Pulse
Who Let the Dogs In?
Animals bring joy and healing to patients who may need a dose of unconditional love during difficult times.
On a snowy February evening, 16 people and nearly as many dogs have gathered at the Twin Cities Obedience Training Club in Minneapolis to find out if they have what it takes to comfort people being treated for cancer or motivate those who are relearning how to walk or talk.
The owners and pets sit quietly as instructor Carol Ouhl describes what therapy animals can do in hospitals, nursing homes, hospices, schools, even prisons, and explains that dogs of all kinds can be therapy dogs as long as they like people, are healthy and even tempered, and have good manners and basic obedience skills. Ouhl, who has been visiting hospitals and nursing homes with her own dogs since 1992, was the first person in the Twin Cities to teach courses that prepare prospective volunteers and their pets for the sights, sounds, and smells of health care facilities and the unpredictable behaviors of patients.
Ouhl says it was “divine intervention” in the form of an 80-pound German shepherd she owned who preferred sitting on her lap to competing in obedience and breed competitions that drew her to the work. She joined a group of people at the facility where she was doing obedience training who were taking their dogs to visit residents of nursing homes and medical centers. “I got hooked and since have spent all my spare time doing this,” she says.
Jack of All Trades
One therapy prescribed at Mayo Clinic has four legs, floppy ears, and a long snout with a black nose.
Jack, a 6-year-old miniature pinscher, has been visiting and working with patients at Mayo Clinic for the last four years. Originally destined to be a hearing-assistance dog, he was placed with Marcia Fritzmeier, who was working as a medical secretary in the physical medicine and rehabilitation department at Saint Marys Hospital, to learn obedience skills and how to function in public places. One way Fritzmeier trained Jack was by taking him to work with her.
But when it came time for Jack to take his final test for certification through Hearing and Service Dogs of Minnesota, he did not pass. He jumped on the couch and burrowed between the cushions instead of alerting Fritzmeier to the sound of a smoke alarm. “I honestly think he wanted to stay here,” she recalls.
Rather than become the ears of someone with a hearing impairment, he changed jobs and became a “facility-based service dog,” a dog who comforts and works with patients recovering from illnesses and surgeries or going through lengthy tests and difficult procedures.
Jack became a favorite in the rehab department, encouraging a brain-injured patient to pet him with his affected arm, helping a 4-year-old girl with cerebral palsy learn to walk with a walker, and letting a girl whose hands were permanently clenched stretch her fingers by rubbing them on his back. “Interaction with an animal is different than with a human,” says Sherilyn Driscoll, M.D., director of pediatric rehabilitation services and one of Jack’s biggest fans. “People don’t feel pressure to perform [in front of a dog]. There aren’t the expectations.”
At first, Fritzmeier took the 14-pound Jack to visit rehab patients over her lunch hour or during breaks. Requests for visits soon came from other departments: neurology, oncology, the chronic ventilation unit, even the cardiac ICU. Now Jack visits or works with patients on the orders of a physician and has seen more than 700 patients in the last four years, many of whom leave with Polaroid pictures of themselves with the dog.
Fritzmeier has collected more than 100 surveys from patients who have had contact with Jack, asking them to rate their satisfaction with his visits. The results have been “overwhelmingly positive,” she says. She hopes the findings will result in a career change from medical secretary to full-time service dog handler with the complementary and integrative medicine department.
“As a motivational tool, Jack helps change patients’ attitudes about their therapies and recovery processes. He gives patients the ability to refocus and get their mind off their illness,” Fritzmeier says. “For some, Jack is the only pleasurable thing they can look forward to. And he loves every one of them.”—K.K. |
In addition to getting other pet owners hooked, she has been going to health care facilities to teach physicians and other providers about the benefits animals bring to health care—how they can encourage a patient to walk down a hall, sit quietly for an electroencephalogram, or express their hopes and fears, and that they have been shown to reduce anxiety, decrease depression, and distract patients from their pain.
Although hospitals have allowed people to bring in pets to see family members for years, the idea of having volunteers and their animals visit didn’t catch on in Minnesota until the late 1970s. R.K. Anderson, D.V.M., M.P.H., director of the University of Minnesota’s Center to Study Human-Animal Relationships and Environments, surveyed 420 nursing homes in the state to find out whether pets visited or lived in those facilities. More than half of the respondents said they did. In 1980, Anderson and colleagues worked with the Minnesota Department of Health to get legislation passed making it legal to have pets in nursing homes.
It was only a matter of time before animals were officially invited into hospitals, rehabilitation centers, and other facilities. “The volunteer coordinators and the nursing staff began to realize that there was a tremendous positive response, and they started making requests to have these groups of volunteers and dogs go elsewhere,” says Ouhl, who first brought her dogs to a nursing home in which her aunt lived and has since visited Gillette Children’s Hospital in St. Paul and the Struthers Parkinson’s Center in Golden Valley.
What started out as owners and animals visiting with patients and residents split into two distinctive activities: “animal-assisted activities,” in which a volunteer and pet provide companionship and emotional support, and “animal-assisted therapy,” which is directed by a physician, physical or occupational therapist, or other health care professional and incorporates the animal into a patient’s treatment plan. In animal-assisted therapy, goals and results must be documented.
Dogs are the most frequent participants in animal-assisted activities and therapy, says Ouhl, who tests the abilities of teams of animals and owners for registration with a national therapy animal organization. However, she also has evaluated cats, rabbits, guinea pigs, miniature horses, two pot-bellied pigs, and even a cockatoo.
Doing it for the Dog
As an occupational therapist in the behavioral health unit at St. Joseph’s Hospital in St. Paul, Pam Van Cura has been incorporating dogs into her work for the past 11 years. Her first dog, Chester, a golden retriever, helped her establish rapport with patients suffering from depression, severe anxiety, and hallucinations. When Chester made rounds with her, patients who hadn’t left their rooms in days would come out to see the dog.
One woman, who had psychosomatic paralysis, believed she couldn’t move her arm—until she saw Chester and lifted that arm to pet him. “She thought the dog had cured her,” Van Cura recalls. Chester got a catatonic patient to throw him a ball and encouraged a man who was unsteady on his feet to walk him. He also boosted patients’ self-esteem by following their commands to sit or lay down. When Chester died last summer, Van Cura says patients not only grieved the loss of the dog but also mourned their own pets and loved ones. “It got people talking about their own experiences,” she says. Van Cura is now training Max, a 7-month-old golden, to work on the unit.
Laura Vos, supervisor of volunteer services for Hospice of the Lakes in Bloomington, tells similar stories about the five teams of dogs and owners that visit hospice patients. “Sometimes when the patient isn’t able to connect with or feel comfortable talking with a member of the care team, they’ll bond with a dog,” she says, telling of one woman who would tell the chaplain she was fine, then share her fears about dying with Sasha, a Samoyed. Sasha also helped mediate a visit between a dying man who was living in a nursing home and his young grandchildren, who found the environment frightening. “It brings people together,” she says of the dog visits.
Pets at Work
Information on how to bring animal-assisted activities or therapy to your facility is available from the University of Minnesota’s Center to Study Human-Animal Relationships and Environments (www.censhare.umn.edu/care07.html) or Delta Society(www.deltasociety.org/Animals
HowAAAStart.htm).
Volunteers and their animals should be registered with the Delta Society, Therapy Dogs International, Therapy Dogs Incorporated, or Love on a Leash: The Foundation for Pet Provided Therapy, all of which provide liability coverage for animals and handlers who pass a screening.
Although advocates of animal-assisted activities or therapy like to talk about their experiences, they want to see more research documenting its benefits. “Those of us who have been in the industry for a number of years are trying to promote more analytical studies to see where animal-assisted activities and therapy are applicable, where they work, and where they don’t,” Ouhl says. |
Flipper, Fido, and Facts
In the last few years, she has noticed more studies of specific applications of animal-assisted therapy. For example, an article in the December 2005 issue of the
British Medical Journal reported how animal-facilitated therapy using dolphins was effective in alleviating symptoms of depression. At a 2004 international conference, Italian researchers presented findings that Alzheimer’s patients had an increased attention span, more interaction with other patients, fewer behavior problems, and improved disposition and verbal interactions when they were in the presence of a dog. An article out of San Diego State University published in a 2006 issue of the
Journal of Holistic Nursing found visits with a dog reduced children’s perception of postoperative pain. And researchers from Virginia Commonwealth University in 2005 found as little as five minutes of interaction with a therapy dog reduced chemical signs of stress among health care professionals.
Ouhl says such published research will help her achieve her goal of making animal-assisted activities and therapy as accepted as other complementary modalities such as music therapy. “Somewhere down the road, it’s going to happen,” she says. “The motivation these animals provide to people that gives them yet another reason to help themselves heal is phenomenal.”—Kim Kiser