A touch of magic: using a service dog for dementia care - 1999 Optima Award

Nursing Homes, Sept, 1999

Adapting the demonstrated positive experience of using service dogs to aid the blind, deaf and physically disabled, an 816-bed academic nursing home introduced a trained service dog to work with elderly nursing home residents on its 63-bed Alzheimer's Special Care Unit.

In the only known program of its kind, the dog is trained to use distraction and diversion techniques to minimize dangerous wandering and reduce confrontation involving Alzheimer's patients. In addition, the dog promotes safety awareness, provides social support and adds to the unit's homelike environment. Residents' wandering has been greatly reduced, and response to the service dog from staff, residents and family is extremely positive.

The dog is also trained to provide support and social stimulation through brief, repetitive contacts. The practice of using animals as friendly visitors is well known, as are "pet-assisted therapy" programs. This innovation advances the practice by training the dog to perform specific, vital tasks and assist in the care of residents. This supports staff and families as well as residents, and greatly enhances the facility's milieu.

The following describes how this program was created and developed.

The Problem

Our 63-bed Alzheimer's Special Care Unit was designed to provide a warm, social and homelike environment for residents with midstage Alzheimer's disease and related dementias. To maintain this environment, the Home sought a way to keep residents away from the exits without disturbing the unit's ambiance. Local fire laws prohibit the use of magnetic locks on fire exits; therefore, residents of the care unit wear sensors that trigger a soft-sounding alarm if they approach a fire exit. Nevertheless, a great deal of staff time was needed to persuade residents to avoid the exit areas. Thus, not only did we want to move residents away from exits without confrontation, we were attempting to reserve staff time for important clinical tasks rather than guiding patients away from fire doors.

As a solution, we considered the positive results service dogs had achieved assisting the blind, the deaf and the physically challenged with their tasks of daily living. We decided to implement the use of a well-trained service dog to help shepherd residents away from exits. We sought, as well, to enhance social contacts and communication among the residents through the use of the service dog.

For further information, the Home consulted Canine Companions for Independence, The Seeing Eye, and a nationally known dog trainer and animal behavior specialist. Despite our numerous inquiries, there was no known use of service dogs assisting Alzheimer's patients. Our goal was to find an appropriate service dog that had a low-key nature, was pleasant and nonaggressive. We hired a nationally known animal behavior specialist/dog trainer to help us conduct a nationwide search.

The Plan and Implementation

Our major objectives included:

* Reducing/eliminating dangerous wandering

* Minimizing confrontation through distraction and diversion techniques

* Enhancing our homelike environment

* Increasing social interaction among residents

* Increasing family communication

* Increasing staff time for important clinical tasks

* Promoting staff satisfaction and appreciation.

The major challenges were:

* To identify a dog with a temperament complementary with the frail elderly.

* It was essential that the dog be tolerant of wheelchairs, walkers, visitors, staff, confused residents, etc.

* The dog had to be able to focus on a specific task/job and be capable of integrating into the community of the unit.

* There were no common training, certification and uniform standards among trainers.

* We had to find a professional who could conduct the search and the demanding process of animal screening.

* We had to find a professional who could conduct the training.

* We had to train staff to deal with some residents who might respond inappropriately to the dog.

* We had to create schedules for feeding, walking the dog, use on weekends, etc.

The most challenging aspect of this project was finding an appropriate service dog. Supported in this effort by a dog trainer and animal behavior specialist, we conducted a national search, including contacting breeders, private dog owners and shelters. After screening many animals, a golden retriever (now five-and-a-half years old) was acquired from a well-known breeder. We called him Magic.

Magic began training at the CNG Canine Patrol School. His training centered around "socializing" him with wheelchairs, crutches and walkers; taking him out for long walks in town; and visiting stores and shops to observe his reaction to different people. Following CNG training, Magic attended the Center for Applied Animal Behavior. At the Center, he continued the basic exercise of gently pushing and nudging people away from doors. He also learned to respond to the door alarm system and made frequent visits with the trainer to the unit to acclimate to a new environment.