, hours, matters a great deal.
Amey Raihala, R.N., a palliative care specialist at Hospice of Northwest Ohio, knows this well.
The Perrysburg woman has discovered a singular way to accompany patients on their final journey home, not just as a medical provider but as a volunteer with a musical gift she and other area women are eager to offer.
They are members of a "Threshold Choir," a movement founded 12 years ago on the West Coast, which Raihala brought home to Perrysburg and Toledo in 2007.
"Another volunteer, Denise Martin, had been coming to see patients and singing to them. About the same time I came back from a Hospice conference in Minneapolis where Kate Munger was presenting."
Munger, founder of the Threshold Choir movement, "opened the conference and asked people to close their eyes and be the person in the bed."
As she explained the concept of Threshold - a small choir of all female voices singing at the bedside to bring comfort to those on the threshold of living and dying - and demonstrated the kind of repetitive, harmonic singing she was talking about, "I thought, 'that's good. I want to be part of this,'" Raihala recalled. "So I went to her class."
The singing is typically done in chants, rounds and lullabies, to hymns or simple childhood songs.
"When harmony is added (Munger) talks about that shiver up the spine. When it gets to that point with the patient, it's magical."
More magical, still, is the way family members of the patient are gently invited to join in the singing, which follows an ancient tradition, according to Raihala.
After offering Hospice of Northwest Ohio administration a demonstration of what a Threshold Choir really was, they quickly got on board with the idea.
Today, the local choir has an average of 17 to 20 members. About 25 percent of them, like Raihala, are Hospice staff members; the rest are volunteers from the general public.
They rehearse once a week at each Hospice location. The Perrysburg center, at 30000 E. River Road, hosts practice on Tuesdays at 6:30 p.m.
"When we are invited to the bedside, we visit in small groups," Raihala said. "We choose songs that appeal to the patient's taste and spiritual direction."
Families tell Raihala and the other choir members they feel the songs bring peace to their dying loved ones.
"For patients who are restless, you can see the patients visibly calm down most of the time. It's been shown to relax breathing, heartbeat."
Raihala said it has happened more than once that a patient died while the Threshold Choir was singing to them.
That certainly is not the aim, or the norm, but volunteers are prepared for any scenario.
Often the patient is past being able to speak, but they are conscious and will start to smile as the singing continues.
In other cases, the patient is awake, alert, and "the things in the songs start a conversation between the patients and their families," said Raihala.
Threshold Choir visits are usually arranged with the family ahead of time. "We sing to our patients in all of our locations," including hospice home-care patients, said Barb Sharek, Hospice external communication coordinator.
But some visits are spontaneous.
"Sometimes, when we're practicing, people walking by will hear us and ask 'Can you come to my Dad's room and sing?'" Raihala said. "Or, if we're singing for one patient, when we leave the room the family of another patient will be outside the door and ask if well go sing for their loved ones."
Experiences such as these have made being a Threshold Choir member one of the most meaningful aspects of Raihala's own Hospice experience.
The 55-year-old mother of two, and grandmother of three, formerly worked at the Perrysburg Hospice center but is currently on the nursing staff at the Toledo facility.
A 1974 graduate of Perrysburg High School, she attended the University of Toledo and obtained her nursing degree from Owens Community College in 1978.
Threshold choir members sing a cappella - no instruments - and the effect has been described as "angelic sounding," said Sharek.
"What makes it different" from any other kind of singing, or even calming music on the radio, "is that you're singing only for that patient, and you're singing with intention," Raihala added. "Often, the families are moved as well."
Sharek noted that the agency "has also been able to persuade our Threshold Choir to sing at our annual memorial service" for patients who have died, which is held each November.