Animal comforts

People in hospice can struggle to express themselves and make connections with others. They spend most of their time in bed or perhaps in a nearby chair, and typically rely upon visitors to come to them. For some, a visiting animal that curls up in their lap or just sits nearby patiently can bring welcome comfort and companionship.

These factors and more contribute to the rising popularity of pet therapy, or animal-assisted interactions, in hospice and other long-term living facilities today. Interactions can be formal, involving a licensed therapist, or they can be more casual, with a friendly volunteer bringing an approved pet for regular visits.

Randie Dale Duretz, ADC, CDP, CRT, AP-BC, CCCI, of Luther Woods Nursing and Rehabilitation Center in Hatboro, Pennsylvania, first witnessed the power of animals to draw people out when her own grandparents were in a nursing home. They no longer recognized Duretz or other family members but they did focus on the three dogs that Duretz brought to visit them one day on a whim. When she only brought two to a later visit, they asked about the missing one. She realized that the dogs had reached them.

Randie Duretz and dog Pixie get a big smile from this resident.

“It made them happy for that special moment,” says Duretz, who is director of activities and volunteers at Luther Woods. “It was remarkable.”

She has brought those lessons to her work over the past three decades at Luther Woods, a 140-bed facility that offers multiple levels of care, including hospice. She has nine dogs who visit the facility regularly. Some residents just look into the dogs’ eyes and smile, but others reach out and stroke them. Some can be encouraged to open their eyes or reach out their hand, despite not doing those things on a regular basis.

Many patients tell her they had pets when they were younger and eagerly look forward to the visits. “We have one woman who puts on lipstick on the days they are coming,” she says.

Duretz sometimes uses a pet visit to help orient a resident, asking questions such as what color a dog’s fur is or where its nose is. “We always ask in an adult-appropriate way,” she says.

For hospice patients who are very near death, Duretz will sometimes lay a dog or cat next to them in bed. “I tell them that the animal is there and maybe describe what color it is,” she says. “Hearing is the last thing to go, and I believe we are sometimes able to reach and comfort them.”

A powerful connection

Candace Hammer Chaney, RN-CHPN, who is the comfort therapy program coordinator for Assured Hospice in Washington state, also has seen the connection that animals can make with a hospice patient. “An animal can provide unconditional love without judgment. So much of what hospice workers do is meet people where they are and accept them, whatever their story is,” she says.

Some hospice patients cannot talk about their lives and fears with another person, but animals can offer pure acceptance that helps them open up. “We have seen patients who can’t carry on a conversation with a person start to find words with an animal,” she says. “Animals can trigger spots of memories that talking to another human being wouldn’t have triggered.”

For those who still find words elusive, just touching an animal can be safe and comforting, she says, pointing out that by the time patients enter hospice, people have quit touching them in soothing ways. “Many of them have lost their spouse or partner, and most of the touch they get is during medical procedures. An animal can provide touch in a way that isn’t invasive and doesn’t cause pain, which may have been missing from their lives for so long,” she says.

Professionals vs. volunteers

Chaney notes many professionals tend to avoid the term “pet therapy” today. “The joke that it is not the pet that needs the therapy,” she says with a laugh. “We tend to refer to it now as animal-assisted interactions and animal-assisted activities.”

Her facility works with professionals such as psychotherapists or social workers who use animals to facilitate therapy, much like professional art or music therapy. But it also offers programming in which volunteers bring their pets in to visit residents. These animals and owners are certified beforehand to make sure they are a good fit, and that visits can be a positive, safe interaction for the patients and the animals.

It is important to find animals that can relate to people. Some animals are better than others at reading human emotions and responding appropriately, she says.

“I remember there was this one cat that would start to hang around a room and be with a person who was within a few days to maybe a week of dying. Dogs also can pick up who is hurting. In a group therapy session, they will go sit by that person and just comfort them, put a paw on them,” she says. “Since they don’t have language, they connect with emotion more.”

Duretz says it is important to work with pets that are not be easily frightened by loud animals or timid about being petted by multiple strangers.

It also is important to find committed owners, as the animal needs to be groomed and have current vet records and trimmed nails as so not to injure residents with thinning skin. (She will often put a blanket on a resident’s lap before letting the animal sit there, as an added precaution.)

Duretz says that most of the pet owners who visit her facility are retired people who want to help others. “They always walk out of here knowing they reached someone in some way,” she says.

Not just cats and dogs

Animal visitors today are not just dogs and the occasional cat. Chaney and Duretz both have miniature horses that visit. These are the size of a large German shepherd dog and eagerly seek out human affection.

Chaney has worked with rabbits—their silky coats are very pettable—and has even heard of a facility using a camel.

At Luther Woods, a traveling zoo comes once a year with cows, turkeys, pigs, geese and more to help engage the patients. A bird named Sprite that lives in the activity room offers another opportunity for cross-species interaction. “It’s never a dull moment with the pets around here,” Duretz says.