Helping Parkinson's Patients Regain Their Voices

Mar 15, 2018

Pam Baldwin helps Parkinson's patients whose vocal abilities have diminished. Baldwin is the choir director for the Tremble Clefs.
Credit Doug Nadvornick/SPR

When you say Parkinson's Disease, you think tremors or shaking. At least I did. And the other day I was talking about it with Samantha Elandary of the Parkinson Voice Project near Dallas, Texas.

“The main symptoms of Parkinson’s can be a tremor or slowness of movement, impaired balance and rigidity or stiffness. There actually is no specific test, except an autopsy, to diagnose Parkinson’s for sure. And as you can imagine, not too many people want to sign up for that,” Elendary said.

Elandary is the founder and CEO of the project.

Samantha Elandary: “Up to 90% of people with Parkinson’s can have difficulty with speaking and swallowing.”

But, she says, Parkinson’s is not fatal. And with the right therapy, patients can retain much of their quality of life. That therapy includes physical and vocal exercise.

“Anything that we do automatically, talking, walking, swinging our arms when we walk, all of those things are automatic movements. And people with Parkinson’s can have a hard time with those," Elendary said. "But, we have a backup system that is responsible for intentional movement, meaning when you’re deliberate and purposeful, you can make your legs work the way you want them to work. You can make your voice come out stronger and so we want people to know they can have more control over their speech and their swallowing.”

The Parkinson Voice Project has developed two therapy programs that are used around the nation. In Spokane, they were adopted by the communication disorders program operated by Eastern Washington University and Washington State University.

Doreen Nicholas is the director of the two universities’ speech clinic on the downtown Spokane campus. She says the approach is to get Parkinson’s patients to speak with intent.

“Patients with Parkinson’s tend to talk with the low volume and they maybe they might have a hoarse quality in their voice. But we would just say ‘with intent’, which really means trying to raise that decibel level," Nicholas said. "When you do that, they naturally take a breath and they talk louder and they sound much better and people can hear and understand them.”

Nicholas leads patients through some warmup exercises before they begin singing. She says they start with 12 vocal therapy sessions in four weeks. Then they transition to a weekly class called The Loud Crowd. Many also join a local group called The Tremble Clefs. That’s this group. They meet on Tuesday afternoons.

Once Nicholas has her patients’ voices ready, choir director Pam Baldwin and pianist and music therapist Donna Douglass lead them through some old favorites, such as "By the Light of the Silvery Moon." The words are projected up on the screen.

“The patients love it. The patients usually come in. They are talking in a soft voice. They may be a little skeptical. You can see it on their face," Nicholas said. "But it’s fun as they leave the session to see how their faces lit up a bit. They’re smiling. They usually bring a spouse with them and we’re able to have them see a change in that first 45 minutes.”

We caught Roy Hooten on a good day. Today his voice is strong, but there are times he says his wife complains about his volume.

“We have a four-level house so I’ll be talking to her and she doesn’t hear me and so I’ve got to come down a couple flights. Uh, here I am," Hooten said. "Just little things like that.”

Patsy Wright is in fine form as well.

“I have off days and on days. In a half hour I may be off and I just don’t have a voice and I just can’t project the voice and I try to enunciate the words. It just doesn’t work,” Wright said.

But today it does work. Wright says she can tell she’s making progress from when she first started.

"I couldn’t carry one note to another. I was just monotone. And it’s really, really helping me,” she said.

Samantha Elandary from the Parkinson Voice Project says programs like this are helping to save lives. She says the number one cause of death for Parkinson’s patients is aspiration, breathing in food and water. But by speaking with intent and singing, she says people can keep their muscles strong and minimize the chances of something going wrong.