增進銀髮族吞嚥功能之音樂照護活動設計

古言：「民以食為天」、「吃飯皇帝大」，一旦因為疾病、老化或意外等因素使「吃」變的困難時，將嚴重影響生活。歌唱則是口腔運動之綜合活動，除了唇、齒、舌、頰、咽喉運動外，更含括呼吸循環、共鳴震動與唾液吞嚥，其中腹式呼吸、面罩共鳴、吐字、發聲更是歌唱訓練重點，藉由節奏、音準、共鳴、語音及呼吸等訓練，達到歌唱美感的要求，同時強化吞嚥周邊肌群。本音樂照護活動設計改編自日本大阪YMCA之口部按摩操、健口操（PA、TA、KA、LA）及臺北市政府衛生局之健口瑜珈。本活動在口說與律動上選擇風格清新的台語歌「心花開」與節奏強烈的櫻桃小丸子主題曲「大家來跳舞」作為配樂與動作設計，至於歌唱健口操則設計二個版本；分別改編義大利輪唱曲「笑哈哈」為PA、TA、KA、LA 輪唱，而為因應台灣大部分高齡族群的福佬語系，研究者改寫台灣民謠「農村曲」，並融入強化舌頭力量之設計，最後為達歌唱中的美感與愉悅性，農村曲於B段加入輪唱與第二聲部，提供銀髮族在歌唱中享受音樂活動的樂趣，同時增進吞嚥肌群功能！

關鍵字

銀髮族；吞嚥；音樂照護

並列摘要

The old saying: ＂Food is the heaven for the people＂ and ＂Eating is the emperor.＂ Once it becomes difficult to ＂eat＂ due to diseases, aging, or accidents, it will seriously affect life. Singing is a comprehensive activity of oral exercise. In addition to lip, tooth, tongue, cheek, and throat exercises, it also includes breathing cycle, resonance vibration and saliva swallowing. Among them, abdominal breathing, mask resonance, spitting, and vocalization are the focus of singing training. , Through the training of rhythm, intonation, resonance, voice and breathing, it can meet the requirements of singing beauty and strengthen the muscles around swallowing. The design of this music care activity is adapted from the mouth massage exercises, aerobic exercises (PA, TA, KA, LA) of YMCA in Osaka, Japan, and the mouth yoga of the Taipei City Government Health Bureau. In this event, the fresh Taiwanese song ＂Heart Blossom＂ and the strong rhythm of Chibi Maruko's theme song ＂Everyone Come Dance＂ are selected as the soundtrack and action design for this activity. As for singing and aerobic exercises, two versions were designed; the Italian round song ＂Laughing Haha＂ was adapted for PA, TA, KA, and LA rounds. In response to the Fulo language family of most of the elderly in Taiwan, the researchers adapted Taiwanese folk songs ＂Rural music＂ and incorporates a design that strengthens the strength of the tongue. Finally, to achieve the beauty and pleasure of singing, the rural music adds a round singing and a second part in the B section to provide the silver-haired people with the fun of music activities while singing, while enhancing Swallow muscle function!