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Shoesmith E, Surr C, Ratschen E. Animal-assisted and robotic animal-assisted interventions within dementia care: A systematic review. DEMENTIA 2023; 22:664-693. [PMID: 36765455 PMCID: PMC10014823 DOI: 10.1177/14713012231155985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Animal-assisted interventions and robotic animal interventions are becoming increasingly popular to support the care of people with dementia and may have the potential to improve a range of psychosocial outcomes. This review aims to identify, describe, and compare animal-assisted and robotic animal interventions delivered to people with dementia, their characteristics, effectiveness, and the proposed mechanisms underlying any potential impact. METHODS A systematic literature search was conducted in MEDLINE, AMED, EMBASE, PsycINFO, OVID Nursing, PubMed, CINAHL and Web of Science. Random-effects meta-analyses of randomised controlled trials (RCTs) were conducted to summarise studies that evaluated common outcomes (agitation, depression, quality of life). A narrative approach was used to synthesise other findings. RESULTS Fifty-one studies were included: 18 RCTs; 12 non-randomised trials, 13 cohort studies, 7 qualitative studies and one mixed-methods study. Meta-analyses were conducted for a small number of RCTs, with effectiveness of animal-assisted interventions demonstrated for agitation. Narrative findings suggested animal-assisted and robotic animal interventions may be promising in improving depression, agitation, and quality of life. Three potential mechanisms of action were identified for both animal-assisted and robotic animal interventions, namely enhancing social connections, providing engaging and meaningful activities, and the affect-generating aspect of the human-animal bond. A fourth mechanism was identified for animal-assisted interventions only: promoting physical activity. Robotic animals appear to have a place in complex human-animal relationships, but a greater understanding of robotic animal interventions is required to harness the benefits that may be derived from their use. CONCLUSION Delivering these interventions appear promising in improving psychosocial outcomes for people with dementia. As most included studies had methodological limitations, these findings are preliminary, but contribute to the body of evidence providing an understanding in terms of intervention characteristics and mechanisms of action. When developing intervention guidance, attention should be given to potential mechanisms and fundamental characteristics such as session content, delivery format and facilitator role.
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Affiliation(s)
| | - Claire Surr
- Centre for Dementia Research, 4467Leeds Beckett University, UK
| | - Elena Ratschen
- Department of Health Sciences, 8748University of York, UK
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Orr N, Abbott R, Bethel A, Paviour S, Whear R, Garside R, Coon JT. What are the effects of animals on the health and wellbeing of residents in care homes? A systematic review of the qualitative and quantitative evidence. BMC Geriatr 2023; 23:170. [PMID: 36964508 PMCID: PMC10038779 DOI: 10.1186/s12877-023-03834-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/16/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND There is some evidence to suggest that animal-assisted interventions can have beneficial impact for residents in long-term care, but the focus of the evidence has largely been on behavioural and psychosocial measured outcomes. Animals, either as companion animals or in the form of pet/animal-assisted therapy, may provide benefits in the form of social contact, as well as opportunities for sensory experiences and meaningful engagement not picked up by outcome tools. This review aimed to create a state-of-knowledge synthesis, bringing together qualitative and quantitative findings, on the impact of animal-human interaction on care home residents and care home staff. METHODS Fourteen databases were searched from inception to July 2020. Forward and backward citation chasing of included articles was conducted. Screening was undertaken independently by a team of reviewers. Thematic synthesis and meta-analysis were used to synthesise the qualitative and quantitative data. RESULTS Thirty-four studies, published in 40 articles (20 qualitative and 20 quantitative) were included. Five themes relating to resident wellbeing were identified in the qualitative evidence synthesis. These were animals as 'living beings', reminiscence and storytelling, caring (as 'doing' and 'feeling'), respite (from loneliness, institutionalisation, and illness), and sensory engagement. A sixth theme related to staff perceptions and wellbeing, and a seventh to animal health and wellbeing. Maintaining identity was identified as an overarching theme. The majority of randomised trials had small sample sizes and were rated as low quality, mostly showing no evidence of beneficial effect. There was, however, limited evidence of a positive effect of pet/animal interaction on outcomes of loneliness, anxiety and depression, supporting the themes of respite and sensory engagement. CONCLUSIONS The presence of animals can significantly impact the health and wellbeing of some care home residents. Residents had meaningful relationships with animals and derived pleasure and comfort from them. Interacting with animals offered residents a way to maintain a sense of self in the care homes, and with support, residents with dementia could also express their identities. Facilitating residents to interact with animals as part of person-centred care may also help residents to feel 'at home' in the care home. TRIAL REGISTRATION PROSPERO registration no: CRD42017058201.
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Affiliation(s)
- Noreen Orr
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK.
| | - Rebecca Abbott
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Alison Bethel
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Sarah Paviour
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rebecca Whear
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Knowledge Spa, Truro, Cornwall, TR1 3HD, UK
| | - Joanna Thompson Coon
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
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Barcelos AM, Kargas N, Maltby J, Hall S, Assheton P, Mills DS. Theoretical Foundations to the Impact of Dog-Related Activities on Human Hedonic Well-Being, Life Satisfaction and Eudaimonic Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12382. [PMID: 34886109 PMCID: PMC8656591 DOI: 10.3390/ijerph182312382] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Cross-sectional comparisons of well-being between dog owners and non-owners commonly generate inconsistent results. Focusing on the uniqueness of the relationship might help address this issue and provide a stronger foundation for dog-related psychotherapeutic interventions. This study aims to evaluate the impact of dog-related activities (e.g., exercising the dog) on owner hedonic well-being, life satisfaction and eudaimonic well-being. It was also hypothesised that psychological closeness to the dog would affect these well-being outcomes. For this study, 1030 dog owners aged over 18 years old answered an online questionnaire about the impact of 15 groups of dog-related activities on their well-being. Ordinal regressions were used to estimate the mean response (and its uncertainty) for each outcome, while conditioning for psychological closeness to the dog and controlling for several key covariates. Tactile interactions and dog playing were significantly more beneficial than other activities for hedonic well-being, and dog training and dog presence for eudaimonic well-being. In contrast, dog health issues and behavioural problems were linked to decrements in these well-being outcomes. Higher psychological closeness to the dog predicted greater improvement in well-being in positive dog-related activities. Our quantitative study validates the general findings of previous qualitative work and lays the groundwork for future longitudinal studies.
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Affiliation(s)
| | - Niko Kargas
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK;
| | - John Maltby
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, UK;
| | - Sophie Hall
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Phil Assheton
- Department of Statistics, StatsAdvice.com, Ltd., 10551 Berlin, Germany;
| | - Daniel S. Mills
- School of Life Sciences, University of Lincoln, Lincoln LN6 7TS, UK;
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4
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Jain B, Hafford-Letchfield T, Ellmers T, Chandra C, Billings B, Teacher R, O'Farrell Pearce S, Clancy C. Dog-assisted interventions in care homes: A qualitative exploration of the nature, meaning and impact of interactions for older people. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1450-1460. [PMID: 33094892 DOI: 10.1111/hsc.13201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/06/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
Dog-assisted interventions (DAI) have been shown to have a wide-range of potential benefits for older adults living in care homes. Yet, there is a lack of published qualitative research which explores the experiences of care home residents, staff and dog-owner volunteers involved in DAI to fully understand its meaning, impact and value. This study aimed to explore the impact of a DAI on the social and emotional wellbeing of older residents living in care homes. The research employed a qualitative study design comprising overt, naturalistic researcher observation of weekly DAI sessions with 54 older adult residents across four participating care homes in the South East region of England over 3 months in 2018. Data were also collected through focus groups with 12 care home staff and 7 dog-owner volunteers. The data from the observations and focus groups was individually coded followed by thematic analysis across the three data sources. Findings demonstrated there were clear benefits for older people who engaged with DAI, as well as for dog-owners and to some extent for care home staff members. Benefits included sensory, emotional stimulation and opportunities for social interaction, reminiscence on early life experiences and these were supported by the development of some new social relationships. While there were some environmental challenges to implementing DAI, the findings confirm its value for care home residents, with minimal drawbacks from an organizational standpoint. As a low cost intervention, adoption of DAI in care home settings appeared to strengthen relationships between residents and staff and enable wider relationships with an external community resource.
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Affiliation(s)
- Briony Jain
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Trish Hafford-Letchfield
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, UK
| | - Toby Ellmers
- Cognition and Neuroscience Research Group, College of Health and Life Sciences, Brunel University, London, UK
| | - Carl Chandra
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Barbara Billings
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Ruth Teacher
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Sioban O'Farrell Pearce
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Carmel Clancy
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
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5
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O'Shaughnessy NJ, Chan JE, Bhome R, Gallagher P, Zhang H, Clare L, Sampson EL, Stone P, Huntley J. Awareness in severe Alzheimer's disease: a systematic review. Aging Ment Health 2021; 25:602-612. [PMID: 31942805 DOI: 10.1080/13607863.2020.1711859] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 12/13/2019] [Accepted: 12/31/2019] [Indexed: 12/26/2022]
Abstract
Objective: There is limited understanding about how people in the severe stages of Alzheimer's disease (AD) experience and demonstrate awareness. We synthesised all available evidence with the aim of understanding how awareness is preserved or impaired in severe AD and what evidence there is for different levels of awareness according to the levels of awareness framework.Method: A systematic search of the following databases: Embase, PsycINFO, MEDLINE and Web of Science was carried out. A narrative synthesis and analysis was conducted of all included studies. All studies were assessed for quality using the AXIS and CASP tools.Results: Our findings suggest that lower level sensory awareness is relatively maintained in severe AD. Findings for higher level awareness are variable and this may be related to the diversity of methods that have been used to explore awareness in these circumstances.Conclusion: Awareness is complex, heterogeneous and varies significantly between individuals. Environmental and contextual factors have a significant impact on whether awareness is observed in people with severe AD. Adaptation of the environment has the potential to facilitate the expression of awareness while education of caregivers may increase understanding of people with severe AD and potentially improve the quality of care that is received.
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Affiliation(s)
| | - J E Chan
- Division of Psychiatry, University College London, London, UK
| | - R Bhome
- Division of Psychiatry, University College London, London, UK
| | - P Gallagher
- Division of Psychiatry, University College London, London, UK
| | - H Zhang
- Division of Psychiatry, University College London, London, UK
- National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - L Clare
- Centre for Research for Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - E L Sampson
- Division of Psychiatry, University College London, London, UK
| | - P Stone
- Division of Psychiatry, University College London, London, UK
| | - J Huntley
- Division of Psychiatry, University College London, London, UK
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6
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Nilsson A, Handlin L, Lidfors L, Petersson M, Uvnäs-Moberg K. Interacting With a Visiting Dog Increases Fingertip Temperature in Elderly Residents of Nursing Homes. Front Psychol 2020; 11:1906. [PMID: 32849116 PMCID: PMC7412930 DOI: 10.3389/fpsyg.2020.01906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/10/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate whether interacting with a visiting dog influences fingertip temperature and cortisol levels in residents living in nursing homes for the elderly. The study included two groups, the dog group (n = 13) and the control group (n = 11–15) and lasted for 8 weeks for the dog group and 6 weeks for the control group. All participants were residents living at nursing homes for the elderly. The researchers visited small groups of the participants twice weekly during the entire study in both the dog and the control group. The visiting dog and the dog handler accompanied the researchers during weeks 3–6. Fingertip temperature was measured and saliva samples for cortisol determination were collected at 0, 20 and 60 min for the dog group and at 0 and 20 min for the control group. For analysis the study was divided into periods; Period 1 (week 1–2), Period 2 (week 3–4), Period 3 (week 5–6) and Period 4 (week 7–8, only the dog group). Mean values based on all data obtained at 0 and 20 min during period 1–3 were compared between groups. A second, separate analysis for the dog group also included data from 60 min and for period 4. For the dog group fingertip temperature increased significantly between period 1 and 2, 1 and 3 and 1 and 4 (p < 0.05). In addition, fingertip temperature rose significantly between 0 and 20 min and between 0 and 60 min within all periods. For the control group a significant decrease in fingertip temperature was observed between period 1 and 3 (p < 0.05). Fingertip temperature did not differ between the two groups during period 1, but was significantly higher for the dog group than for the control group during periods 2 and 3 (p < 0.05 and p < 0.001, respectively). Cortisol results are only presented descriptively due to that many samples had too low volume of saliva to be analyzed. In the present study interaction between elderly residents and a visiting dog resulted in increased fingertip temperature, probably reflecting a decrease in the activity of the sympathetic nervous system and therefore a decrease in stress levels.
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Affiliation(s)
- Anne Nilsson
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
| | - Linda Handlin
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Lena Lidfors
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
| | - Maria Petersson
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Uvnäs-Moberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
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7
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Rodrigo-Claverol M, Malla-Clua B, Marquilles-Bonet C, Sol J, Jové-Naval J, Sole-Pujol M, Ortega-Bravo M. Animal-Assisted Therapy Improves Communication and Mobility among Institutionalized People with Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5899. [PMID: 32823839 PMCID: PMC7459682 DOI: 10.3390/ijerph17165899] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022]
Abstract
Disorders of communication, social relationships, and psychomotricity are often characterized by cognitive impairment, which hinders daily activities and increases the risk of falls. This study aimed to evaluate the efficacy of an animal-assisted therapy (AAT) program in an institutionalized geriatric population with cognitive impairment. The variables evaluated included level of communication and changes in gait and/or balance. We performed a two-arm, parallel controlled, open-label, nonrandomized cluster clinical trial in two nursing home centers from an urban area. Patients in the two centers received 12 weekly sessions of physiotherapy, but the experimental group included AAT with a therapy dog. The study included a total of 46 patients (23 Control Group [CG], 23 Experimental Group [EG]) with a median age of 85.0 years. Of these, 32.6% had mild-moderate cognitive decline (Global Deterioration Scale of Reisberg [GDS] 2-4) and 67.4% severe cognitive decline (GDS 5-6). After the intervention, patients in the CG and EG showed a statistically significant improvement in all the response variables. When comparing both groups, no statistically significant differences were found in any of the Tinetti scale results (measuring gait and balance). However, the communication of patients in the EG, measured on the Holden scale, showed a statistically significant greater improvement postintervention than that of patients in the CG. AAT can be useful as a complementary, effective treatment for patients with different degrees of cognitive decline.
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Affiliation(s)
- Maylos Rodrigo-Claverol
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | - Belén Malla-Clua
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Carme Marquilles-Bonet
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Joaquim Sol
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Metabolic Physiopathology Research Group, Experimental Medicine Department, Lleida University-Lleida Biochemical Research Institute (UdL-IRBLleida), 25198 Lleida, Spain
| | - Júlia Jové-Naval
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | | | - Marta Ortega-Bravo
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Research Group in Therapies in Primary Care, Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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8
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Marks G, McVilly K. Trained assistance dogs for people with dementia: a systematic review. Psychogeriatrics 2020; 20:510-521. [PMID: 32065698 DOI: 10.1111/psyg.12529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/10/2019] [Accepted: 01/06/2020] [Indexed: 01/17/2023]
Abstract
This systematic review investigated evidence for the effectiveness of trained assistance dogs as an intervention and support for people with dementia. Peer-reviewed articles were retrieved from multiple databases (SCOPUS, Web of Science, and Google Scholar). Reference lists of the articles retrieved were also screened to identify key authors for inclusion. Articles were subject to a quality review, and the results synthesised to address the research questions. Both qualitative and quantitative data were reported. There was evidence of the potential positive effects of dog-assisted interventions in relation to mood, prosocial behaviours, activities of daily living and/or quality of life, cognitive impairment and symptoms specific to dementia, and existential functions. However, the form and quality of the studies varied considerably. It was concluded that further research is needed, particularly for those with younger onset dementia (YOD), for whom there were no specific studies available. Attention needs to be given to establishing adequate-sized samples and designs incorporating control groups. Research would benefit from employing mixed-methods, allowing for the triangulation of qualitative and quantitative data. For deteriorating conditions such as the dementias, studies need to be conducted over time. Furthermore, given the important place family members play in the lives of those with dementia, the effects of dog-assisted interventions on the wider family should also be considered.
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Affiliation(s)
- Genée Marks
- Deakin University, Geelong, Victoria, Australia
| | - Keith McVilly
- School of Social and Political Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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9
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Briones-Peralta MÁ, Pardo-García I, Escribano-Sotos F. Effects of a practical training programme on burnout among professional caregivers in a care home for older adults with dementia: a pilot study. Psychogeriatrics 2020; 20:391-397. [PMID: 32034853 DOI: 10.1111/psyg.12523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/10/2019] [Accepted: 01/14/2020] [Indexed: 11/30/2022]
Abstract
AIM As the number of persons with dementia has increased so has the need for both specialized care and long-term care centres. Professional caregivers working in these centres encounter specific problems, including stress, burnout, and feelings of dissatisfaction, each which can affect the quality of care. Due to the nature of their work, they are more likely to experience stress, which may lead to burnout syndrome. Therefore, the aim of this work was to assess the results of a practical training programme with regard to burnout among direct care professionals in a nursing home for people with dementia. METHODS A practical training programme was conducted for caregivers at the Sagrado Corazón de Jesús Nursing Home in Cuenca, Spain. The programme used a dynamic, interactive methodology to provide training related to concepts and strategies for dementia care. Weekly 2-h sessions were held over 9 months, from April 2016 to January 2017, with the post-test administered in February. Pretest and post-test measures were taken for a sample of 36 caregivers. An anova was used to analyze the differences in means before and after training. An ancova was also performed to determine the effects of the intervention. RESULTS The results revealed a significant difference between pre- and post-intervention emotional exhaustion and depersonalization scores. Personal accomplishment scores improved, but the changes were not significant. CONCLUSION A practical training programme for direct care professionals working with dementia patients can decrease burnout levels.
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Affiliation(s)
| | - Isabel Pardo-García
- School of Economics and Business Administration, Sociosanitary Research Center, Castilla-La Mancha University (UCLM), Albacete, Spain
| | - Francisco Escribano-Sotos
- School of Economics and Business Administration, Sociosanitary Research Center, Castilla-La Mancha University (UCLM), Albacete, Spain
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10
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Jain B, Syed S, Hafford-Letchfield T, O'Farrell-Pearce S. Dog-assisted interventions and outcomes for older adults in residential long-term care facilities: A systematic review and meta-analysis. Int J Older People Nurs 2020; 15:e12320. [PMID: 32394594 DOI: 10.1111/opn.12320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To comprehensively review studies on dog-assisted interventions (DAIs) among older people in residential long-term care facilities (RLTCFs) and to provide an overview of their interventions, outcomes and methodological quality. METHOD We searched 18 electronic databases to identify English articles (published January 2000-December 2019) reporting on well-defined DAIs targeting older adults (≥65 years) in RLTCF. Data were extracted by two independent reviewers. Descriptive statistics were produced for quantitative studies, with key themes identified among qualitative studies. Where possible, estimates were pooled from randomised controlled trials using random effects meta-analyses. RESULTS Forty-three relevant studies (39 quantitative; 4 qualitative) were identified. The majority of quantitative studies were assessed as low-quality according to the MMAT criteria (n = 26, 67%). Almost half of the quantitative studies (n = 18, 46%) found no significant changes over time or between groups across outcomes measured. The most salient intervention effects included improved social functioning (n = 10), reduced depressive symptoms (n = 6) and loneliness (n = 5). A random-effects meta-analysis revealed a medium effect in favour of DAT on reducing depressive or loneliness symptoms (pooled SMD: 0.66, 95%CI 0.21-1.11; I2 = 50.5; five trials), relative to treatment as usual. However, compared to treatment as usual, no overall effect of DAI on activities of daily living was detected (p = .737). Key themes from qualitative studies included (a) animals as effective transitional objects, (b) the therapeutic value of pets and (c) the significance of the care environment and stakeholders in facilitating DAI. IMPLICATIONS FOR PRACTICE The findings of this review indicate that while DAI has value for older people in RLTCF, challenges remain in accurately measuring its impact to provide a stronger evidence-base. Standardisation of DAI service design, delivery and evaluation is required for future research and practice in providing holistic care for older adults.
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Affiliation(s)
- Briony Jain
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Shabeer Syed
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Trish Hafford-Letchfield
- Department of Mental Health and Social Work, Middlesex University, London, UK.,School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
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11
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Nordgren L, Asp M. Photo-Elicited Conversations about Therapy Dogs as a Tool for Engagement and Communication in Dementia Care: A Case Study. Animals (Basel) 2019; 9:ani9100820. [PMID: 31627391 PMCID: PMC6826407 DOI: 10.3390/ani9100820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022] Open
Abstract
Understanding the inner life of people with dementia can be challenging and there is a need for new and different approaches. Previous research shows that people with dementia can experience emotions such as harmony, closeness, and joy as well as sadness and concern when interacting with a therapy dog. Simultaneously, memories of past episodes are brought back to life when the person interacts with the dog. This raises questions about whether photos of interaction with a dog can evoke memories or support people with dementia in communicating emotions in a corresponding way. The aim of this study was to explore photo-elicited conversations as a tool for engagement and communication in dementia care. Repeated video observations of photo-elicited conversations between a woman with dementia and a dog handler/assistant nurse were used to collect data. The video recordings were analyzed with a phenomenological hermeneutical method. The role of photo-elicited conversations as a tool for engagement and communication in dementia care is that the conversations can help the person with dementia to feel a sense of being situated and recall feelings of liveliness and belongingness, and thus supporting the person's sense of self. The results can be used to deepen nursing staff's understanding of using photo-elicited conversations in dementia care.
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Affiliation(s)
- Lena Nordgren
- Centre for Clinical Research Sörmland, Uppsala University, 631 88 Eskilstuna, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, 752 36 Uppsala, Sweden.
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, 722 20 Västerås, Sweden.
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12
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Bray J, Brooker DJ, Garabedian C. What is the evidence for the activities of Namaste Care? A rapid assessment review. DEMENTIA 2019; 20:247-272. [DOI: 10.1177/1471301219878299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives To assess the quality of research evidence for the different activity components for the psycho-social Namaste Care intervention for care home residents with advanced dementia. Design Namaste Care is a multi-component intervention delivered on a daily basis to people living with advanced dementia or people at end of life with dementia. A significant part of its operationalisation within care homes is the delivery of a number of activities delivered by trained in-house Namaste Care workers to a group of residents with similar high dependency needs. The Namaste Care workers focus on touch, music, nature, sensory experience, aromas and interactions with objects delivered in a way to enhance feelings of enjoyment and wellbeing. This review evaluated the evidence for using these activities with people living with advanced dementia. A systematic search of peer-reviewed research articles was conducted between November 2016 and September 2018 using search terms of activities used in Namaste Care. The quality of each accepted article was rated using the Rapid Evidence Assessment scale. Results The initial literature search returned 1341 results: 127 articles including 42 reviews were included. The majority of activity interventions yielded between 10 and 20 peer-reviewed papers. The use of smells and aromas, interacting with animals and dolls, the use of various forms of music (e.g. background music, singing, personalised music), nature, lighting, various forms of touch/massage and sensory interventions (including Snoezelen) all appear to have proven efficacy with people living with advanced dementia. Conclusions There is generally a limited number of research papers and reviews in this area, but overall there is a good evidence base for including these activities within Namaste Care for people living with advanced dementia.
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Affiliation(s)
- Jennifer Bray
- Association for Dementia Studies, University of Worcester, UK
| | - Dawn J Brooker
- Association for Dementia Studies, University of Worcester, UK
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13
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Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162843. [PMID: 31395808 PMCID: PMC6721103 DOI: 10.3390/ijerph16162843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 12/30/2022]
Abstract
Chronic joint pain is associated to an increase in the consumption of medication and decrease in life quality in elderly people, which requires developing non-pharmacological treatments. The aim of this study was to evaluate the effectivity of a group intervention, based on animal-assisted therapy and applied to elderly people with chronic joint pain and polymedication, regarding the decrease of chronic pain, use of analgesics and improvement of life quality. A randomized controlled trial, two arms and open-label was conducted in a Primary Health Center. Twelve weekly sessions of kinesitherapy; in the EG, these exercises were performed with the additional assistance of the therapy dog. A total of 52 participants (22 Control Group (CG), 30 EG), average age 77.50 (±7.3), women 90.4%. A significant reduction on post-intervention values of pain β = −0.67(−1.27, −0.08), p = 0.03 and pain induced insomnia β = −0.53(−1.01, −0.05), p = 0.03 was found in EG for increasing baseline values. Animal-assisted therapy leads to an additional reduction in the perception of pain and pain induced insomnia in individuals with higher baseline severity. The presence of the dog improves the attachment to intervention and the satisfaction of the participants.
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Ritchie L, Quinn S, Tolson D, Jenkins N, Sharp B. Exposing the mechanisms underlying successful animal-assisted interventions for people with dementia: A realistic evaluation of the Dementia Dog Project. DEMENTIA 2019; 20:66-83. [PMID: 31335169 DOI: 10.1177/1471301219864505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is increasing recognition of animal-assisted interventions as a promising area of practice within health and social care for people living with dementia. However, much of the research focuses on benefits for those living in care homes and not in their own homes. The Dementia Dog Project is an innovative project that aims to support people with dementia to engage with dogs and to promote the use of dogs in dementia care in the community. The pilot project introduced a dementia assistance dog to four couples where one person had a diagnosis of dementia. The aim of this paper is to explore the mechanisms that can successfully expose the benefits of integrating dogs into dementia care by drawing on the findings of a realistic evaluation of the pilot phase of the Dementia Dog Project (2013-2015). A realistic evaluation, with its focus on context, mechanisms and outcomes illuminates why an approach may work in some situations but not in others. This makes it especially appropriate to the unique, complex experience of living with dementia and the early development stage of the programme. The analysis triangulated data from a range of primary and secondary sources including interviews with the project team, case reports, team meeting notes and transcripts of interviews with participants. The findings identified three mechanisms that help to unlock the most positive outcomes for both the participants and the dogs. These were (1) the human-animal bond, (2) relationship dynamics and (3) responsibility of caring. The findings presented within this paper provide essential information to inform and advance the planning for the use of assistance dogs for people with dementia.
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Affiliation(s)
- Louise Ritchie
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Samuel Quinn
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Debbie Tolson
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Nick Jenkins
- School of Media, Culture and Society, University of the West of Scotland, South Lanarkshire, UK
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15
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Mandrá PP, Moretti TCDF, Avezum LA, Kuroishi RCS. Animal assisted therapy: systematic review of literature. Codas 2019; 31:e20180243. [PMID: 31271584 DOI: 10.1590/2317-1782/20182018243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/29/2018] [Indexed: 11/21/2022] Open
Abstract
PURPOSE to verify the applications of AAT in health by performing a systematic review of the literature. RESEARCH STRATEGY a survey was carried out in four databases with the descriptors: animal assisted therapy, horse assisted therapy, speech therapy. SELECTION CRITERIA article published between 2010 and 2018, in Portuguese or English, free electronic access and that mentioned the characteristics of the intervention program. DATA ANALYSIS criteria: casuistry, area of knowledge, program characteristic, type of research, year and language of publication, nationality, periodical and impact factor. RESULTS 43 articles published in 30 journals, 16 with impact factor, were reviewed. Clinical studies prevailed (93.02%), 37.20% were from Medicine, the population studied had different diagnoses and ages, 55.81% with adults / elderly. AAT was used preferentially for physical rehabilitation (67.44%) and the main mediator was the dog, mentioned in 72.09% of the articles. Eight (n = 8) programs with a focus on communication intervention were described. CONCLUSION There is scientific evidence on the use of AAT published in the period studied, in Brazil and in the world. The programs were used by different health and education professionals. The AAT goals were specific to the profile of the participants, and consistent with the characteristics of the mediator animal and the site.
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Affiliation(s)
- Patrícia Pupin Mandrá
- Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Thaís Cristina da Freiria Moretti
- Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Leticia Alves Avezum
- Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Rita Cristina Sadako Kuroishi
- Departamento de Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - São Paulo (SP), Brasil
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Nicholas DB, Orjasaeter JD, Zwaigenbaum L. Considering Methodological Accommodation to the Diversity of ASD: A Realist Synthesis Review of Data Collection Methods for Examining First-Person Experiences. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00164-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Swall A, Craftman Å, Grundberg Å, Wiklund E, Väliaho N, Hagelin CL. Dog handlers' experiences of therapy dogs' impact on life near death for persons with dementia. Int J Palliat Nurs 2019; 25:65-71. [PMID: 30785819 DOI: 10.12968/ijpn.2019.25.2.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND: Persons with dementia may have severe physical and psychological symptoms at the end of life. A therapy dog used in their care can provide comfort and relieve their anxiety. The dog handler guides the dog during the interaction with the patient. AIM: To describe the impact of therapy dogs on people with dementia in the final stages of life from the perspective of the dog handler. METHODS: Interviews were conducted and analysed using qualitative content analysis. FINDINGS: The dog provides comfort and relief through its presence and by responding to the physical and emotional expressions of the dying person. CONCLUSIONS: Interactions with dogs were found to have a positive impact on persons with dementia and eased the symptoms associated with end of life according to the dog handlers.
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Affiliation(s)
- Anna Swall
- Senior lecturer, RN, Faculty of Health Sciences, School of Health and Social Studies, Dalarna University, Sweden
| | - Åsa Craftman
- Senior lecturer, Department of Nursing Science, Sophiahemmet University, Sweden
| | - Åke Grundberg
- Senior lecturer, Department of Nursing Science, Sophiahemmet University, Sweden
| | | | - Nina Väliaho
- Ms in Nursing, Palliative Care Unit, Borås, Sweden
| | - Carina Lundh Hagelin
- Associate Professor, Senior Lecturer, RN, Ersta Sköndal Bräcke University College, Sweden and Karolinska Institutet, Department of Neurobiology, Care Science and Society, Stockholm, Sweden
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18
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Chiberska D. The use of robotic animals in dementia care: challenges and ethical dilemmas. ACTA ACUST UNITED AC 2018. [DOI: 10.7748/mhp.2018.e1342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Swall A, Ebbeskog B, Lundh Hagelin C, Fagerberg I. Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog. Int J Qual Stud Health Well-being 2018; 12:1347013. [PMID: 28699394 PMCID: PMC5510223 DOI: 10.1080/17482631.2017.1347013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: Living with Alzheimer’s disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog. Method: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method. Results: The main theme was “Using one’s own resources and abilities as a human being”, which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog. Conclusions: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.
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Affiliation(s)
- Anna Swall
- a Department of Health Sciences, School of Health and Social Studies , Dalarna University , Falun , Sweden
| | - Britt Ebbeskog
- b Karolinska Institutet, Department of Neurobiology , Care Science and Society , Stockholm , Sweden
| | - Carina Lundh Hagelin
- b Karolinska Institutet, Department of Neurobiology , Care Science and Society , Stockholm , Sweden.,c Sophiahemmet University , Department of Nursing Science , Stockholm , Sweden
| | - Ingegerd Fagerberg
- d Department of Health Care Science , Ersta Sköndal Bräcke University College , Stockholm , Sweden
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Yakimicki ML, Edwards NE, Richards E, Beck AM. Animal-Assisted Intervention and Dementia: A Systematic Review. Clin Nurs Res 2018; 28:9-29. [PMID: 29441797 DOI: 10.1177/1054773818756987] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.
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Affiliation(s)
| | | | | | - Alan M Beck
- 1 Purdue University, West Lafayette, IN, USA
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21
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Björk S, Lindkvist M, Wimo A, Juthberg C, Bergland Å, Edvardsson D. Residents' engagement in everyday activities and its association with thriving in nursing homes. J Adv Nurs 2017; 73:1884-1895. [PMID: 28229474 DOI: 10.1111/jan.13275] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 01/17/2023]
Abstract
AIM To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving. BACKGROUND Research into residents' engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives. DESIGN A cross-sectional survey. METHOD A national survey of 172 Swedish nursing homes (2013-2014). Resident (n = 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed. RESULTS The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving. CONCLUSIONS Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.
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Affiliation(s)
| | - Marie Lindkvist
- Department of Statistics, Umeå School of Business and Economics, Umeå University, Sweden.,Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | | | - Ådel Bergland
- Lovisenberg Diaconal University College, Oslo, Norway
| | - David Edvardsson
- Department of Nursing, Umeå University, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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22
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Swall A, Ebbeskog B, Lundh Hagelin C, Fagerberg I. ‘Bringing respite in the burden of illness’ - dog handlers’ experience of visiting older persons with dementia together with a therapy dog. J Clin Nurs 2016; 25:2223-31. [DOI: 10.1111/jocn.13261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Anna Swall
- Department of Health Sciences; School of Health and Social Studies; Dalarna University; Falun Sweden
| | - Britt Ebbeskog
- Department of Neurobiology; Caring Science and Social Science; Karolinska Institutet; Huddinge Sweden
| | - Carina Lundh Hagelin
- Sophiahemmet University; Stockholm Sweden
- Department of Learning; Informatics; Management and Ethics; Karolinska Institutet; Stockholm Sweden
- Stockholms Sjukhem Foundation; Stockholm Sweden
| | - Ingegerd Fagerberg
- Ersta Sköndal University College; Department of Health Care Sciences; Stockholm Sweden
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