June 24, 2003
By Ann Geracimos
The Washington Times
Patients resigned to the clinical atmosphere of Inova Fairfax Hospital's rooms and corridors often find comfort in the presence of a friendly, furry dog.
When the animal leaps joyfully onto the bed, instinctively a patient reaches out to touch the small, warm creature that offers a lick or two on a willing face or hand. For these inpatients, the visit can be relief from the tedium of confinement and a reminder of life in the world outside.
Whether the patient is aware of it, the visit also can be therapy — helping a patient get better faster in ways that Cheryll Battle, director of Inova's department of rehabilitation, acknowledges medical science cannot always explain.
Under the supervision of canine trainer and trauma nurse Leslie Horton, the hospital's 16-month-old Animal Assisted Care Program can give a psychological boost and simultaneously help those suffering from memory problems after a stroke. When used as part of routine physical rehabilitation, service dogs help with mobility exercises to spur post-injury independence.
Health care workers point to studies that show many animals play a role in alleviating stress and lowering people's blood pressure, but there also are times when a dog seems alert to a need before being instructed to help.
One afternoon recently, Chug, a 4-year-old chow-Lab-shepherd mix, was doing his rounds in the hospital's neuroscience unit guided, as always, by Mrs. Horton. She had told Chug to wait for her temporarily at the nurses' station while she went to help obviously agitated relatives standing beside the bed of an elderly patient who was having what looked like an anxiety attack. Sensing a problem, Chug followed her and — on command from his owner — jumped on the bed. Calm settled on the group moments later as the patient reached out to touch the dog.
It was all in an afternoon's work for this particular canine, who visits as many as 16 patients a day. Mrs. Horton, 40, who runs One Fine Canine Inc., in Frederick, Md., finds and trains most of the dogs used in the hospital program, supplemented by two volunteers — including one who is a veterinarian. Volunteers train their dogs — so far, all of them mutts — before each dog-volunteer team is tested, and then work under her supervision. Ten more volunteers are on the wait list.
Earlier that day, Chug had been part of a demonstration lecture his owner gave to update 18 hospital physicians and staff members on the program.
During her lecture, Mrs. Horton showed how Chug can finesse a door handle, turn on a light switch, and pick up a credit card from the floor. "Although he weighs only 45 pounds, he can pull a 180-pound man in a wheelchair," she boasted. "It's all temperament. We need to get rid of preconceived notions about [an animal´s] size."
She warned, too, against thinking of working dogs simply as pets since even when a patient is stroking a dog's coat, an action both patient and dog obviously enjoy, the motion can be helpful in strengthening weak limbs. Unlike most pets, Chug is insured for $30,000, which Mrs. Horton described as the average cost of training a service animal. "Which is why they are in low supply," she added.
Later, Mrs. Horton and Chug visited with a recovering cancer patient and a stroke victim. The latter, Jeannie Poteet, 78, was asked to repeat answers to questions Mrs. Horton had posed about Chug the previous day to test her mental concentration. Mrs. Poteet stroked Chug while her husband, Joe Poteet, who was visiting that day, said that the couple has a pet bichon frise at home in Mount Jackson, Va.
"What does Chug do?" Mrs. Horton asked.
"He makes people happy," was Mrs. Poteet's reply. "He can lead. He can entertain people in the hospital. I think that is the most important thing. I think dogs are wonderful," she added after some prodding.
Chug was helping reinforce behavior during this visit, Mrs. Horton said after leaving the room. After a therapeutic encounter, she tallies progress on a special "Animal Assisted Therapy/Personal Assistance Therapy Evaluation" form. "The goal of rehabilitation isn't to get [patients] performing perfectly," she said, "but to get them to maximize the capacity they have."
Although her dogs are bathed daily before coming to the hospital, Mrs. Horton is careful to use a clean bedsheet for each encounter and to wash a patient's hands afterward. A doctor's order is required before a dog visits a patient, and all patients and their roommates are checked for sensitivity prior to exposure to the animals. Chug has a badge and a working dog's red harness, but Mrs. Horton always asks strangers whether they are allergic to or afraid of dogs before introducing Chug.
Undoubtedly, it adds considerably to Mrs. Horton's empathic skills that Chug is now around for her own needs as well. Mrs. Horton was diagnosed not long ago with a type of multiple sclerosis, a disease of the nervous system that causes a person to occasionally lose control of movements. Chug can help block her fall if that happens.
"You don't have to be blind to have a service dog," Mrs. Horton tells people at every opportunity, recalling how she often has to fight for her dog's right to be with her in a public place.
Inova is unusual in allowing dogs into acute care units for healing purposes as well as having patients' own pets visit — but only after a careful examination by a veterinarian. Dogs in Inova's program are vaccinated and checked by a veterinarian every three months.
Programs such as Canine Companions for Independence, a national California-based non-profit group, assist adults and children with disabilities at home, at work and in retirement centers.
Through its own breeding and training program, CCI dogs have met a variety of needs in the last 14 years: helping the physically disabled perform daily tasks, acting as companion dogs, alerting deaf and hard-of-hearing people to everyday sounds, and working as facility dogs alongside professional and volunteer caregivers in the field. The wait list for people applying for a dog is anywhere from six months to two years.
Deborah Bartgis, a recreational therapist at Blakehurst Continuing Care Retirement Center in Towson, Md., has a 2-year-old CCI golden retriever named Kimala with her 45 hours a week to work with elderly patients. The dog can provide simple companionship as well as help impart a sense of responsibility.
"Folks will volunteer to hold her leash and I think it gives them a sense of importance, because so often we take snatches of their independence away and nobody feels they are needed anymore," Ms. Bartgis said.
One of the clients with dementia in the retirement facility speaks French to Kimala, addressing her as Tutu. "It's a sign of affection," Ms. Bartgis said. "She may have had a dog growing up."
Another woman in late stages of dementia sits within a foot of Kimala's body and is warned by others in the group to watch out for her. Ms. Bartgis sees such a sign of recognition as remarkable since many residents sleep most of the day: "It improves their emotional level," she said. "I also think it mimics a homelike environment."
Another woman pets the dog as reinforcement after performing walking
exercises. Others who simply move their arms up and down the dog's body
are involved in physical rehabilitation, too, says Ms. Bartgis. "Most of
our folks are here permanently until the good Lord takes them. So if we
can improve their quality of life, that is great."
Copyright © 2003 News World Communications, Inc.