Articles written by me on Self-care and Palliative Medicine
On Self-Care & Palliative Medicine

Furry Friends

Furry Friends

Only inches from my face, she holds my gaze with her shiny brown eyes.  She listens intently as I share a brief tale.  With a slightly quizzical look, she cocks her head, then slowly extends her broad pink tongue with a loving swipe to the end of my nose.  Bella, my 5 year old Labrador-mix, has me smiling as she happily shows me love.

Synchronicity provided ample opportunity for me to read and ponder accounts of human-animal relationships this month.  On an airplane to a meeting in Baltimore, I discovered a series of articles in Southwest Airline’s October flight magazine about nurturing and beneficial relationships between people and dogs, people and camels, people and cattle.  I rode the train from Baltimore to Washington, D.C., and read a fascinating article in Amtrak’s October magazine about a program that couples Arizona prison inmates with wild horses; the mutual taming from this pairing is profound.  And, when I tuned into public television one evening this month, the program, Nature was airing an episode on loving, trusting relationships between humans and primates, and even highlighted an amazing bond between a wild female cheetah and a man. Such examples illustrate both the richness and the complexity of human-animal bonding.

Our connection with animals, especially pets, can be powerful and often salubrious as well.  Studies show the beneficial impact that pets have on owners’ blood pressure, cholesterol levels, exercise regimens and socialization. Using these known benefits to pet owners, Pet Therapy expands healthful human-animal engagement.   Let’s consider therapy benefits and concerns in greater detail.

The older, generic term, Pet Therapy, has been justifiably replaced by more precise terminology these days.  Animal-assisted therapy, animal-assisted activities, and residential animals replace the broader, less descriptive term.  While animal-assisted therapies tend to be goal-directed interventions, other animal-assisted activities may have a more general purpose, such as providing comfort and enjoyment for residents in extended care facilities. Characteristically, all of these animal-human interactions have emotional and physical benefits, and ongoing research continues to evaluate such exchanges.

Service animals are distinct from therapy animals in the role they perform.  A service animal is an animal individually trained to do work or perform tasks for the benefit of a specific person with a disability. A service animal is not a pet but rather an animal trained to provide assistance to a person because of a disability.  Guide dogs (colloquially known as seeing-eye dogs) constitute an important group of service animals.

Imagine you are a child waiting for a scary dental procedure, or an illness-weary cancer patient waiting your turn for another course of chemotherapy.  A quiet dog slowly approaches your chair, stands in front of you while gazing calmly into your eyes, and then gently places a paw or its head into your lap.  Both are common scenarios for therapy animals, and both tend to produce smiles, a respite from medical traumas, and momentary relaxation.

Therapy animals visit hospital rooms, physical therapy departments, and palliative care patients in their homes, residential communities, or hospice units.  They make regular visits to senior living centers. These animals can be trained to reinforce rehabilitative behavior: As they are able, stroke patients and people recovering from surgery might be motivated to walk, toss balls, or exercise in other deliberate ways when an eager four-footed companion encourages them.  Depressed patients can be momentarily cheered by a visit from a furry friend who has no agenda other than gentle connection.  Veterans with post-traumatic stress disorder also benefit from regular sessions with therapy animals.  This list is by no means exhaustive, but it does illustrate the broad range of animal assisted-activities.

Therapy animals can work their comforting magic on vision-impaired, hearing-impaired, and even cognitively impaired individuals.  No conversation is involved, so the animals’ gentle touch and uncomplicated presence can be calming and reassuring even when sensory deficits are significant or dementia is advanced.

Therapy animals (usually dogs) go through rigorous training and have comprehensive assessments of their physical health and temperament.  They receive regular veterinary check-ups and vaccinations and are evaluated for their responses to loud noises, beeping sounds (often heard in hospital settings), and other potentially distracting or distressing stimuli.  A bath within 24 hours of therapy work is mandated for these animals.

Although increasingly popular in the United States, animal-assisted activities are not embraced by all cultures.  Especially with animal-assisted therapy, patients and their families are offered a choice to participate or not, and potential risks and benefits are explained.

Transmission of diseases from animals to humans (zoonotic diseases), bites, and potential allergies are the chief worries about animal-assisted interactions.  Training programs, careful selection of animals for their health and temperament, and routine monitoring of sessions all help to minimize these risks.  Additionally, animal bathing and grooming within 24 hours of therapy sessions decrease the dander allergens in an animal’s coat, removing loose fur.  As an additional precaution, staff and patients are routinely encouraged to wash their hands immediately after therapy sessions.

Especially in residential animal programs, jealous attachments to animals can occur or some residents might develop unrealistic expectations of the animals.  When residential animals die, people who have developed strong bonds with these animals will have understandable grief reactions.

Those of you who are caregivers, either by choice or necessity, understand the emotional and physical toll that such commitment and duties can take on one’s body and spirit.  Bless you for undertaking such roles!  Now extrapolate to a therapy animal.  Consider that a therapy animal might visit a depressed individual, a person anxious about an uncertain diagnosis, and a person with advanced serious illness who is nearing death all in the same morning.  Likely, the animal will have a calming effect on each patient, yet the animal will also be affected by the energy of such patients.  At least in the Mayo Clinic’s Caring Canines Program, sessions are limited to 90 minutes, allowing animals to recover afterwards.   We consider potential harm to patients in animal therapy; it is comforting to know that animal safety is also addressed in specific ways.

In summary, the benefit derived from many animal-human connections can be translated into genuine therapy for people suffering with an array of ailments.  In diverse settings, animal therapy provides opportunities for motivation, socialization, and recreation and can enhance quality of life in the process.  Animals are trained and chosen wisely, and the therapy sessions are monitored and time-limited for safety of both the humans and the therapy animals.

Those of us who are pet owners understand the special bond that develops between us and our family-member animals.  They have a knack for making us feel like we’re the most terrific, lovable, and generally perfect-in-every-way people on the planet.  Mary Oliver captures this sentiment poignantly in the final lines of her poem, “The Sweetness of Dogs”:  “Thus we sit, myself thinking how grateful I am for the moon’s perfect beauty and also, oh! how rich it is to love the world.  Percy, meanwhile, leans against me and gazes up into my face.  As though I were just as wonderful as the perfect moon.”

 

Stephen L Hines, MD

October 2017

 

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