NURSING AT McLEAN
Pet therapy is good medicine on South Belknap II
by Lesley Adkison, APRN, BC
'Mary' said little during her first few days on the Special Care Unit and staunchly refused to eat, drink, take medication, or bathe. She would glower and stand against the wall beside my office, just watching and waiting. It wasn't until she saw me carrying Knight, our pet-therapy cat, that Mary initiated even a brief conversation. After acknowledging the cat, Mary reached out and stroked Knight, responding affirmatively to the question about whether she'd ever had a cat. That was the extent of the conversation. Mary didn't change any of her other behaviors that day, but the interaction was a beginning. She walked by my office later in the afternoon, peering in to watch me at my desk. The next day, I got a smile. Eventually, Mary came into my office initiating interaction on her own.
Lesley Adkison with Knight
Mary's story is not unusual on South Belknap II. Most of our patients have some form of dementia, and many have underlying life-long psychiatric issues. These patients, more than most, are likely to benefit from interaction with pets during their hospitalization.
Certainly, much has been written about the value of pet therapy in hospitals, nursing homes, prisons, and schools. Pets are known to decrease blood pressure, provide companionship, stimulate conversation, and even encourage exercise in sedentary individuals. On a dementia unit, the value of pets goes even further-they allow an instant connection with the present and may trigger memories from the past.
Individuals with dementia live 'in the moment.' They react to body language, tone, gestures, and stimuli in the immediate environment. Facts become less important as the disease progresses. The emotional state of an individual at any given time during the day determines the quality of life at that moment. The goal of staff, therefore, is to increase the number of positive interactions for each patient. One way to promote positive feelings is through visits from animals and their owners.
Animal volunteers at McLean Hospital are required to go through a strict screening process. Each animal's aptitude for pet therapy is assessed by a veterinarian and specialized training organizations. Recreation Therapy Department employees identify and approve all therapy animals used on units, accompany the pets and their owners during visits, and evaluate the effectiveness of animals in clinical situations.
Pets on an inpatient dementia unit are a lot like the patients they visit-they exist in the here-and-now and respond to behavioral cues of pleasure, displeasure, sadness, or joy. Riley, our Bernese Mountain Dog, saunters onto the unit proudly wearing his McLean badge, ready to meet and greet anyone in his path. It should be said that Riley isn't a trickster; he has no special talents. He is simply grounded in his doggie self, content to just 'be' with patients, asking for nothing in return. He gently responds to patients' body language, allowing each patient to interact as she/he feels able.
Riley and Knight offer what the Alzheimer's Association calls a "failure-free activity." The term refers to an activity that can be adapted to suit the needs of people with memory loss. It's an activity that encourages decision-making and participation in the environment. In the case of pet therapy, patients may choose to simply look at an animal, stroke its fur, or engage in a conversation about pets they've had in the past.
Choice is an important part of failure-free activities. Individuals with dementia often have no control over their environment. Pet therapy allows patients to make choices about when to interact, how to interact, and how long to interact.
All humans need physical touch. Tactile stimulation is provided when patients pet an animal's soft fur, feel the vibration of a cat purring, or feel a cold, wet nose on their hand. Animals are able to connect in a tactile way when words cannot get through.
Physical activity and range-of-motion exercises are often difficult for older individuals. Introducing pets to help a patient extend an arm or take a dog's paw is a way to encourage beneficial physical therapy in an enjoyable way.
The benefits of pet therapy are apparent as we look into the eyes of our patients following a visit from Knight or Riley. The atmosphere on the unit is lighter, and more patients can be seen in common areas. Those who connect with the gentle spirit of these animals are noticeably calmer, less agitated, and more apt to smile.