The Role of Pets in Supporting Cognitive-Behavioral Chronic Pain Self-Management: Perspectives of Older Adults

The role of pets in the lives of people with dementia: a scoping review

OBJECTIVES

This scoping review is designed to understand the role of pet ownership in the lives of people living in the community with dementia.

METHOD

A five-stage framework for conducting a scoping review guided the review. Two research questions framed the study. Nine databases were searched, with six papers meeting the criteria for detailed review.

RESULTS

Pets can play a central role in the lives of people living with dementia. These relationships can be profound and can provide companionship and a sense of purpose. The activities associated with pet ownership and possible benefits for the person living with dementia have been explored to varying degrees and some benefits have been shown regarding the impact on physical and mental well-being. However, little is known about the challenges that may be faced when caring for a pet.

CONCLUSION

Despite the importance of pet ownership, experiences of ownership documented among people living with dementia is limited. Still, the studies indicate how pet ownership can support people to remain socially engaged. Future studies should seek to gain a broader understanding of pet ownership across environments such as care homes and hospitals and in the context of social citizenship, active participation and living well. Creative research methods should be adopted to support the inclusion of people living with dementia in research.

Co-sleeping with pets, stress, and sleep in a nationally-representative sample of United States adults

This cross-sectional study tested the direct and stress-buffering effects of co-sleeping with pets on human sleep characteristics in a nationally-representative sample of United States adults. Participants completed questionnaires assessing their sleep characteristics, including perceived sleep quality, perceived sleep efficiency, insomnia severity, and multidimensional sleep health. We evaluated whether co-sleeping with pets was associated with sleep characteristics and whether co-sleeping with pets moderated the association of stress and sleep characteristics. Exploratory analyses examined whether sleep characteristics were impacted by number of pets, pet type, and bondedness to pets. Our final sample of 1591 participants (Mage = 46.4 years, SD = 17.5; 56% female; 76% White) included 758 participants who reported co-sleeping with pets (47.6%). Co-sleeping with pets was associated with poorer sleep characteristics-specifically, poorer perceived sleep quality and greater insomnia severity. Although higher levels of stress were associated with poorer sleep, we did not observe evidence for a stress-buffering effect of co-sleeping with pets. Exploratory analyses indicated that the negative impact of co-sleeping with pets on human sleep was associated with dog ownership but not cat ownership, more pronounced when individuals own a greater number of pets, and not impacted by bondedness to pets. Our findings contribute to emerging evidence for the impact of co-sleeping with pets on human sleep. Study was pre-registered at: https://aspredicted.org/3VN_WF6 .

Effectiveness of animal-assisted therapy and pet-robot interventions in reducing depressive symptoms among older adults: A systematic review and meta-analysis

BACKGROUND

Systematic reviews suggest that animal-assisted therapy (AAT) and pet-robot interventions (PRI) achieve a reduction in mental health variables such as depressive symptoms. However, these systematic reviews include both randomised and non-randomised studies, which prevents an adequate assessment of the effect of confounding variables.

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the comparative effectiveness of AAT and PRI through randomized controlled trials (RCTs) in reducing depression in older adults.

METHODS

Our study is a systematic review. We searched three databases of scientific articles: SCOPUS, Web of Science and PubMed. We included studies that their population was older adults, aged 65 years or older, with or without a clinical condition, clinical diagnosis based on mental examination/test or documentation from medical records, accredited by the facilities' staff. We included trials in which the comparator was a passive intervention or an active intervention. We used the Cochrane risk-of-bias tool for randomised trials (RoB 2) to assess the risk of bias for each study. Our study was registered in PROSPERO (CRD42023393740).

RESULTS

Twenty-three studies were included in this systematic review. However, only 19 trials were included in the meta-analysis. At the overall risk of bias level, 78.9% of the studies were at high risk of bias (n = 15). We found that AAT (g= -0.72; 95%CI -1.13 to -0.31; p = 0.001) has a moderate and statistically significant effect as an intervention to reduce depressive symptoms in older adults. However, the PRIs do not show a significant effect on reducing depressive symptoms in older adults. In addition, a sub-analysis based on dog-assisted therapy (g= -0.65; 95%CI -1.21 to -0.08; p = 0.025), a specific type of AAT, showed a modest effect on reducing depressive symptoms.

CONCLUSIONS

Our study concluded that AAT and DAT had a moderate and statistically significant effect as interventions to reduce depressive symptoms in older adults. On the other hand, PRI did not show a significant effect in reducing depressive symptoms.

Relations Between Guardians and Domestic Animals During the Sars-Cov-2 Pandemic in Brazil

OBJECTIVE

The aim of this study was to evaluate how relationships between guardians and domestic animals were established and their possible effects during the COVID-19 pandemic period in Brazil.

METHODS

Data were collected by completing an online questionnaire. Throughout the national territory, 2002 people completed the questionnaire, while respecting social distancing from January 20, 2021, to March 20, 2021. The inclusion and exclusion criteria were 'to own pets' or 'those who had them during the period of quarantine' in Brazil. The data obtained were treated qualitatively through discourse analysis and content analysis, while the quantitative data were tabulated by the questionnaire application platform itself.

RESULTS

The results showed that 97% of the participants were affected by the coronavirus pandemic in Brazil and that of these, 95.5% stated that their pet was important to overcome and bear bad feelings during the period of social isolation. It was possible to observe through the participants' reports through the online questionnaire that the relationships with their pets were deepened during the pandemic period, and that these had an important role in overcoming bad emotions caused by social distancing.

CONCLUSION

It was concluded that due to these relationships, behaviors such as anxiety and sadness were reduced and the pets themselves also showed an increase in affective behaviors in relation to their guardians.

Daily Mobility and Social Interactions Among Community-Dwelling Older Adults With Pet Dogs: A Scoping Review

Dogs are part of many people's lives and are involved in interventions to improve the well-being of older adults in institutional settings. However, the literature on the impact of pet dogs on community-dwelling older adults is still relatively limited. This study mapped the impact of having a companion dog on the daily mobility and social interactions of community-dwelling older adults using a scoping review. Electronic databases were searched, and studies written in English, Portuguese, and Spanish that were published in a peer-reviewed journal were identified. After a careful review, 26 eligible studies were identified, and relevant findings were extracted. The main findings indicated that having a dog may promote or hinder daily mobility and social interactions and that having a dog is about routines and sharing affection. More research is needed to clarify what makes having a companion dog key to promoting active and healthy aging.

The role of pets in the support systems of community-dwelling older adults: a qualitative systematic review

OBJECTIVE

Western countries face ageing populations and increasing numbers of older adults receiving long-term care at home (home care). Approximately 50% of households in Western countries own pets, and while pets impact the health and wellbeing of their owners, most healthcare organisations do not account for the role of pets in the lives of their clients. Due to the lack of research in older adults receiving home care that own pets, this study aimed to review previous qualitative research about the role and significance of pets for older adults in general.

METHOD

PubMed and PsycINFO were systematically searched with variations on (MeSH) terms for older adults (mean age 65 years and older), pets, and qualitative study designs. Iterative-inductive thematic analyses were performed in ATLAS.ti.

RESULTS

We included fifteen studies and extracted twenty-eight themes within seven categories: Relational Aspects, Reflection and Meaning, Emotional Aspects, Aspects of Caregiving, Physical Health, Social Aspects, and Bidirectional Behaviour. Older adults reported not only on positive aspects of pet ownership such as the emotional support their pets provided but also on negative aspects such as postponing personal medical treatment.

CONCLUSION

Older adults perceived pets as important for their health and wellbeing. This implies that care workers may be able to improve home care by accounting for the role of pets of older adults receiving home care. Based on our findings, we suggest that community healthcare organisations develop guidelines and tools for care workers to improve care at home for clients with pets.

Pet ownership issues encountered by geriatric professionals: Preliminary findings from an interdisciplinary sample

Pets often factor in older adults' health behaviors and decisions. However, the degree to which issues related to pet ownership are encountered or addressed by professionals working with this population remains unknown. The aim of this study was to identify specific issues stemming from pet ownership professionals had encountered in their work with older adults, people living with dementia, and care partners. An interdisciplinary (e.g., social services and healthcare) sample (N = 462, 89.13% female, M age = 53.02, SD age = 12.18) completed an online survey addressing pet ownership issues encountered in their work. Descriptive statistics, t-tests, and repeated measures ANOVAs were used to analyze quantitative data. A conventional content analysis was used to analyze open-ended responses to an item asking about "other" issues encountered in their work with these populations. The professionals estimated 46.29% of clients had been pet owners, 41.23% regularly asked about pets, and 79.22% had encountered issues related to pet ownership. Specific issues raised to the professionals varied by type of client. The professionals reported older adults most often raised getting pet items into the home and concerns about their pets' health. The issues most often raised by people living with dementia to the professionals were planning for the pet due to a housing transition and basic pet care. Care partners focused on basic pet care and planning for the pet due to a housing transition. The professionals themselves most often raised the issues of basic pet care, concerns about falling, and the pets' behavior. Professionals who entered clients' homes were more likely to raise issues stemming from pet ownership compared to those who reported they did not enter clients' homes in their current job, t(429.40) = 5.59, p < 0.00001. The eleven new issues identified by the content analysis (e.g., pets impeding care, people refusing care due to the pet) underscored how the health and wellbeing of people and their pets are linked. The results of this study provide strong evidence that professionals do encounter issues related to pet ownership. Including issues stemming from pet ownership into procedures, policies, and programs is likely to have positive impacts on those served by and working in the geriatric workforce.

Pet Ownership and Mental and Physical Health in Older White and Black Males and Females

Pet ownership literature remains mixed regarding associations with mental and physical health outcomes among older adults. The present study investigates the relationship between pet ownership and depression, health, and physical activity in an older adult sample balanced by sex (male/female), race (White/Black), and urban/rural status. Participants were adults aged 65+ recruited between 1999 and 2001 in the University of Alabama at Birmingham Study of Aging. Participants completed the Geriatric Depression Scale, a single-item self-reported health measure, and a physical activity questionnaire. Dog owners reported better subjective health and were more likely to walk for exercise as compared to non-pet owners. Cat owners did not differ from non-pet owners in terms of self-reported health or walking. White participants were more likely than Black participants to report ownership of a pet. No relationships were found between pet ownership and symptoms of depression. Findings were not influenced by sex, race, or geographical location. Dog ownership may be associated with positive physical health behaviors and subjective health perceptions. Additional research focused on mechanisms and cognitive impact is needed. Although there may be physical health benefits of dog ownership, adopting a pet should not be viewed as a simplistic solution to alleviating depression in older adults.

Understanding the impact of dog ownership on autistic adults: implications for mental health and suicide prevention

Mental health problems and suicide are more frequent in autistic adults than general population. Dog ownership can improve human well-being. This study aimed to generate a framework of well-being outcomes for dog-related activities in autistic adults and compare it to the framework generated for a general adult population. Thirty-six autistic dog owners (18–74 years old, 18 males) from diverse UK regions were interviewed and transcripts thematically analysed. 16.7% reported that their dogs prevented them from taking their own lives, mainly due to the dog's affection and the need to care for the animal. Close dog-owner interactions (e.g., cuddling, walking, dog's presence) were the most frequent activities improving emotions/moods and life functioning, whereas routine-like activities (e.g., feeding the animal) particularly enhanced life functioning. Well-being worsening was mainly linked to dog behaviour problems, dog poor health/death and obligations to the dog. Despite some negatives associated with ownership, having a dog could improve the well-being of many autistic adults and assist suicide prevention strategies in this high-risk group. The framework was consistent with that generated previously, indicating its robustness and the potential opportunity to focus on dog-related activities rather than the vague concept of “ownership” when considering the impact of ownership on well-being.

Use of animal-assisted interventions in relieving pain in healthcare settings: A systematic review

BACKGROUND AND OBJECTIVE

Therapeutic interaction with animals for patients coping with physical and mental health conditions is a growing interest among healthcare providers and researchers. We aimed to comprehensively summarize and evaluate the current state of evidence examining the use of animal-assisted interventions [AAI] for pain relief in healthcare settings.

DESIGN

Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

METHODS

Two researchers independently assessed publications dated before February 5, 2021 in OVID Medline, CINAHL, and PsychINFO databases, and used the Delphi list to evaluate the quality of the evidence.

RESULTS

Of the 109 studies screened, a total of 24 studies totaling 1,950 participants were ultimately included. Studies varied in design, including single group trials (8), controlled trials with at least two groups (6), and randomized controlled trials (10). The most common form of pain measurement was the visual or numeric rating scale. For the 18 studies that reported data on changes in pain severity from pre-to-post-test, 13 reported a significant reduction; using the converted common metric we created, these reductions ranged from 0.20 to 3.33 points on a 10-point numeric rating scale.

CONCLUSIONS

AAI may be considered a promising approach in need of further, more rigorous research. Available evidence supporting AAI remains weak due to issues of study quality and design, thereby impeding our ability to draw reliable conclusions on the utility of AAI in relieving pain. Given the rapidly increasing availability of these interventions in hospitals, it is important to better understand its effectiveness.

What Are the Benefits of Pet Ownership and Care Among People With Mild-to-Moderate Dementia? Findings From the IDEAL programme

Pet ownership has been associated with positive outcomes in many populations, yet the associations with physical and psychological wellbeing in people with dementia remain unclear. The current study used baseline data from 1,542 people living at home with mild-to-moderate dementia from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Regression analyses investigated associations of pet ownership and pet care with self-reports of walking, loneliness, depression, and quality of life (QoL). After adjusting for covariates, having any pet was associated with higher likelihood of walking over 3 hr in the last week. Those with a dog and who were involved in its care were less likely to be lonely than those with no dog. Having any pet but no involvement in its care was associated with increased depression and decreased QoL compared with those without a pet. The key factor in the associations was involvement in the care of the pet by the person with dementia.

Understanding the Benefits, Challenges, and the Role of Pet Ownership in the Daily Lives of Community-Dwelling Older Adults: A Case Study

Simple Summary

This qualitative case study explores the perceived benefits and challenges of pet ownership for a community-dwelling older adult and her miniature schnauzer, from the perspectives of the pet owner and her community healthcare provider. The findings suggest that the pet’s well-being is an important part of the pet–owner relationship for Violet, the older adult. Sharing her daily life with her pet, Jack, gives her a sense of safety, positively influences her mood, and motivates her to carry out her daily activities. In return, Jack benefits from her daily presence and care. The challenges of pet ownership included a low-risk potential of falling, pet-related concerns, and financial costs. Both participants agree that the benefits outweigh the challenges for both Violet and Jack. Findings of this study suggest that caring for the pet is a meaningful aspect of the pet–owner relationship. Future studies should explore how to support human–animal relationships for community-dwelling older adults via pet ownership. Improving the fit between characteristics of the elderly pet owners and their pets will maximize benefits and minimize potential challenges; thus, supporting both aging-in-place and the well-being of animals.

Abstract

Human–animal interactions may positively impact the health and well-being of older adults. Considering about one third of community-dwelling older adults report owning a pet, better understanding the benefits, challenges, and the role of pet ownership may help support the relationships between older adults and their pets. This case study aims to better understand the role of pet ownership in the daily lives of older adults and explore the benefits and the challenges of owning a pet for this population. Interviews were conducted with Violet, a 77-year-old dog owner and her healthcare provider. Qualitative data were analyzed by two evaluators and validated by the participants. Both participants agree that the benefits outweigh the challenges for both the older adult and her pet. The benefits and challenges were the following: Violet, taking care of her dog (Jack), (1) could provide Violet with a sense of safety and positively influence her mood; (2) may introduce a slight fall risk; (3) includes financial costs to consider. Ensuring Jack’s well-being is important for Violet and her dog benefits from Violet’s continual presence and care. The findings suggest that improving the fit between characteristics of the owner and their pet may support the meaningful role of pet ownership within the context of aging-in-place.

Can dogs and cats really help our spinal cord stimulation patients?

OBJECTIVES

Pet ownership has been shown to decrease morbidity and mortality in several aspects of health but has not been studied in chronic pain patients. We evaluate whether subjects who underwent spinal cord stimulation (SCS) and own a pet have improved outcomes compared to non-pet owners.

METHODS

After obtaining IRB approval, we re-contacted 38 subjects who underwent SCS surgery with preoperative and 1-year postoperative data on Numerical Rating Scale (NRS), McGill Pain Questionnaire (MPQ), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and Pain Catastrophizing scale (PCS). We examined influence of pets and pet ownership-specific behaviors on improvement in SCS outcomes.

RESULTS

Patients included 24 males/14 females with a mean age of 59.9 ± 11.5 years. At mean follow-up of 12.2 months (range 10-14), there were improvements in NRS, ODI, BDI, PCS and MPQ. Twenty subjects owned pets and 18 did not; all believed pet ownership could improve health. Pet owners improved more on NRS-right now (p = 0.05) and BDI (p = 0.05), and were more satisfied with SCS (p = 0.04). No significant improvement was seen in ODI, MPQ, or PCS. However, PCS did improve in pet owners who exercised their pet (PCS-total, p < 0.01; PCS-helplessness, p < 0.01; PCS-rumination, p = 0.05; PCS-magnification, p = 0.02).

CONCLUSIONS

We provide preliminary evidence that pet ownership is associated with improved pain, depression and SCS satisfaction. Exercising with a pet also appears to be beneficial in limiting pain catastrophizing. Pets show promise as a novel means to improve patient SCS outcomes.

More than Ownership: The Importance of Relationships with Companion Dogs for the Psychological Adjustment of Fibromyalgia Patients

OBJECTIVE

This study explored the role of companion dogs for psychological adjustment to pain in patients with fibromyalgia with different levels of social support. It also considered the potential moderating effects of the quality of the owner-dog relationship and the use of interactions with dogs as a coping strategy.

SETTING

A cross-sectional approach was followed using an online questionnaire.

SUBJECTS AND METHODS

Linear regression analyses were performed on data obtained from 106 participants (dog owners and non-owners). Sub-analyses were performed on 64 dog owners.

RESULTS

Complex associations were observed between human social support, dog ownership and anxiety/depression levels. For participants with low levels of social support, owning a dog was associated with higher levels of anxiety and depression. In contrast, for moderate and high levels of social support, owning a dog was associated with lower levels of anxiety and depression. Sub-analyses showed that participants in this study actively used interactions with companion dogs to manage their pain more frequently than other pain coping strategies. Among those interactions, patting and stroking the dog to cope with pain was associated with lower anxiety levels, even after adjusting for social support. Emotional closeness with the dog was associated with lower depression levels.

CONCLUSIONS

Obtained results highlight the importance to go beyond mere ownership when addressing the effects of companion dogs and suggest that the development of emotional ties with companion dogs and the active use of interactions with these animals to cope with pain may contribute to better psychological adjustment in patients with fibromyalgia, regardless of human social support.

The Association of Persistent Low Back Pain With Older Adult Falls and Collisions: A Longitudinal Analysis

Mobility-related injuries associate with reduced quality of life, greater functional dependence, and quicker mortality in older adults-warranting prevention efforts. One factor elevating injury risk may be persistent low back pain, which can negatively affect cognitive and physical functions essential for safe mobility. Among older adults obtaining license renewal (n = 1,127), this study examined the association between persistent low back pain and incidence of falls and motor vehicle collisions (MVCs) for up to 15 years. Overall, older adults with persistent low back pain were more likely to have a fall (odds ratio [OR] = 1.54, 95% confidence interval [CI] = [1.34, 1.77]) or MVC (OR = 1.38, 95% CI = [1.07, 1.77]) than those without back pain. Furthermore, the number of falls and MVCs was lower for people with better lower limb and visuospatial function, respectively. Ameliorating pain and functioning in persistent lower back pain might contribute to improved mobility and a reduction of injury-related risk in later life.