As an animal assisted therapy team for 13 years, Rufus (a Jack Russell Terrier) and I had the good fortune to work with a variety of populations. We saw small miracles everywhere we visited — schools, hospitals, libraries, rehabilitation centers, etc. — but none hit closer to home than visiting my mom in the memory care unit at Villa St. Benedict in Lisle, Ill.

Rufus, the therapy dog. Photo courtesy of Rick Osbourne, PYOW Publishing.

The basic goals/outcomes of animal assisted therapy (AAT) remain the same over a variety of populations: A life is enriched and a connection is made by the presence of the animals. Working with those who have Alzheimer's disease and related dementias (ADRD), the focus is on making a connection and maintaining functional fitness, including both motor skills and social interactions.

My own personal experience began when my mom was diagnosed with dementia. During the last six years of her life, the time I spent with her was always enhanced by the opportunity to connect. We connected with music by playing her favourite polka music. We connected with food by making meals together and baking. But the best connection was with Rufus.

The animal assisted therapy connection

For instance, when she was prescribed some functional physical therapy, Rufus was there to encourage simple motor skills such as sitting and standing. When Mom sat, he sat; when she stood, he stood. This activity also encouraged verbal communication, by speaking the commands to him. This gave her an opportunity to have some control in a world in which she now had so very little. Best of all, she had fun doing it.

In our ever-aging population, in order to work effectively with folks with ADRD, I believe it is necessary to have a basic understanding of the disease and how to interact with participants. There are many types of dementias — the most common of them is Alzheimer’s disease.

Simply put, dementia causes a person’s connections to disintegrate, creating disorientation and alienation from themselves and the world. It is a disease that tends to reduce and dismantle the “dot-connecting” process.

"When Rufus is in the room, he sparks a connection that is unmatched by anything I could ever say or do."

– Pam Osbourne, author of A Dog Takes a Bite Out of Alzheimer's

Therapy dog Izzy being groomed. Photo courtesy of Rick Osbourne, PYOW Publishing.

The Alzheimer’s Association

The Alzheimer’s Association (www.alz.org) provides a wealth of knowledge that helps to create a better understanding of this disease and ways in which to communicate. The Alzheimer’s Association is an invaluable resource for those who have had no experience with the disease prior to working with them in an AAT setting. The information provided includes descriptions of the types of dementias, the basic 10 warning signs of Alzheimer’s versus typical age-related changes and guidance on how to participate in support groups.

The therapy team

As a member of a therapy team, I wanted to know more about what would improve my visits with my mom and what would provide motivation and encouragement. I learned over the years that our interactions would most often be “in the moment” and possibly not remembered from one minute to the next. This requires a lot of patience and the ability to respond to people with whom you are carrying on a conversation that is suddenly headed in an entirely different direction, and possibly, on a totally different subject. The ability to listen and be flexible is crucial. Understanding this will increase enjoyment and reduce frustration as you plan and create activities that acknowledge this is how it is.

Before you visit

Before you visit, prepare. Communicate with the health-care professionals at the community you plan to visit to determine the goals they have for their residents, both collectively and individually.

Rufus being dressed. Photo courtesy of Rick Osbourne, PYOW Publishing.

You can then plan to visit a group or individuals to encourage group goals (social) or individual goals. For example, if someone is having difficulties eating, feeding the dog with a fork can encourage a person to eat. Activities of daily living, such as getting dressed or brushing one’s hair, can also be encouraged by doing those same activities with the dog. Rufus is always happy to encourage getting brushed, creating an activity that encourages fine motor skills, counting and cognition.

When Rufus is in the room, he sparks a connection that is unmatched by anything I could ever say or do. People who have been reluctant to communicate or participate suddenly are speaking, smiling and reaching out. During exercise time, Rufus has encouraged folks to move who were reluctant participants at first. Whether it’s encouraging basic movements or simply taking the dog for a walk, Rufus gets the participants’ attention and encourages them to get up and move.

Enjoy and savour those special moments you will have each and every time you visit. Expect the unexpected. The ordinary will be made extraordinary.

A connection will be made.

Some general guidelines for working with ADRD participants:

• Patience is paramount.
• Be prepared to take your time and listen to participants. Be flexible. Sometimes you will be guided in a whole new direction.
• Introduce yourself and your dog each and every visit. If you’re working with a group, introduce yourself to each person as you visit.
• Most participants will have age-related hearing loss, so it’s critical to speak loudly, clearly and slowly.
• Maintain eye contact.
• Be aware of the participant’s fragility. If a dog is shaking hands with a participant, a hard claw may tear fragile, delicate skin. Sometimes I have a participant put on a glove to “shake.” Putting on or taking off a piece of clothing with the assistance of a four-legged friend reinforces dressing skills that are sometimes lost in individuals with ADRD.
• Demonstrate and assist, if needed. Always give the participant time to respond to your demonstrations and instructions.
• Explain each activity one step at a time. The participant may not be able to “sequence.”
• Instructions should be simple, given in the same way, with the same terminology. As you repeat instructions (and you will) don’t try to explain in a different way, as this may be more confusing. Repeat, and possibly demonstrate the activity.
• Pace the number of planned activities.