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Published on: April 20, 2010
by Madeline Vann, MPH for Everyday Health:
Therapy dogs and other animals can stimulate social interaction and ease agitation in dementia patients. But it takes specially trained pets to bring the full benefit of animal therapy into elder care settings.
Talk to animal therapy practitioners and researchers and you will hear stories about therapy dogs and dementia patients that bring tears to your eyes.
You may hear of Diva, a German shepherd, who sought out an elderly, non-communicative man sitting alone and let him wind his fingers in her fur and hug her. Then there is the resident golden retriever-lab mix in an Alzheimer’s care unit who found his favorite patient agitated in a hallway — and gently took him by the sleeve to lead him back to his room. Or you’ll hear about Leonardo, a cat who curls up on the bed next to end-stage Alzheimer’s patients in hospice units.
But behind every successful animal-assisted therapy visit, there is also a lot of planning, training, and work to be done so that animal therapy is safe for people living in elder care settings.
The Benefits of Animal Therapy
“Even people with Alzheimer’s recognize a dog and they see that the dog is someone new in their environment. I think they see it as someone with whom they can interact without any worry,” explains Mara M. Baun, DNSc, a coordinator of the PhD in nursing program at the University of Texas Health Sciences Center at the Houston School of Nursing in Houston.
Baun has been researching the benefits of therapy animals for over a decade. In one of her studies, she and her team compared degrees of social interaction of adults in an Alzheimer’s unit with and without the presence of a dog.
“When they had the pet with them, they had more interactive behaviors, although some of them were aimed at the dog, not at the person,” she says. Her work has shown this effect is consistent whether the dog and dementia patients interact one-on-one or in a group setting.
In addition to stimulating a social response, dementia patients may benefit from the presence of therapy animals because of:
Reduced agitation. Agitation behaviors, common among dementia patients, are reduced in the presence of a dog.
Physical activity. Depending on a patient’s mobility, they may be able to groom the animal, toss a ball, or even go for a short walk.
Improved eating. Dementia patients have been shown to eat more following a dog’s visit.
Pleasure. Some patients simply enjoy the presence of the dog and its human companion, as well as the tricks therapy dogs can do.
Making Animal Therapy Work in Elder Care Settings
If the idea of animal therapy is appealing, it’s worth knowing that there is a lot of work that goes into matching the right animal and human handler team with the right patients. Here are some of the issues involved:
Temperament. An animal’s personality will dictate whether they can be a good therapy animal. You want an animal that is not easily startled and is comfortable interacting with unpredictable strangers in a calm manner. Dogs are the easiest to train for these types of situations, says Cheri Weston Swenson, MSN, a therapy animal handler and an evaluator for Delta Society Pet Partners Teams in Minneapolis-St Paul, Minn. Still, she knows teams that work with Delta Society-registered guinea pigs, rabbits, horses, and even chickens.
Individual strengths. Each animal has their own strengths. Swenson says her cat, Leonardo, does best when he is interacting one-on-one — but her dog, Victor, is fine in group situations. Some animals are better suited to children than dementia patients.
Training. Swenson trains her dogs to be comfortable with hospital equipment, tubing, wheelchairs, and the crowded situations they might encounter in an Alzheimer’s unit. Therapy animals should also be able to sit, stay, do tricks on command, introduce themselves nicely (such as putting their head gently on a knee), and pass over tantalizing smells. At the same time, human companions must cultivate their ability to be good advocates for their pets in difficult situations.
Registration or certification. “I am almost never asked about our qualifications and that bothers me,” says Swenson. “We want to uphold a high standard for therapy animals and their handlers.” She recommends seeking out therapy animals and human companions who are registered with the Delta Society, Pet Therapy International, or Therapy Dogs International. Delta Society, for which she is an evaluator, retests both humans and pets every two years — a good thing, says Swenson, who has observed that even the most committed teams can become lax during that time.
Cleanliness. Swenson bathes her indoor animals at least once a month and spends about 30 minutes grooming them before a visit — this includes cleaning their ears and mouth, clipping their nails, washing their feet, and brushing them thoroughly.
Infection control. Infectious agents such as MRSA, C. difficile, E. coli, and Salmonella are a concern in elderly care settings, affecting both dementia patients and the therapy dog teams that visit them. In addition to properly cleaning the therapy animals before and after a visit, infection control measures include:
Giving treats. Swenson says feeding is a universal bonding behavior, and many of the people her animals visit want to give a treat. She carries small hand-held shovels into which they can place a treat (which she provides) for the animal to retrieve — but then the therapy dogs are required to do some kind of trick in exchange. Other animal and pet teams do not allow treats, however.
Cleaning the hands of everyone who will touch the animal before and after contact.
Preventing animals that eat a raw foods diet from being therapy animals.
Avoiding contact with the animal’s mouths.
Using sheets and barriers, such as rolled towels, to keep some distance between the animals and the dementia patients’ bedding or furniture. Fresh sheets and towels must be used in each room.
Flexibility. With dementia patients, visits can be unpredictable, says Swenson. She has seen her dog surprised to find that a patient he knows well may, on occasion, push him away. Both human and animal have to be able to adjust to changing situations.
Baun adds that some facilities try to have a resident animal. This can work, she says, but the animal must have off-time — just like every other worker — as well as a place of its own to rest and a clear understanding at the staff-level about who is responsible for the animal’s well-being. The best situations occur when a staff member brings a suitable animal in with him during the day and then they go home together at night.
Properly trained and prepared therapy animals can be a real blessing to dementia patients in elder care settings — it’s a great option to look into for your loved one.
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