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Pets and Hospice Care: 'The Warmth of Touch'

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"My little old dog:
A heart-beat
At my feet."
-- Edith Wharton

"I love a dog. He does nothing for political reasons."
-- Will Rogers

It was quite a sight: Tug, a 50-pound mass of brown silky curls, lying in bed next to Ann, a lifelong dog lover who was in her final days. Ann was a patient in Haven Hospice Specialty Care Unit, Visiting Nurse Service of New York's in-patient hospice care facility within Bellevue Hospital Center. Tug, a 2-year-old Barbet (or French Water Dog), is a hospice volunteer who visits patients weekly, with his owner Tracey, for animal-assisted therapy.

2011-12-09-Tug3.jpg

A big dog, he usually stays on the floor or on a chair next to the bed, but Ann eagerly invited him onto the bed. "It was wonderful to see them connect," says Tracey, who brings Tug to visit with patients, family members and staff every Tuesday morning. "He's very good company in this situation. He's so in the moment. He has no expectations, he's not looking for anything, and he's a good listener."

Tracey's description of her canine volunteer partner is also a very good description of what the care and companionship of hospice aims for: being present in the moment.

Pet owners and health care workers alike know the positive health and healing power that animals can bring into our lives. Studies have shown that animal-assisted therapy can offer immediate physiological and psychological benefits, including lowering blood pressure, stress and anxiety in many patient populations, including those in hospice, the elderly and those with behavioral health issues. (For more about how pets can have a positive effect on the health of their human companions, check out the power of pets.)

Pets provide a touch, a look or just a calming presence that is nonjudgmental, elemental and all about connection. These powers are often amplified at the bedside of a patient in his or her final days. That's why Visiting Nurse Service of New York's Hospice and Palliative Care partners with the Good Dog Foundation to train dogs and their owners to be hospice volunteers. The Good Dog Foundation, which offers training, education and research on animal-assisted therapy, evaluates the dogs for their gentle demeanor and ability to remain calm in unpredictable situations. The humans are evaluated for their positive dog training skills and also undergo VNSNY's hospice volunteer training.

Some dog volunteers like Tug and Tim, a 7-year-old German shepherd, make regular rounds at Haven, walking the hallways, making room-to-room visits for those who are interested, stopping by the family room and other common spaces and interacting with staff.

Others, like Magnus and his owner Andrea, visit patients in the home. Andrea still remembers a patient named Paulette, a small, bed-bound woman in her 80s who always invited Magnus up to the bed for kisses and cuddles. In Paulette's final hours, when Andrea brought Magnus for one last visit, "She opened her eyes and gave a big smile as she weakly reached out to pet him. 'Does he want some W-A-T-E-R?'" Paulette asked, spelling the word, as she always did, so he wouldn't get too excited.

The Power of Pets

Gail Sirota, who manages VNSNY's hospice volunteers, enumerates the benefits she sees week after week when Tug and Tim make their rounds.

The Power of Touch
When a hospice patient reaches out to pet the dog, or when the dog offers a gentle lick or lays his chin on a hand or forearm, the physical connection reverberates in many ways. "The warmth of touch is so important," says Gail. "Touch validates that you're still living, that you're still a person worthy of love -- and there's nothing better than unconditional love. The dog doesn't know that you're sick, that you don't look like what you used to look like."

The Power of Memories
Whether or not the patient or family members want to pet or cuddle the dog, often the mere presence of Tim or Tug will start the memories rolling. "I used to have a dog, Alfie, oh, she was the best dog," says Gail, offering a typical example. "They start talking about the pets they used to have, and it helps them open up."

Nancy, who volunteers with Tim, still recalls visiting a patient and her multi-generation Asian-American family who waxed nostalgic about their own German shepherd. He was a biter. Fortunately, a family member was a doctor -- and could stitch up the unlucky souls who found themselves at the wrong end of a dog bite. "We were all cracking up," Nancy remembers about the robust family storytelling. "These kinds of conversations happen all the time, patients and family members reminiscing about the very special place they have in their heart for the dogs they've owned over the years."

The Power of Diversion
"For the family members," says Gail, "the dog provides a momentary break from their constant fears and worries." The can be especially true for children coming to Haven to visit family members.

Tracey has experienced the power of diversion many a time, walking down the hall with a lovable mop top of a dog, who has more than once been described as looking like a Muppet. "They see him, they stop and ask questions and tell stories," she says. "The light conversation is a nice break for them."

All in a Day's Work

How do the dogs feel about their volunteer work?

Nancy offers what I find a fascinating insight into how Tim, the German shepherd, views his role at Haven. For him, she says, it's a job, one that he is committed to, derives satisfaction from, and -- as many at Haven will attest -- is very good at. "He could walk in the front doors of Bellevue Hospital," Nancy muses, "and if someone could press the 7th floor elevator button for him, he would know exactly where to go and what to do."

German shepherds, she points out, are typically a "one-person dog," meaning that he is not constantly seeking human affection. Rather, he provides comfort at Haven because he understands it to be in his volunteer job description. "He doesn't dislike it -- I wouldn't do it if he didn't like it -- but in his mind he's working," she explains. "He'll have people come up to him in the hallway, get down on the ground and put their face in his neck, put their arms around him. He's glad to just let them do it as long as they need to. He's a good boy."

For Tug, too, a visit to Haven is all in a day's work. "When I put his therapy dog scarf on, he's very happy and eager about it," says Tracey. "He knows what he's doing. In general he's gentle with people, but when we're visiting with someone more fragile, he's even more careful in the way he approaches and interacts."

She adds, "He is an exceptional dog." And, after a pause: "I might be a little biased."

I suspect all who've benefited from Tug's visits are a little biased in that direction, too.

Photo Credit: VNSNY Hospice

Have you or a loved one benefited from the therapeutic power of a pet, whether in hospice or another care situation?