DOGS AT WORK ANIMAL THERAPY Dondi Austin, CNM, MS Kaiser Permanente, Downey.
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Transcript of DOGS AT WORK ANIMAL THERAPY Dondi Austin, CNM, MS Kaiser Permanente, Downey.
Working Dogs
Guide DogsService DogsAssistance DogsHearing DogsSkilled
Companion DogsFacility Dogs
Psychiatric Service
DogsTherapy DogsSeizure Alert
DogsOlfactory
Research Dogs
Working Dogs… Other Jobs
Police Dogs – K9 unitsExplosive Detection DogsDrug Sniffing DogsSearch & Rescue Dogs / Cadaver
Dogs
Americans with Disabilities Act (ADA)
Rehabilitation Act of 1973 Prohibited discrimination on the basis of a disability
Americans with Disabilities Act (1990) Expanded coverage to anyone with a “physical or
mental impairment that substantially limits one or more of the major life activities” entitling them to protection under the law, against discrimination in employment, housing, transportation & other areas of public life.
Under the ADA
Businesses & organizations that serve the public MUST allow people with disabilities to bring their service animal into all areas of the facility where customers are normally allowed to go.
Applies to ALL businesses including: Restaurants Hotels Taxis/shuttles Hospitals/medical offices Grocery/dept stores Theatres Health clubs Parks & zoos
Americans with Disabilities Act
Businesses MAY ask if an animal is a service animal and/or what tasks the animal has been trained to perform
Businesses MAY NOT ask about the persons disability nor require special ID for the animal
*puppies in training are not covered by the ADA; puppy raisers are taught to ask permission
Americans with Disabilities Act
People with disabilities who use service animals CANNOT be Charged extra fees Isolated from other patrons Treated less favorably than other patrons
They may be charged for damages in the same manner as other patrons if damages are caused by the service animal
Americans with Disabilities Act
A person with a service animal CANNOT be asked to remove the service dog from the premises UNLESS:
The animal is out of control & the owner does not take effective action to control it (e.g. a dog barking repeatedly during a movie)
The animal poses a direct threat to the health or safety of others.
* allergies or fear of animals are NOT valid reasons
Americans with Disabilities Act
A business is NOT REQUIRED to provide care or food for a service animal or to provide a special location for the animal to relieve itself
Canine Companions for Independence (CCI)
Founded in 1975
Non-profit organization that enhances the lives of people with disabilities by providing highly trained assistance dogs & ongoing support to ensure quality partnerships
Canine Companions for Independence
Headquarters - Santa Rosa, CARegional Center – Oceanside, CA (southwest)Largest non-profit provider of assistance dogsBreeding programVolunteer puppy raisers
CCI Assistance Dogs
4 types of Assistance Dogs:1. Service Dog = assists with physical tasks to
increase independence of a disabled person by reducing reliance on other people
Disabilities may include: spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida, arthritis
CCI: Types of Assistance Dogs
2. Skilled Companions = dogs trained to work with a child/adult with a disability, under the guidance of a facilitator (parent, spouse, or caregiver) who are responsible for customizing the training needs.
Can also serve as a social bridge for people who are not used to relating to a person with a disability
Disabilities may include: cerebral palsy, muscular dystrophy, Down syndrome, autism
Cory with Skilled Companion “Melly”
“I used to be the kid in the wheelchair, now, I’m the kid with the amazing dog.”
CCI: Types of Assistance Dogs
3. Hearing Dogs = alert the deaf and hard of hearing to sounds such as a doorbell, telephone, alarm clock, someone calling a name or a smoke alarm
Customized training may include E-mail message alert, text alert, microwave timer, dropped keys (retrieval)
Disabilities served: hearing impairment
CCI: Types of Assistance Dogs
4. Facility Dogs = taught over 40 commands designed to motivate & inspire clients with special needs
Generally work in healthcare & educational settings
CCI Facility Dog Millie
“ Millie gives patients a sense of wellbeing, a connection to their home life, a bridge to trusting hospital staff & motivation to get out of bed.”
-Jennifer Johnson, Child Life Specialist
CCI: Wounded Veterans Initiative
Providing assistance dogs to veterans with physical disabilities resulting from military service: Service dog Hearing dog Skilled Companion dog Facility dogs
To visit & work directly with veterans through therapy professionals
“The most advanced technology capable of transforming the lives of people with disabilities has a COLD NOSE & a WARM HEART.”
Psychiatric Service Dogs (PSDs)
A service dog trained individually to mitigate the effects of their disabled partner’s psychiatric disabilities by performing certain tasks
Disabilities served: panic disorders, post traumatic stress disorder, depression, bipolar disorders & agoraphobia
Psychiatric Service Dogs
Job Description: Guide a handler disoriented by anxiety Conduct a room search (to alleviate fear of
intruder) Interrupt a panic attack & seek help for an
incapacitated handler Provide tactile stimulation to bring partner back
to awareness Can interrupt repetitive behaviors Can provide an excuse to leave an upsetting
situation
Psychiatric Service Dogs
Other therapeutic behaviorsBring medications, portable phone or
beverage, answer doorbellCall 911 (large button – pre-programmed
with speaker phone – dog barks @ speaker)Summon help – nudge another household
member or carry a note
Psychiatric Service Dogs
Handlers report the presence of their dog helps them feel calm, relaxed & more willing to interact with others eliminating feelings of isolation
A PSD is a trusted companion & can therefore serve as a bridge between the handler & his/her environment
Psychiatric Service Dogs
The Depression & Bipolar Support Alliance (DBSA)
“strongly believes that Psychiatric Service Dogs have afforded many disabled individuals to reach a new level of wellness & opportunity to lead happy & productive lives.”
Caring for a dog helps maintaining a routine which can help to manage daily tasks & activities
Caring for a dog can lead to feelings of self confidence, self reliance & improved self esteem
How do you get a PSD??
Working through Behavioral Health Professionals
Adopt from a program that specifically trains PSDs NEADS = National Education of Assistance Dogs
Encourage partner to write out a job description for PSD
Includes partner’s lifestyle, type of housing, location, job, hobbies, travel, and level of activity
Psychiatric Service Dogs for Veterans
Long history of pairing service dogs with physically disabled vets
PSDs are now being paired with vets dealing with Post Traumatic Stress Disorder (PTSD)
PTSD a disorder characterized by recurrent & intrusive
distressing recollections of a past event Symptoms include: hallucinations, flashback imagery,
recurring dreams, feeling that the events are still happening
Behaviors include: anxiety, extreme wariness, irritability, anger, sleep disorders, which can lead to substance abuse
Psychiatric Service Dogs for Veterans
Psychiatric Service Dogs – are specially trained to help traumatized veterans leave the battlefield behind as they re-integrate into society.
Job Description for PSDs assisting PTSD partners:(87 different commands)
“Block” – dog stands perpendicularly in front of the person in order to keep others at a safe distance
“Get my back” – dog sits facing backward by person’s side Trained to jolt a soldier from a flashback Sense a panic attack before it starts
*Caring for the dog renews a veterans sense of responsibility, optimism & self awareness
Psychiatric Service Dogs for Veterans
For the Battle Scarred, Comfort at Leash’s End
“Just weeks after Chris Goehner, 25, an Iraq war veteran got a dog, he was able to cut in half the dose of anxiety & sleep medication he took for PTSD. The night terrors & suicidal thoughts that kept him awake for days on end ceased.”
“Aaron Ellis, 29, another Iraq veteran with PTSD scrapped his medications entirely soon after getting a dog, and set foot in a grocery store for the first time in 3 years.”
Lorber, J. (April 2, 2010) The New York Times
Psychiatric Service Dogs for Veterans
Dozens of interviews with veterans & therapists report drastic reductions in PTSD symptoms & in medication use but… does scientific evidence support anecdotal reports on dogs speeding recovery?
Federal Government – currently spending several million $$ to find out SB written by Senator Al Franken (D. Minn) Pilot program run by the Dept. of Veterans Affairs,
gives veterans with PTSD a service dog (est. cost $20,000/dog)
Puppies Behind Bars (PBB)
Program founded in 1997 by Gloria Gilbert Stoga, NYC woman working for Mayor Guilliani’s Youth Commission
1991 – she adopted an 18 month old puppy from Guiding Eyes for the Blind (Yorktown, NY) released for health reasons
4 yrs later she read a newspaper article about prisoners in Ohio who raised guide dog puppies for the blind
Got the “go ahead” from Bedford Hills Correctional facility, but had no puppies (none of the Guide Dog schools agreed)
Puppies Behind Bars
Stoga bought 5 puppies “rejected” by Guiding Eyes for the Blind @ $500 each to board with inmates as a pilot program
3 weeks later –Guiding Eyes for the Blind agreed to give the puppies free of charge
2 out of the first 5 puppies went on to graduate & become working guide dogs
*current success rate for puppies raised by inmates = just > 50%
Puppies Behind Bars
“Inmates are very motivated & raise very well behaved dogs, as good as those of our best raisers”
Puppy raiser inmates are chosen based on: Clean disciplinary record x 1 yr Interview with prison officials, Stoga, & other puppy
raisers
2 raisers/puppy: primary & back-up
Puppies Behind Bars
Dogs live in a crate in the inmates cellDogs spend 20 months with the raiser & are
taken everywhere including prison jobs, dental appts etc.
Raisers attend 6 hrs training /weekDogs are furloughed out to volunteer families
2-3 weekends/month to provide experiences the prison environment cannot (e.g. shopping malls, car travel, children, household appliances)
Puppies Behind Bars
Quotes from inmates
“To watch them grow & learn & to know that you’re responsible – well, that goes deep … you get confidence & you believe that you can do something good.”
“I’ve seen 6’2”/250lb guys rolling around the floor kissing & talking in high voices to their dogs. We don’t care what anybody thinks, its all about what’s good for the dogs. We owe them. They did what nothing or nobody could do… they took away our selfishness.”
Puppies Behind Bars
“The dogs have had a calming, humanizing effect on the entire staff, me included. They’ve broken these inmates down, taken their hard shells & cracked them open. Their level of love & commitment to these dogs is something I never expected to see.”
Jim Hayden - Asst. Deputy Superintendant of Programs Fishkill Correctional Facility, Beacon, NY
Puppies Behind Bars
1997 -began with 5 puppies @ Bedford Hills Correctional Facility training guide dogs for the blind now @ 6 different correctional facilities
After Sept. 11, 2001 – at the request of law enforcement agencies, Explosives Detection Canines (EDCs) were added
2006 – began training service dogs for adults & children with other disabilities
DOG TAGS: Service Dogs for those who’ve served us. Training dogs to be placed with the wounded soldiers returning from Iraq, including PSDs
Canine Support Teams (CST)
Founded in 1989 by Carol RoquemoreTo provide specially trained dogs to people
with disabilities other than blindnessService dogs are placed with people who use
wheelchairs, walkers, crutches or canesDogs are taught to assist their partners by
pulling wheelchairs, turning lights on & off, retrieving dropped items & opening/closing doors & drawers, barking to get help or providing stability for walking
Canine Support Teams
Prison Pup Program – makes use of available puppy raisers, with “lots of time” Has shortened the waiting list for partners
2002 California Institute for Women – became the first prison in the state of CA to have a service dog training program
> 85% of CST dogs placed have been trained through the Prison Pup Program
Canine Support Teams
PAWZ for Wounded Vets Program provides service dogs for men & women who have
sustained disabling injuries, including PTSD, as a result of service in the military
Effects of Human-Animal Bond
Contact has been shown to: Lower BP, pulse & respiratory rates Reduce perception of painReduce wound healing timeReduce recovery timeDecrease medication useIncrease survival rates for individuals with
chronic illnesses
THERAPY DOGS
Hospital / Nursing Home visitors Hospice visitors Physical Therapy Programs Schools – (special needs students; ADHD,
Autism) Public Libraries –Animal Reading Friends
(ARF) Court system – to support victims preparing
to testify
THERAPY DOGS
Animal Assisted Therapy (AAT)Animal Assisted Activity (AAA)
Scientific dataMarx, M. et al. (2010). The Impact of Different Dog – related
Stimuli on Engagement of Persons with Dementia. Am J Alzheimer’s Disease & Other Dementias.
Conclusion: AAT is well suited for nursing home residents with
dementia. Provides social interaction not dependent on level
of cognitive functioning.
THERAPY DOGS
Kawamura, N., Niiyama, M., & Niiyama, H. (2009). Animal Assisted Activity (AAA); Experiences of Institutionalized Japanese Older Adults. Journal of Psychosocial Nursing. participants descriptions of experiences were analyzed based on Collazi’s
phenomenological methodology
Summary: 6 themes1) Positive feelings about the dog2) Confidence in oneself (r/t sense of responsibility)3) Recalling of fond memories4) A break from the daily routine5) Interacting with other residents through the dogs6) Enhanced communication with volunteers
THERAPY DOGS
Multiple other studies show positive effectsIncreasing social behaviorIncreasing verbal interactionsDecreasing agitated behavior & loneliness
AAA with residential geriatric patients demonstratedDecreased BPDecreased HRDecreased depressionIncreased life satisfaction
THERAPY DOGS
COULD YOUR DOG BE A THERAPY DOG ??
Delta Society Volunteer organization specializing in human health through service
& therapy animalsCurrently > 30,000 therapy dogs certified in the US
Qualifications: calm, friendly, at least 1 year old & well behaved around strangers
Training: 12 hr course; partner taught how to handle dog in a variety of situations (IVs, wheelchairs, etc.)
22 part evaluation – obedience, skills & controlVet certificate of health
THERAPY DOGS
“It doesn’t matter if you have disabilities, can’t read very well or are old & sick – the dog loves & comforts you anyway.”
Linda Buettner – Professor UNC, Greensboro
Therapy Dogs: Infection Control
DiSalvo, H. et al. (2006). Who let the dogs out??? Infection control did: Utility of dogs in health care settings & infection control aspects. Am J Inf Control.
Animal Assisted Therapy Advantages
well documented Disadvantages/ Potential Risks
pt. phobias Allergies Bites – usually NOT a major threat Zoonoses – dogs viewed as lowest risk for transmission Animal caused injuries
Therapy Dogs: Infection Control
Policies for dogs in health care settings: 3 categoriesService Dogs – covered by ADA Therapy Dogs *Visitation Dogs *
*NOT permitted in multibed unit if any pt objects in isolation/immunocompromised pt rooms Some ICUs (usually allowed in burn centers, rehab &
trauma units)
Therapy Dogs: Infection Control
ConclusionBenefits greatly outweigh risksDevelop pet therapy policies emphasizing
different categories of dogs
JCAHO standard IC.4.10 “reduction of risks associated with animals brought into
the hospital”
Can Dogs Smell Cancer?
Tumors release tiny amount of chemicals different than those of healthy tissue
Early 2000’s British researchers taught 6 dogs to identify the smell of bladder cancer in urine samples in a “meticulously controlled/ double blinded/ peer reviewed study”… “The results are unambiguous. Dogs can be trained to recognize
& flag bladder cancer”The Lancet (1989) – reported dog detecting malignant
melanomaPine Street Foundation (reprint from Integrated Cancer
Therapies) reported dogs accurately distinguishing breath samples of lung & breast cancer patients from controls.
Seizure Alert Dogs
Alerts pt/family member BEFORE a seizure begins allowing appropriate steps to be taken for safety
DO NOT at this time understand how dogs might be able to do this OR how good they are at it
Seizure Response Dogs
Responds to a person having a seizure by alerting others remaining with the pt – to help avoid injury reassuring & reorienting a pt as they awaken
from seizure
Seizure Dogs
Epileptic seizure studies – dogs performance poor
Non-Epileptic seizures – dogs behavior more predictive thought to reinforce psychogenic event
Seizure Dogs
While the role of seizure alert dogs has not been scientifically validated at this time, the dogs do provide important emotional support, which is seen as beneficial to patients with chronic illnesses. Their companionship can be reassuring & their ability to obtain help may be life-saving.
Guide Dogs
A dog specially trained to provide mobility & independence to the blind & visually impaired.
The Seeing EyeFounded in 1929 (celebrating 81 years)15,000 dogs assisting ~ 8,000 men & womenHeadquarters in Morristown, NJ
Guide Dogs … cont
Morris Frank Read about dogs being trained as guides to assist
blinded veterans of WWI Dorothy Harrison Eustis – American training
shepherds in Switzerland agreed to help Mr. Frank if he would return to the US & “spread the word”
1928 Mr. Frank returned to New York City & demonstrated the abilities of his dog “Buddy” to a group of reporters
His one word telegram back to Mrs. Eustis read “SUCCESS”
Guide Dogs
Guide Dog Schools: California Guide Dogs for the Blind – San Rafael, CA (Boring,
OR) first on the west coast – 1942 Started out in order to help returning servicemen (WWII) Graduated >10,000 teams to date
Guide Dogs of America (GDA) - Sylmar, CA Founded in 1948 originally named International Guiding
Eyes
Guide Dogs
Puppy Raisers Takes 8 week old puppies into their home House trains, crate trains, socializes pups Exposes them to the environment – malls, restaurants,
grocery stores, clinics, office buildings, elevators Returns the dog to the school @ 18-20 months for
formal training
Guide Dog Training
Formal guide dog training - “Harness Work”
4-6 months with certified trainer 28 day partner training; blind recipient & dog
work with trainer on campus with the dog sharing the room
Graduation On-going support – including in home
Guide Dogs
Breeders Adopted by host family – with same rules as puppy
raisers Return to facility for mating & whelping Females remain with puppies to nurse x 8 weeks Puppies adopted by puppy raisers – breeder returns to
hostAmbassadors
Represent the Guide Dog program @ public events, schools, fundraisers, etc.
Career Change Dogs “Working dog changes job”