Thursday, September 20, 2012

Why Animal-Assisted Therapy?


I have found that most animal-assisted therapy (AAT)teams start with visiting nursing homes in which dementia patients reside or visiting hospitals and adult day centers.  Generally, they are involved with the activities department of the facility, visiting in the Animal Assisted Activity realm, the warm, fuzzy visit.  That is where I began many years ago.
Several years ago my Mother was diagnosed with terminal cancer.  Not long after that she was moved into a nursing home in our hometown.  Aubie, my 9 year-old shih-tzu, was just a young dog and my mother just loved him.  I would take him on my visits to see my mother and Aubie was a natural.  He would visit everyone on the way in and on the way out.  One day on the way out Aubie jumped into the lap of a woman that had Alzheimer’s.  I was very upset because I did not expect it, I did not know what she was going to do, and her son was standing next to me.  She just reached down, petted Aubie and and a giant smile appeared on her face.  I was relieved and turned to her son to apologize only to find him with tears running down his face.  Again concerned, I asked him what was wrong, afraid that Aubie had created a problem.  Through his tears, he told me that it was the first time he had seen his Mother smile in two years.  It was then that I knew the power of relationship between people and animals.

 Put as simply as possible, when introduced properly into a therapeutic setting, animals make people feel better, improve quality of life and assist in healing.  In addition, an animal’s loyalty and authentic nonjudgmental willingness makes our relationships with them some of the most enduring and safe interactions possible.   Utilizing animal-assisted therapy allows healthcare workers to relate with patients experientially, rather than relying strictly on the therapeutic understanding of families, individuals, and groups that may be lost, literally, in translation.   
AAT has been found to be beneficial with all age groups, children, adolescents, young and older adults.  In long-term care, focusing on AAT as compared to other non-animal therapy activities.  The outcome of the study concluded that residents involved in the AAT activities were three times more likely to initiate and have longer conversations than those involved in the traditional activities.  The most important finding appeared to be the frequency of touch.  Since touch is a considerable part of human socialization and the elderly are often deprived of physical affection, touching the animals during the visits increased the residents’ positive social behavior and improved quality of life.  The next step is to prove to the world what we already know through research. 

Dementia is a loss of previous levels of cognitive, executive, and memory function in a state of full alertness.  Primary dementia is irreversible.  Alzheimer’s disease (AD), the most common form of dementia, is a progressive disease for which there is no cure.  This disorder creates a large and growing public health problem.  Because there is currently no successful cure or method of prevention, the main goal of most interventions is to improve patients’ quality of life.  Social and recreational activities are important for achieving these goals.  Although (AAT) has previously been instituted as a therapeutic activity for residents of long-term care facilities, there is little empirical research documenting its effectiveness, especially in patients with cognitive impairments.  Human-animal interaction research is in great need of carefully controlled, empirical studies that are able to demonstrate concrete, measurable results. 
This research project is designed to compare AAT with human interaction in improving the social outcomes of persons with dementia living is long term care facilities.  We will conduct a controlled trial with randomized cross-over between conditions. Persons with dementia  living in long term care facilities will be included in the study. Consented, willing participants will be assigned in random order to AAT or human interaction (control) blocks for two weeks then switched to the other condition.  Specially trained dogs and their handlers will visit patients using standard AAT protocols.  The control intervention consists of conversation or reading from and looking at pictures in a newspaper to control for non-specific benefits of one-to-one interaction. Presence of positive and negative social behaviors and level of engagement will be measured during the visits as well as weekly measure of the Cohen-Mansfield Agitation Inventory.

Participating faculty will also engage undergraduate nursing students who receive training in animal-assisted therapy to participate in this project.  Faculty believe this opportunity will provide a positive learning experience for these students and positively affect students’ overall attitude about caring for the elderly.  In addition the effects of the visits and interaction on the attitudes toward working with older people will be measured with the students involved in the project.  Our results show that use of AAT is effective in improving the behavior of individuals with dementia, it will potentially provide a safer and more enjoyable intervention rather than reliance on pharmacology alone.







 

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