Archive | September, 2012


25 Sep

Even the most independent of outdoor working dogs enjoys a good scratch behind the ears from his owner/leader but a palliative pet must be willing to accept and enjoy a flood of affection from strangers.  Acceptance of continual petting, patting, stroking and hugging is the bread and butter of a palliative pet.  Further, given the mental and physical states of some hospice residents, over exuberant contact such as tugging, pinching and accidental pain from a wheel chair must not elicit a bite response.

Many outdoor working dogs have been bred for hunting, but even the best field dog has been trained to elicit its innate special character.  Young pointers are taught to point and retrievers are taught to retrieve.  Setters have been bred to have a natural proclivity to hunt birds and puppies which show excitement and interest in birds are described as being “birdy”.  Training setters to become effective hunting companions is often accomplished using domesticated fowl such as pigeons.

It is not surprising then that palliative pets can be trained to maximize their inner ‘care giver’ through ongoing training.  It is rare for humans to engage in intimate physical touch with strangers and so it is not too surprising that dogs commonly reflect this same aversion to unsolicited contact.  But just as humans overcome hesitance to touch through formal societal niceties such as handshakes, some dogs can be taught not only to accept physical contact with strangers but to seek it out.

Entering into the world of palliative care, a pet should come prepared with basic formal obedience training that is exhibited at the highest level of leader control.  Having to repeat commands to an animal is a clear sign that the leader does not have complete control over the pet and that more training is warranted.  Further, the palliative pet must be taught that there are no circumstances wherein a bite response is an acceptable behaviour.  Handling and gentling exercises especially those that eliminate nipping, scratching, clawing, kicking, growling, pawing, jumping up, and all forms of dominant behaviour should be the ongoing focus of palliative pet training.

It is a treat to come home from a long day at work and find the aroma of dinner wafting through the air.  The smell of garlic or the scent of baking bread or perhaps cinnamon rolls is a treat for the senses.  Humans can distinguish these different odours but imagine what the world is like for a dog.  A scent hound like a beagle has millions more scent receptors in their noses than do humans giving them an exquisitely sensitive sense of smell.  We have less than 2% of the number of scent receptors in our noses than does a blood hound and areas in dogs’ brains have evolved to put that exquisitely sensitive nose to good use.  For instance, dogs are now used in cancer detection.  Given this incredibly sensitive capacity for scent it is reasonable to assume that when a dog enters a hospice facility for the first time it is able to detect the unique smell of human bodies in a state of decline.  Further, it may be that although a dog has superior social skills that this new smell may trigger a reaction that initially limits the dog’s engagement with the dying.  Positive reinforcement and motivational training can be used to overcome such initial hesitation.  Negative reinforcement or punishing a dog for refusing to engage in social behaviours in a palliative care environment is contrary to obtaining the optimum outcome you seek.  Often a dog’s negative response to new situations is due to inappropriate or limited instruction.  Simply assuming a dog will respond the same way in all environments to all people is erroneous.

A dog that is not engaging normally in this new environment does not have “a behaviour problem”.  Nor should one think that when one is training the animal that one should be training solely to avoid “behaviour problems”.  Modern training methods rely on reinforcing positive responses.  For instance, rather than punishing a puppy for peeing on the carpet, modern training focuses on where the puppy should pee, reward him for peeing there, providing consistent positive support and guidance.  Within a short time the puppy will seek out the positive responses and ignore opportunities to pee on the carpet where there is no positive response given.  Urination is a normal body function and the only thing wrong about the location is a human imposed restriction that takes some time for an animal of limited intelligence to understand and then act upon accordingly – likewise for palliative social interactions.  Expectations of humans must be introduced to the dog in a positive way so that the animal enjoys the environment.  Reflecting back on parent directed childhood visits to a dull and unengaged relative it was not surprising that such interactions resulted in equally unengaged responses from myself and my siblings.  Regardless of the fact that people are dying in a hospice facility, it is vital that the leader make the environment enjoyable, supportive and engaging to the palliative pet as no amount of “correction” will instill the social responses the owner/leader is seeking.

Some breeds have only limited social behaviours encoded in their DNA and in such cases these animals have limited use as palliative pets.  Further, within breeds individual animals may be more or less suited for palliative environments.

The American Temperament Test Society, Inc. (ATTS) is a U.S. based not-for-profit organization founded in1977 that promotes uniform temperament evaluation of purebred and spayed/neutered mixed-breed dogs.  In pursuit of their motto “a sound mind in a sound body”, certified ATTS testers have evaluated more than 30,000 canines.  Upon successful completion of the pass/fail test, an animal is awarded certification. Many breeders utilize these evaluations as a fundamental tool in establishing their breed lines. The minimum age for the ATTS to evaluate a dog is 18 months.

If an owner/leader is wishing to select a puppy that when grown will be suitable for volunteering in palliative care environments, the process of determining suitability is less clear or rubust.  Given the ATTS age limit, pet owners/leaders must look elsewhere for guidance.

Jack and Wendy Volhard  are renowned for their expertise in assessing the conformation and behavior of canines.  With 13 books to their credit and numerous articles and videos based on a motivational-based training methodology they have created an effective and simple puppy evaluation tool.  The Volhard Puppy Aptitude Test for prospective owners is used to assess the following behaviours which then lead to an overall score.  Social Attraction, Following, Restraint, Social Dominance, Elevation, Retrieving, Touch Sensitivity,  Sound Sensitivity, Sight Sensitivity, Startle response to a strange object are the ten categories used and ranked by an unbiased party in a surrounding unfamiliar to the animal.  An owner wishing to select a puppy for palliative environments may find this or similar evaluation tools of use in the selection process.

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Alzheimer’s Disease and Palliative Pets

22 Sep

The American Psychiatric Association characterizes Alzheimer’s Disease as a progressive brain disorder that exhibits symptoms of cognitive impairment to memory, language, judgement and abstract reasoning.  On average, this life limiting disease results in a life expectancy following diagnosis of approximately seven years and is identified as the fourth leading cause of death in the United States.  In recent years medical professionals have seen a growing interest in the therapeutic effects of animal assisted therapy and activities.

A study published in “Companion Animals in Human Health (see References section)” by Kathryn Batson et al titled “The Effect of a Therapy Dog on Socialization and Physiological Indicators of Stress in Persons Diagnosed with Alzheimer’s Disease” concluded that pets can serve as a useful intervention for increasing socialization in Alzheimer’s sufferers.  These researchers looked at the impact of a trained therapy dog, in this case a miniature schnauzer, on a variety of social interaction variables such as smiling, tactile contact, verbal praise, physical engagement as well as physiological factors such as heart rate and blood pressure.

The presence of the therapy dog enhanced nonverbal communication as shown by increases in looks, smiles, tactile contact and physical warmth.  The findings of the study support the advantages of short-term visits on the mental state and quality of life of person’s suffering from Alzheimer’s Disease.  The results fit with similar research on the effects of pets on socialization of the elderly and suggest that the greater alertness of the research subjects suffering from profound impairment may activate a more basic form of communication and socialization than verbal interaction.

The study concludes that given the simplicity and ease with which pet interactions can be offered, such interventions can and should be woven into the fabric of care for Alzheimer’s patients.

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The Pet and Leader Duo

21 Sep

The palliative pet and its leader/owner make up a volunteer duo that brings much joy, serentity and vitality to a person at the end of their life.  In support of the dying, many compassionate people find volunteering in an end-of-life care facility or residence to be rewarding as well as a challenging endeavour.  To effectively lead your palliative pet in dealing with dying individuals it is essential that not only is the pet suitable for the role, but that the pet’s leader is equally appropriate and prepared for the environment.  Encountering death is not a common occurrence in our modern-day world and volunteering with a pet in such an environment can be profoundly emotionally impactful.  To ensure that volunteers can effectively function with the dying, their relatives, friends and colleagues, most hospice facilities will require that the volunteers receive training in:

– Awareness of the philosophy of Palliative Care and Hospice Culture

– Understanding the medical issues volunteers may be faced with

– Loss, Grief & Bereavement Care

– Multicultural awareness

– Self-Care for the Volunteer & Caregiver

– Personal/Practical Care in each setting

– Spiritual Care/Psychosocial Care

– Communication skills/Active Volunteering

– Funerals/End of Life Celebrations

When a volunteer visits a person receiving end-of-life care, it is imperative that one has a genuine support for and belief in the hospice palliative care concept.  Having a warm, friendly and mature outlook and being willing to listen without judgement are essential facets of effective volunteering.  We live in a multicultural society and respect for religious beliefs of others without imposing one’s own is fundamental.  It is not ‘about’ the volunteer, it is ‘about’ the person at the end of their life and respecting their beliefs, however foreign, contrary or unjustifiable to you as a volunteer is vital.  Although the visits palliative pets and their leader engage in are often memorable and impactful, the volunteer must at all times respect the confidentiality of the dying.  As a volunteer you will be required to participate in ongoing training and supervision and to follow guidelines developed and implemented by the care facility.  Flexibility is key in volunteering and you may be asked to see patients in hospitals, hospices and private homes.  As you will be engaging with people at the end of their lives, you may become aware during a visit of a medical issue arising during a visit and you must be willing and comfortable with sharing pertinent information with members of the health care team.

Together, the well trained pet and leader duo can provide a positive, engaging and life affirming presence in end-of-life situations not only to the patients but to facility staff and the health care team as well.

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A Pet’s Nurturing Soul

8 Sep

A Pet’s Nurturing Soul – Where does it come from?

A palliative pet lies on a bed with a dying man and licks his hand and rests its head on his lap.  Is the dog feeling compassion?  Probably not.  Stanley Coren, the renowned psychologist at the University of British Columbia, explains in his new book “Do Dogs Dream? Nearly Everything Your Dog Wants to Know” that a dog’s range of emotion is roughly equivalent to that of a child at the age of two and a half years.  It is likely then that such a complex emotion as compassion is not within the scope of a palliative pet.  What dogs do feel beyond the basics of distress, contentment, disgust, fear and anger are the more complex emotions such as joy, suspicion and true affection.  Multifaceted emotions such as contempt, guilt and pride appear to be beyond the scope of a dog’s emotional spectrum.

So in the above scenario so familiar to hospice volunteers and staff, what are we witnessing?  Probably an extension of an innate nurturing quality.  A mother dog with her pups is finely tuned to signals of physical and emotional distress in members of her litter and as a member of a pack, a dog is by nature acutely aware of the status of the members of the pack.   As dogs themselves feel distress, it is not surprising then that they can pick up on the emotional states of persons at the end of life and recognize that these newly adopted members of their pack require nurturing.   Outside the structure of the pack the ability to pick up on emotional and physical distress of prey was key to successful predatory behaviour in their evolutionary history.  However within the pack, nurturing served to maintain the overall wellbeing of the group.

Are some dogs better suited emotionally for palliative care environments?  Coren describes research that clearly shows that personality (dogality?) testing on first generation puppies of crossbred Border Collies and Newfoundlands showed a blending of the personality types of the parents.  Newfoundlands are generally very social, calm and affectionate.  Border Collies are generally high energy, intense and focused on herding opportunities.  The emotional profile of the offspring of these parents showed that they were “more affectionate than their Border Collie father, but more intense and excitable than the Newfoundland mother.”  Clearly then, genetics play a major role in the emotional profile of dogs.  Hence animals bred for their sociable nature rather than guarding or fighting are on the whole more likely able to tap into the nurturing, affectionate, and loving nature so valued in palliative pets.

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