Animal Assisted Therapy Kerry McKiernan and Ollie

Animal-Assisted Therapy (AAT) Goal-directed intervention in which an animal meeting specific criteria is an integral part of the treatment process. . AAT is delivered and/or directed by a health professional working within the scope of his or her profession. AAT is designed to promote improvement in human physical, social, emotional, and/or cognitive functioning. This process is documented and evaluated.

https://www.stuff.co.nz/national/health/1075986 55/animalassistance-pilot-scheme-at-hutt- hospital-a-success-for-stroke-patients

  https://www.tvnz.co.nz/shows/seven-sharp/clips/ollie-the-support-dog-changing-stroke-patients-lives-with-unique-brand-of-pet-therapy

RESEARCH Lower blood pressure and lower resting heart rate (Morrison 2007). Studies conducted with cardiac patients have shown a decrease in levels of stress hormone, and anxiety scores have dropped.  Reduction in pain Improvement in alertness and anxiety in dementia (Veld 2005).  Successful in improving self awareness, attention, listening skills and self control, impulse control in children. 

Referral form Patient education hand-out Staff information sheet and education would be provided to the OPRS team regarding AAT] Questionnaires to staff and patients  Implementation of AAT for stroke patients admitted to OPRS    Evaluation  Overall success of the programme The referral system Looking at the success of time of day, duration, location of therapy How has this impacted on MDT working Impact on inpatient team regarding staffing levels and workload cover Highlight any limitation of current set up and delivery Highlight any areas that AAT has been particularly successful

Process Meet and greet Read information and sign consent Discuss goals based on OT/PT/SLT Timetabled Therapy can be targeted at Transferable skills Working on increasing particular component Directly associated with their own dogs Documentation in notes

Upper Limb

Scanning/Vision/Perception

Sensory

Reaching/weight transfer

WEIGHTBARING, POINT KNEELING

Walking

Using “touch “ command to target right/left hand ACTIVITY OBJECTIVE Using “touch “ command to target right/left hand Can put red/green dots on each hand and the therapist says a colour this is the hand used for target   Acquire or improve left/right discrimination. Visual spatial awareness, sensory stimulation, concentration, coordination, memory, following instructions, increase upper limb movement Dog is instructed to retrieve cloths/beans bags of various colours. Each colour represents a prearranged task/instruction based on component working on i.e vision, cognition, upper limb. E.g green do 5 shoulder shrugs. Scanning to watch dog pick up item, recall, concentration, specific instructions for goals. Following instructions Positioning dog on the plinth in front of pt. Raising the plinth up/down Increase range of movement in arm, increase strength, sensory stimulation, standing balance and tolerance. Asking the dog to pick up pegs and give then to patient who then puts them on a line/rod. Fine motor coordination, dynamic standing balance(if putting on line), awareness of affected side if dog retrieving form that side, endurance Dog is asked to retrieve items from a box, the patient then has to match the item with there selection. Improve perception, object recognition, concentration, upper limb if retrieving with weak arm, Having 4 coloured spots on floor the patient has to watch and tell OT what colour the dog has stopped. Having certain commands the patient has to give the dog when he is on a certain colour e.g red=sit Scanning, following instructions, memory, concentration, colour recognition, spatial awareness Walking dog round circuit and each cone there are instruction either for patient or command for dog. Mobility, upper limb(sensation, gross and fine motor skills) for holding lead. Recall, reading, concentartion Throwing a ball into dogs mouth Coordination, scanning concentration, upper limb exercises

  Hand signals for commands – e.g open hand=sit, hand to the ground=down Increase range of movement , increase sensory and motor awareness, working memory, concentration Throwing the dice and each number refers to a command. Increase range of movement, strength with throwing dice, can be done in standing for balance, scanning, vision for reading, improve verbalisation, recall, following instructions Brushing dog with brushes of various shapes and sizes and weights on wrists Grasping, increase range of movement and strength, sensory stimulation, can be done in standing to increase balance and tolerance   Patient is lying on plinth - Positioning dog on affected side and place dogs head or paws on the person’s body Patient to concentrate on dogs breathing and how his fur feels helps with increasing awareness to affected side, helps to reduce tone Patting dog, feeling textures (paws), eyes closed identify body parts. Sensory stimulation, body awareness Positioning dog in various positions in front, to side behind patient to get them to reach to pat him. Improve upper limb range of movement, scanning, encourages weight shift. Sitting on a plinth using active hand to pat dog or throw ball. to encourage activation of weak side when sitting and prevents over activity of the good side. Encourage activation of weak side when sitting and prevents over activity of the good side. Improves static and dynamic balance Walking with double lead. Encourages scanning to side that dog is on, increasing awareness affected side, helps to improve natural gait, holding lead with weaker arm provides feedback and can encourage muscle activation and reduced tone.

Examples Mr E Standing balance, throwing ball for Ollie and encouraging weight shift/trunk movement in a functional pattern Bending down to pick up a ball that Ollie has dropped at his feet Difficulty releasing objects – Throwing ball automatic release. Ms C Facilitated stroking using right hand, using for sensory stimulation, holding brush. Walking Ollie encourages natural pattern, encourages change of speed. Speech – Encourage to shout command, carry over from day to day Mrs B Used Ollie to get down on the floor and stroke him, this can helped build up confidence with getting on ground with grandkids. Walked Ollie to build up confidence to walk her own dogs

Benefits Motivation Mood Therapeutic relationship Normalisaition for Patient Takes the pressure of patient Participate longer in session Perform an exercise longer Benefits include symptom management and secondary health complications. 

Future Identify specific measurements Educational tool for other DHBs In-services and training for other DHBs and therapists National guidelines