NIGHTINGALE A bird delegation came to Solomon complaining, “Why is it you never criticize the nightingale?” “Because my way,” the nightingale explained for Solomon, “is different. Mid-March to mid-June I sing. The other nine months, while you continue chirping, I’m silent.” Source: Barks, C.(1995) The Essential Rumi (First Edition). Harper Collins Publishers: New York, NY.

ANIMAL-ASSISTED THERAPY Animal-assisted therapy (AAT) means: ◦ To use specific animals as a treatment modality. ◦ It is effective for physical and psychological problems. ◦ Florence Nightingale (1860) advised using a small pet as a companion for the sick. ◦ Also, Florence Nightingale advised patients with chronic illness to participate in the care of animals. ◦ Dogs, cats and other pets are acceptable in health care facilities, especially nursing homes.

ANIMAL-ASSISTED THERAPY The first comprehensive standard for AAT was developed in 1990 by the Delta Society. Dogs and cats are used for companionability and their ability to interact with humans. ◦ Dogs and cats have been found to be calm, tolerant, and friendly. ◦ Dogs must be obedience trained. ◦ Dogs and cats should be at least one year old before they can be trained for AAT.  They should be old enough to assure ability for socialization and comfortable interaction with a variety of people.  Also, their immune system is more stabilized by this age.  They should have all inoculations.  Their health should be approved by a veterinarian.  Dogs should be comfortable with unfamiliar places, loud noises and peculiar smells.

COMMON ANIMALS USED FOR AAT Dogs Cats Horses Parrots Guinea pigs Rabbits Dwarf goats Llamas Donkeys Different cultures may use other animals.

EDUCATION About twelve countries offer some form of formalized educational program. Participation in continuing education such as: ◦ Workshops ◦ Home study courses A written test is required after workshops or home study courses. Examples of professionals who become educated for AAT are: ◦ Nurses, Physical therapists, Occupational therapists, Psychotherapists, Special Education teachers. The animals also should pass a skill test.

WHY AAT IS HELPFUL Some individuals treat animals as their children. These animals rarely disappoint their owners. These animals provide occasions for unconditional love and no expectations to meet. These animals function as a playmate and a companion. These animals provide an opportunity for: ◦ Sense of trust ◦ Sense of responsibility ◦ Feeling of empathy toward others

WHY AAT IS EFFECTIVE Effective therapy is based on: ◦ Ability to give unconditional affection. ◦ Create feeling of responsiveness. ◦ Feeling of companionability. Animals do not pay attention to age, sex, physical ability, disability, or beauty. These animals accept their owner as they are. It does not matter if a person is in a wheelchair, or has cancer, dementia or depression. For these reasons, usually older adults with multi- medical problems respond very well to AAT.

TYPE OF THERAPUTIC EFFECT Physical goals ◦ Range of motion:  Throw an object for dog ◦ Balance  Carry a cat ◦ Mobility  Walk with dog

TYPE OF THERAPUTIC EFFECT Cognitive goals ◦ Improve memory  Ask to recall cat’s name ◦ Improve verbal expression  Command dog to go away or come ◦ Increase self-esteem  Dog or cat will pay attention to patient ◦ Increase motivation  Look forward to having a next session with pet

TYPE OF THERAPUTIC EFFECT Social goals: ◦ Improved socialization  Participate in activities around the pets ◦ Building rapport with others  Team work during the therapy

HIPPOTHERAPY Hippotherapy means therapeutic horseback riding. The term hippo is from the Greek language, which means “horse.” Hippopsychotherapy: ◦ For psychotherapeutic treatment ◦ Improves self-confidence ◦ Improves self-esteem ◦ Improves social competence

PHYSICAL HIPPOTHERAPY It assists rhythmic movement Improves posture Improves balance Improves mobility

PEOPLE BENEFITING FROM HIPPOTHERAPY Children with: ◦ Cerebral palsy ◦ Sclerosis ◦ Autism ◦ Developmentally challenged Adults: ◦ Multiple sclerosis ◦ Orthopedic problems ◦ Post traumatic spasticity ◦ Stroke ◦ Post-war trauma

EDEN ALTERNATIVE Eden Alternative was founded in New York by Dr. William Thomas. Dr. Thomas has written a book in this area, which has been translated to other languages, such as German and Japanese. North Carolina and Missouri have more Eden Alternative care than any other states in the USA.

EDEN ALTERNATIVE A new approach to long-term care. Uses animals, plants, and children to interact with long term residents. The goal for residents is to feel more at home. Resident’s animals are part of the total environment. Residents have more to say in their daily activities, menus, and daily routine. Also, employees have flexibility in their schedule, i.e., sick days, length of hours to work, scheduling, and support and care received. The goal of Eden Alternative is to improve the quality of life and work for employees and residents in a long term setting.

PET’S CARE Veterinary care ◦ Routine examination ◦ Annual shots and rabies vaccination ◦ Make a visit to veterinarian at the first sign of illness

PET’S CARE Pet Care: ◦ Keep pets clean. ◦ Keep the pet's environment clean. ◦ Regular grooming. ◦ During a walk, have a leash on the pet. ◦ Use commercially prepared pet foods. ◦ Avoid any pet droppings in your home.

PET’S CARE Owner’s care: ◦ Wash hands after contact with pet’s bodily fluids. ◦ Wash hands before eating. ◦ Gloves and face mask should be worn during litter box, aquarium, or bird cage cleaning. ◦ Keep pets off kitchen surfaces. ◦ Do not allow dog to drink out of the toilet (It is a very common practice).

SUMMARY Animal-Assisted Therapy is becoming an important part of health care, especially in long- term care facilities, assistant healing, and children’s hospitals. Nurses have a significant role in facilitating AAT. Nurses are a good source to suggest and assist AAT at the facility in which they work. Nurses should be prepared for opposition to this program from patients, family, and/or administrators. It is very important to have very well written policies and procedures regarding AAT.

SUMMARY Policies and procedures should address: ◦ Goals and outcomes ◦ Staff education ◦ Volunteer recruitment and training ◦ Infection control policy ◦ Regular evaluation of the program ◦ Each state has different rules and regulations regarding AAT. So, state rules and regulations should be followed by everyone in the state in which they are involved with AAT.