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Pet therapy offers emotional, cognitive, and social benefits for people with Alzheimer's disease and other dementias.
This is the fourth in a series of articles covering complementary or alternative therapies for neurology patients-therapies that are now accepted by doctors to augment standard medical treatments.
His full name is Champion Felicity's Diamond Jim, but his family just calls him James. And while this 6-year-old English Springer Spaniel leaped to national fame after winning the coveted Best in Show prize at the Westminster Kennel Club in February 2007, his true calling is not under the bright lights but in nursing homes and adult day-care centers. James is a certified therapy dog, and after the Westminster win, he's giving up the show ring to return to the life he loves best: bringing light to the lives of people with Alzheimer's disease and other dementias.
From his puppyhood, James' owner, Terry Patton of Fairfax Station, Va., knew there was something special about this dog. Patton's father has normal pressure hydrocephalus, an abnormal increase of cerebrospinal fluid in the brain's ventricles that leads to mental impairment, problems with walking, and dementia. He pets pretty hard because he doesn't have control of his hands. That will turn off a lot of dogs; they don't want any part of it, says Patton. But Jim was never bothered. He just sits there and lets my father pet him however he wants.
James is a frequent visitor at Birmingham Green Nursing Home and Assisted Living in Manassas, Va., which has several dementia units. When we arrive, he's so excited and happy to be there. Then you see this special kind of calm and compassion come over his face, says Patton. James knows to sit and wait for some residents to approach him, and with others-the ones who like to have him put his head in their laps-he'll wait to be asked.
When visiting Birmingham Green's lock-down unit, where too much excitement from a pet therapy visit can be overstimulating and upsetting to the patients, James seems to have an internal timer. He knows when it's time to go, and he'll just turn and walk toward the door. We just follow his lead-he's rarely wrong! Patton says.
Wherever James goes, stories of extraordinary responses to his furry appeal are sure to follow. One Christmas, the pet therapists at Birmingham Green planned a skit, walking the dogs around to music. There was a lady who had not spoken or shown any kind of interest in the world around her for a very long time, Patton says. She actually got up, went over and laid down beside James, and then insisted on taking the leash. We'd go every couple of weeks, and there she'd be, waiting at the end of her bed for us to come in.
How can a dog like James reach people with dementia when so many other interventions cannot? Science still doesn't have exact answers to those questions, but there's little question that pet therapy noticeably improves the quality of life for many people with dementia. Mara Baun, D.Sc., a professor in the Department of Continuing Care at the University of Texas-Houston School of Nursing, has done several studies on the benefits of pet therapy-both with visiting dogs and resident dogs-for patients in dementia units.
We found that having dogs around improved socialization, reduced the agitation that often spikes in the early evening hours for people with dementia, and decreased problem behaviors, she says. While there have been no major trials of this wagging, cold-nosed therapy, other small studies have shown similar results.
Dr. Baun still remembers the golden retriever who began living on one Alzheimer's special-care unit in the large Midwestern veteran's hospital where she conducted much of her research. There was a man on the unit who had been diagnosed with early-onset Alzheimer's disease, and was then in his late fifties, she says. He loved that dog, and the dog loved him. In the early days, he was much more active, and he'd take the dog out and play ball with him.
As his disease progressed, the man became increasingly restless, and often paced the long hall of the locked unit where he lived. One day, he became extremely agitated and was shaking the door and trying to get out. The staff couldn't calm him down, Dr. Baun says. The dog went and took him by the sleeve, led him back to his room, and stayed with him until the man calmed down.
Such stories wouldn't surprise social worker Sandy Whiteside. Whiteside has been bringing a succession of dogs to the Memory Lane Club, a day program for people with advanced Alzheimer's disease at the Long Island Alzheimer's Foundation, for about three years now.
I first discovered what therapy dogs can do back in 1997, when my husband's mother was in a nursing home in Virginia, she says. We would bring my flat-coated retriever, Jetta, to visit her. There was a man there who was always grumpy and isolated. He never spoke. The first time she saw him, Jetta went right to him and laid her head on his lap. He started stroking her and said, 'I used to raise cocker spaniels.'
Another patient, who also never spoke, spent most of her time crying. When she spotted Jetta, the woman's eyes brightened; she smiled and dipped her finger in her bottle of Ensure and held it up for the dog to lick.
I realized, 'There's something special happening here!' Whiteside recalls.
Today, she's visiting the Memory Lane Club with Lola, a 6-year-old golden retriever adopted from the North Shore Animal League. About a dozen men and women sit in a circle in their day room, surrounded by colorful walls decorated with quilts, collages, and photos of black-and-white film stars. Not much engages them-until Lola strolls into the circle.
Immediately, the dog plops her head in the lap of Ruth, a woman in purple velour pants who doesn't speak but happily strokes Lola's golden fur. Next to Ruth, a woman named Maggie suddenly brightens, her face transformed by a glowing smile. I'm real glad to see you! she says to Lola and Whiteside. Where've you been?
Across the circle, more people eagerly wait for a chance to commune with Lola. Gunther, a patient who frequently asks when it will be time to go home, is distracted from his preoccupation with leaving by Lola's arrival. I waited all week for this dog to come back, he says, rubbing the dog's belly. Oh, you're a nice dog.
Next to Gunther, tiny Marge is bundled up in a coat and knit hat. She, too, says little, but her practiced strokes and scratches of Lola's back and haunches show that she's had plenty of experience with dogs. Even one woman who's not fond of dogs, and nervously says You don't come to me, can't resist reaching out for a few awkward pats while Lola nuzzles the woman next to her.
Usually, when we get into the circle, it's hard to keep people seated and involved, says Lori Goodcuff, director of the Alzheimer's Companion Respite Program at the Long Island Alzheimer's Foundation. But when Sandy and Lola come, everyone watches the dog and calls to her. In the later stages of the disease, it's important to work with as many senses as we can, and being able to pet dogs is tactile and cognitively stimulating.
Or, as one woman who brings her mother to the day program says, The dogs bring them alive!
WHAT KIND OF DOGS are best for pet therapy with people who have dementia? Certain breeds, like golden retrievers, seem to do particularly well, but Whiteside says it's less about the breed than about the individual dog. Therapy dogs are born, not made, she says. The calm, the compassion-you can't teach it.
IF YOU'D LIKE TO FIND a trained pet therapist or see if your dog might be a good therapy dog, contact the Delta Society (deltasociety. org, 425-679-5500), which has trained thousands of therapy animals and their handlers over the past 30 years through its Animal-Assisted Therapy and Pet Partners® programs.