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The effects of regular dogs and robotic dogs to people in treatment nursing homes

Paul Cherniack and Ariella R. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly.

Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals.

Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity.

Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown.

Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.

Introduction Two-thirds of all US households [ 12 ] and close to half of elderly individuals own pets [ 3 ]. Investigations involving pets and other animals attempting to improve the health of older individuals have involved many species, including dogs, cats, and manufactured simulations of animals [ 4 ].

In this paper, the evidence for the impact of animals on the health of the elderly is assessed.

  1. There has been no formal determination if whether these benefits outweigh the costs of feeding and caring, which are listed for comparison in Table 5.
  2. Animals have the potential to cause human infection and trauma. They could engage in a variety of activities including feeding, petting, grooming the animal, socializing with the trainer, and discussing pets the subjects previously owned.
  3. Biological Sciences and Medical Sciences, vol.

Given the small number of published manuscripts, a systematic review was not attempted. Potential Benefits of Animals 2.

Effects on Mental Health The most frequently studied use of animals with elderly participants has been to alleviate manifestations of cognitive disorders, such as agitation [ 5 ]. All of the studies were unblinded, not all were controlled, but most, though not all, showed small but statistically significant improvements in behavioral symptom scores in the animal-assisted interventions.

One trial, the sole study that used a bird, uniquely noted that animals conferred psychological benefits to cognitively unimpaired older individuals; 144 persons without cognitive impairment in nursing homes in Italy were exposed to either a canary, a plant, or neither of the two [ 6 ].

Current Gerontology and Geriatrics Research

The individuals assigned to care for a canary or plant were provided with care instructions and participated in a three-month intervention, the details of which were not specified in the paper. Subjects who cared for the bird had significantly better scores at the end of the intervention on subscales of psychological symptoms in the Brief Symptom Inventory and LEIPAD-II-Short Version, which subjects in the other two groups did not. Other investigations explored the effects of animals on demented elderly individuals see Table 1.

A dementia unit for US veterans piloted the use of a pet dog to elicit for socialization. Twelve demented patients exhibited a significant larger number of social behaviors, such as smiling or speaking in the presence of the dog, implying that animals might create benefit apart from any effect on cognition [ 7 ].

Studies on use of animals in dementia. Another uncontrolled trial suggested that animals could help alleviate problematic behaviors in demented individuals. This trial enrolled elderly residents of two US nursing homes who had MMSE scores of 15 the effects of regular dogs and robotic dogs to people in treatment nursing homes below who were treated with animal-assisted therapy [ 8 ].

The participants, in a recreational room for one hour a day, met with a dog and its trainer. They could engage in a variety of activities including feeding, petting, grooming the animal, socializing with the trainer, and discussing pets the subjects previously owned.

Subjects achieved a mean 25 percent, significantly better scores on the CMAI index of behavioral disturbance after the intervention.

Two further studies, in addition, piloted the efficacy of animal-assisted therapy on cognition and mood in cognitively impaired older persons. Twenty-five moderately demented residents of a nursing home were divided into two groups [ 9 ]. The participants either walked, played with, petted, or held the animals under the supervision of a trainer.

In the control group mean MMSE score 18. Unfortunately, after the intervention, both groups increased their MMSE and lowered their GDS scores, but the changes in both groups between pre- and postintervention values were not significant. A second small study examined four moderately to severely demented residents of a nursing home who were videotaped for behavioral responses prior to and during an animal therapy session with a dog [ 10 ].

The residents displayed significantly fewer signs of agitation and more social behaviors during animal therapy. An additional trial uniquely explored the possibility that animals might confer physical benefits to older persons with dementia and, furthermore, used fish, which did require the subjects to handle the animals.

In this study, demented individuals in several nursing homes successfully gained weight after fish tanks were installed [ 11 ]. Residents in each of the homes had different exposure times to either the fish tanks or the pictures.

When the data from the subjects who were exposed to the fish tanks was pooled together, there was a mean 1.

Animals might provide other benefits to demented individuals, such as improving their ability to socialize, as suggested in several trials. In one study, which was not blinded, 33 individuals who lived in a nursing home were exposed to animals during 41.

Long conversations between alert participants were more likely to occur in therapy groups when animals were present, but brief conversations were more likely when animals were absent. In another trial, a videotape captured the social interactions between 36 nursing home residents in ninety-minute occupational therapy sessions with or without a dog present [ 13 ]. Residents were more likely to have verbal interactions with the dog in the session.

In a third investigation, thirteen demented residents were exposed to a plush mechanical toy dog that could sit up and wag its tail, or a robotic dog that could respond to seventy-five commands [ 14 ]. Subjects responded to both objects, similarly, by talking to it or clapping their hands when it moved.

Nurses have written their personal, qualitative observations that animals relieve loneliness and boredom, foster social interaction, and add variety to the lives of such persons, indirectly suggesting other possible advantages to human interactions with animals not thus far documented in clinical trials [ 515 ].

There was no formal regulation of the interaction between the cats and the patients, nor any formal measures of the interaction. However, the nurses did state their opinions that the cats increased patient interactivity with their other people and their environment, and that the patients enjoyed their presence. Pets may also positively influence the behavior of demented elderly owners.

In one comparison survey, demented pet owners were less likely to exhibit verbal aggression but were otherwise similar to non-pet owners in likelihood of vegetative, hyperactive, or psychotic behaviors [ 17 ]. Thus far however, none of these studies on the use of animals in demented subjects have suggested a mechanism for how animals might alter the behavior of such individuals.

One might speculate that animals might create a distraction to inhibit disruptive behavior or serve as a surrogate for human interaction to learn or practice social behavior. Several investigations have also piloted the use of animals in the treatment of depression with mixed results. One small trial showed even a brief intervention conferred some benefit. Thirty-five individuals who were about to receive electroconvulsive therapy ECT spent 15 minutes with a dog and animal trainer or the same period of time reading magazines before ECT treatment sessions [ 18 ].

The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

All subjects had both types of pretreatment every other day. Individuals reported lower levels of fear about the upcoming ECT rated on visual analogue scales when they had sessions with the dog. In a similar trial, forty-two depressed patients spent time waiting for ECT in rooms with or without aquariums. The presence of aquariums did not influence the pretreatment anxiety, fear, or depressive symptoms the patients experienced [ 19 ]. Animal-assisted therapy has been considered in the treatment of depression in institutionalized individuals in a number of studies.

In one investigation, twenty-eight residents of an Italian nursing home had three-hour treatment sessions once a week for a month and a half with a cat or no change in their usual routine [ 20 ].

Therapeutic effects of dog visits in nursing homes for the elderly.

A nurse supervised individuals in a therapy room, who could pick up or play with the cat. The individuals who interacted with a cat did not have any significant difference in Geriatric Depression Screen score, or cognition as measured by MMSE, but did have sixteen-point lower systolic blood pressure and five-point lower diastolic blood pressure than subjects who were not exposed to the cat. In an additional survey, subjective rankings of pet attachment were actually associated with higher ratings of depressive symptoms in older individuals living in rural areas [ 21 ].

In another trial of 68 nursing home residents in Australia, individuals who visited a dog reported less fatigue, tension, confusion, and depression [ 22 ]. Cancer patients undergoing chemotherapy were divided into two groups, one of which had a weekly hour-long session of therapy with a dog and one of which did not [ 23 ].

Those patients at sessions at which a dog was present rated their symptoms of depression and anxiety half as severe as those who did not. Taken together, these studies imply a rather modest benefit at best for animals in depressed individuals. A meta-analysis was conducted of five studies of the use of animal-assisted activities therapy in the treatment of depression in institutionalized subjects [ 24 ].

None of the five studies whose data was pooled for the meta-analysis was ever published in a scientific journal; four were printed in doctoral dissertations and the fifth was published in a book chapter almost thirty years ago.

Other studies have examined if pets might assist the treatment of individuals with schizophrenia. Two investigations suggested that animals could improve social behaviors in elderly schizophrenics.

Twenty schizophrenics, at least sixty-five years old, had three-hour visit every week for a year with a dog or cat and a therapist [ 25 ]. The subjects were taught to ambulate with the animals on a leash, bathe, feed, or groom them. A control group had a weekly news discussion session simultaneously with the animal therapy group.

Schizophrenics exposed to animals had significantly improved mean scores on social functioning as part of the Social-Adaptive Functioning Evaluation scale which members of the control group did not. In another investigation, 21 schizophrenic inpatients were divided into an intervention and control group [ 26 ]. Both had 45-minute meetings twice weekly with a psychologist for a total of 25 sessions. In the intervention group, a therapy dog and handler participated.

The dog was the focus of interventions tailored to improved communication, social skills, and cognitive rehabilitation. The control group had similar sessions, except without the dog. Subjects in the intervention group had significantly better scores on the social contact score in of the Living Skills Profile and total the effects of regular dogs and robotic dogs to people in treatment nursing homes on the Positive and Negative Symptoms Score scale.

Not all investigations noted that schizophrenics derive benefit from animals. Fifty-eight older psychiatric inpatients in one trial were randomized to spend five sessions of either an hour a day with either pet therapy or an exercise group [ 27 ]. There was no difference in a forty-question psychiatric symptom score between groups. In addition to the trials of animal therapy in older persons with mental illness, qualitative research comprising focus groups of individuals recovering from acute episodes of psychiatric disease has outlined what subjects perceive to be benefits of pet ownership, such as companionship and a reinforced sense of self-worth [ 28 ].

However, subjects sometimes were troubled by their pet care responsibilities and grieved over the loss of pets. Furthermore, several studies have implied that animals offer psychological or social benefits to the elderly independent of disease state.

In one investigation, the effects of animals on the degree of loneliness of long-term care residents were assessed using a survey instrument [ 29 ]. Thirty-five people who lived in a nursing home had an experience in which, for two and a half months, they interacted with several animals including dogs, cats, and rabbits for two hours each [ 30 ]. They scored significantly higher on the Patient Social Behavior Score during and after the intervention.

  • Dog walking was also associated with likelihood of walking in 608 Washington state residents [ 42 ];
  • In one Australian study, owners of large dogs spent more time walking than those who owned small dogs, and dog ownership per se was not associated with greater probability of obtained recommended activity levels [ 49 ];
  • Residents were more likely to have verbal interactions with the dog in the session;
  • Individuals who had sustained a myocardial infarction in the past year and walked their dogs for fifteen minutes three times daily improved their exercise capacity on stationary bicycles [ 52 ];
  • In a Japanese survey of 5283 adults up to age of 79, dog owners were 1;
  • Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results.

In another study, forty-five residents of three facilities were divided into those who received thirty-minute animal-assisted therapy once a week for a month and a half, the same therapy three times a week, or not at all.

Residents who received any animal therapy scored significantly lower on the UCLA Loneliness Scale than those who did not.

  • Dog owners were more likely to walk at least 150 minutes a week O;
  • Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals;
  • Despite over four decades of research, these studies remain preliminary;
  • Studies on the use of animals on physical activity;
  • Nevertheless, given the preponderance of the evidence, the American Heart Association has released a statement acknowledging the relationship and causality of pet ownership in the attenuation of cardiovascular disease risk [ 57 ].

In a case series, a robotic dog improved the loneliness scores on one assessment instrument of five medically ill elderly persons [ 31 ]. In a qualitative survey, dog owners over age of 70 in Austria stated that dogs provided companionship and a sense of purpose [ 32 ].

However, finally, in few cases, animal-assisted therapy has even been utilized to provide subjective benefit to critically ill patients in intensive care units [ 33 ].