In the first study of its kind, researchers have determined that spending time with horses eases symptoms of Alzheimer’s dementia.
A collaboration between The Ohio State University, an equine therapy center and an adult daycare center found that people with Alzheimer’s were able to safely groom, feed and walk horses under supervision—and the experience buoyed their mood and made them less likely to resist care or become upset later in the day.
The small pilot study, which appears in the journal Anthrozoös, suggests that equine therapy—a treatment used today for children and teens who have emotional and developmental disorders—could work for adults, too.
Holly Dabelko-Schoeny, associate professor of social work at Ohio State, said that equine therapy could supplement more common forms of animal therapy involving dogs or cats and provide a unique way to ease the symptoms of dementia without drugs.
“We wanted to test whether people with dementia could have positive interactions with horses, and we found that they can—absolutely,” Dabelko-Schoeny said. “The experience immediately lifted their mood, and we saw a connection to fewer incidents of negative behavior.”
In addition to memory loss, people with Alzheimer’s often experience personality changes, she explained. They can become depressed, withdrawn—even aggressive. As researchers look for a way to prevent or treat the disease, today’s therapies are becoming more focused on how to ease the emotional burden for patients and their families.
“Our focus is on the ‘now.’ What can we do to make them feel better and enjoy themselves right now? Even if they don’t remember it later, how can we help in this moment?” she said.
At the adult daycare center, a National Church Residences Center for Senior Health in downtown Columbus, clients normally partake in crafts, exercise and other activities to manage their dementia. For this study, sixteen of the center’s clients who had Alzheimer’s—nine women and seven men—volunteered to break with their regular routine.
Once a week, eight of the clients would remain at the center and pursue other activities while the other eight took a bus trip to the Field of Dreams Equine Education Center in Blacklick, Ohio. There, they visited with horses under the supervision of National Church Residences caretakers, as well as faculty and students from the College of Social Work and the College of Veterinary Medicine at Ohio State.
The clients visited the farm once a week for a month, so that every participant had four visits total. They groomed and bathed the horses, walked them, and fed them buckets of grass.
The four horses were chosen for their gentle dispositions and calmness when facing new people and new situations. All participate in therapeutic riding programs for children and teens at Field of Dreams.
The researchers saw obvious signs that the clients enjoyed their time on the farm: they smiled, laughed and talked to the horses. Even those who normally acted withdrawn became fully engaged in the experience.
There was a clear improvement in dementia-related behavior among the clients who visited the farm. To track behavior, the researchers used a scoring system called the Modified Nursing Home Behavior Problem Scale, in which staff at the center rated the frequency with which the participants fidgeted, resisted care, became upset or lost their temper on days they went to the farm or stayed at the center.
On a scale of zero to four—zero meaning the client never engaged in the problem behavior, and four meaning that they always engaged in it—scores for the participants who went to the farm were an average of one point lower than the scores for their peers who stayed at the center. So clients who visited the farm were, on average, better behaved throughout that day.
Through mouth swabs, the researchers also measured the levels of the stress hormone cortisol in the patients’ saliva. For participants with less severe dementia, the researchers saw a rise in cortisol levels, possibly due to the “good stress” of being in a new situation.
There was one unexpected benefit, though: the therapy boosted physical activity. The clients all had physical limitations, but when presented with the horses, they were inspired to push the boundaries of those limitations.
Some clients who never wanted to leave their wheelchair asked for help in standing up; others who rarely wanted to walk stood up and walked unassisted, though a caretaker was always there to help them balance. The clients grew more physically active on each visit to the farm.
Family members reported that their loved one remained engaged with the experience even after returning home. One commented to researchers that her mother “would never remember what she did at the center during the day, but she always remembered what she did at the farm.”
While much study has gone into animal therapy as a treatment for dementia, that work has focused on dogs and cats, which can easily be brought to community-based care centers. This is the first study to examine equine therapy for the same population.
And while horses could possibly be brought to community centers for outdoor therapy, a situation where clients could periodically visit an equine therapy center might be the best option, Dabelko-Schoeny said. That way they get the full experience of being on the farm.
Gwendolen Lorch, assistant professor of veterinary clinical medicine at Ohio State and co-author of the study, agreed that the country setting may have made the therapy more effective.
“I think another positive influence for these clients was the environment. They found the quietness and smells of the country very relaxing and restful. This was in contrast to their normal day care environment and their intercity dwelling,” Lorch said. “It is difficult to tell what factors made this successful, but we do know that it was most likely a combination of events.”
This study was funded by a private donor who wanted Ohio State to study the effectiveness of equine therapy for dementia. Now that the study is over, some of the clients’ families have elected to continue to visit the farm.
Coauthors on the paper included Gary Phillips, senior biostatistician at Ohio State’s Center for Biostatistics; Emily Darrough and Sara De Anna, both former master’s students in social work who have since graduated; and Marie Jarden and Denise Johnson, both doctoral students in veterinary medicine.
Categories: therapeutic riding.
Tags: Alzheimer’s, equine, equine therapy, horse, horses, Ohio State
By Amy Herdy
Mill Valley Film Festival
Amour looks at Growing Old, Death and Love
October 8, 2012
Summary from the Festival Site.
Directed by Michael Haneke
Starring Jean-Louis Trintignant, Emmanuelle Riva
Cinema feeds on stories of love and death, but how often do filmmakers really offer new or challenging perspectives on either? Michael Haneke’s ‘Amour’ is devastatingly original and unflinching in the way it examines the effect of love on death, and vice versa. It’s a staggering, intensely moving look at old age and life’s end, which at its heart offers two performances of incredible skill and wisdom from French veterans Jean-Louis Trintignant and Emmanuelle Riva. The director of ‘Hidden’ and ‘The White Ribbon’ offers an intimate, brave and devastating portrait of an elderly Parisian couple, Anne (Riva) and Georges (Trintignant), facing up to a sudden turning point in their lives. Haneke erects four walls to keep out the rest of the world, containing his drama almost entirely within one apartment over a period of some weeks and months….mong so many other things, this is a film about loyalty and being true to your word right to the very end. ‘Amour’ is a devastating, highly intelligent and astonishingly performed work. It’s a masterpiece. – TIME OUT LONDON
Scott is a colleague of ours who has worked in senior care for many years – driven by his own passion to improve the approach to care he shares is knowledge, insight and experiences with many family members and professional.
Dealing With Denial
Denial can be a dangerous reaction or response (in actuality, some medical experts describe it as more of an unconscious process), especially as it relates to senior care.
In my time in senior care operations, I saw and dealt with denial of all shapes and sizes. Usually, it takes the form of not admitting your loved one has any form of dementia.
Other times, it’s a lack of awareness of the level of care your loved one needs.
I have seen denial at work in my own family and have even caught myself not wanting to admit uncomfortable realities about elderly family members.
One recent episode involved a family acquaintance who, three years prior, had asked for my advice regarding her elderly aunt. My advice was met with dismissal and a snub, even though she was the one who reached out.
Fast forward three years, and this person is in a crisis mode, in fear for herself, her quality of life as well as her aunt’s safety and well-being because the now advanced Alzheimer’s was taking its toll.
When this family acquaintance sought me out again recently, she was overcome with guilt because she hadn’t acted sooner as was suggested.
She went on to tell me everything I said would happen. I certainly took no pleasure in being right in this case; in fact, I felt a deep sense of empathy for this family.
They lost so much quality time that could have still been shared if they had only taken action. They also lost money they could have directed to more productive events and services that would have improved quality of life.
While denial can initially be a coping mechanism, it can ultimately create major health and welfare problems.
It is important to realize that, while there is currently no cure for Alzheimer’s and many dementias, there are actions that can be taken to improve a family and a love one’s situation. These action can create a larger window available for improved quality of life.
Probably the most difficult situation created by denial is when the view of reality is split within a family. Denial, in this case, causes many other problems, one of which is usually regret, the other is animosity.
My point here is more to highlight the issue for awareness rather than to condemn anyone for having a normal reaction or for experiencing a natural coping mechanism.
The problem stems from getting stuck in denial and then loosing valuable time to improve quality of life. The other dilemma with denial is the clash and resulting anger that can cause a “locking of horns” within a family.
It is all too easy to get stuck in a circle of anger. Denial masks many emotions, including grief and fear. Illogical and counter-productive behavior can result from getting “stuck”.
Everything gets compounded when there are out of town family members that do not see the day-to-day symptoms that are more easily hidden during short visits or telephone conversations.
While maybe not scientific, there are a few things that I have seen in my experience that sometimes help dealing with denial:
1.Try to listen with an open mind to others who may be more objective in what they see.
2.Take deep breaths, and pause, before responding to anyone that seems to be in denial regarding a loved one’s care needs or living situation.
3.At some point, the choice is either to try to engage in rational discussion in hope of “shaking some sense into them” or work around them and do whatever you have to do in order to satisfy your own need to do the right thing.
4.Attend a support group, especially if ideas have been raised about the issues of dementia or care needs you question. The objective feedback might be enlightening.
5.Read! There is so much information out there relative to these topics that it is likely you will connect with something that will enlighten you.
Unfortunately, there are those times when nothing you do will break through the denial, and the consequences will be suffered. If you are the one in denial, you will likely look back and likely have a guilty realization.
We are all human. Most of us are all doing the best we can at any given moment. We feel emotions and have coping mechanisms, and denial is a normal one of them.
My purpose here is to remind the reader that there are steps than can be taken to contribute to possibly breaking the cycle of denial before a negative outcome arises that jeopardizes the care, health and quality of life we want for our loved ones.
“It’s not denial. I’m just selective about the reality I accept.” -Bill Watterson (Author of the Calvin & Hobbes comic strip)
Check on someone you care about today.
Reprinted from http://www.mariashriver.com/blog/2012/08/dealing-with-denial-scott-eckstein
This post from Kristy Campbell provides some excellent reflections and support for how families, caregivers and others can work on conflict and the idea of forgiveness.
TIPS FOR TRANSFORMATION
Not So Fast With Forgiveness
I have been struggling with the concept of forgiveness this past year. It’s as if the universe knows this and has decided to present me with numerous scenarios in order for me to work it out.
From a failed marriage to betrayal by friends, I continue to be presented with the same question: Can I forgive? My answer isn’t as simple as you’d think.
Forgiveness has been a basic tenant of my life since I can remember. It comes from my religious upbringing where I was taught that it is my duty and responsibility to offer forgiveness…always. ‘To err is human, to forgive is divine’ was a household principle.
As a little girl, someone stole the watch I had received as a birthday present and when caught, she mumbled her apology in the principal’s office. I said, ‘It’s ok, I forgive you’.
Through the years, when people have hurt my feelings, talked about me behind my back, betrayed me, bullied me, or committed any sort of wrong doing toward me, I would say, ‘It’s ok, I forgive you’.
However, as I’ve aged, I’ve learned something about apologies: not all are heart-felt. Instead, many are a dismissive way to get out of trouble or to casually patch up a deep issue or to pass back the forgiveness ball by saying ‘hey, I said I’m sorry’.
I’ve been struggling with the apology-forgiveness scenario and trying to figure out what to do you do when you feel an apology isn’t genuine. What do you do when the apology doesn’t feel substantial enough to cover the hurt or betrayal? Do I still have a duty or responsibility to forgive?
I recognize the parallel between my personal struggle with forgiveness and the struggle on a global level, so I headed to the library to see what had been written from various viewpoints. I was referred to a book that gave me the answers I needed.
The Sunflower: On the Possibilities and Limits of Forgiveness by Simon Wiesenthal is a classic text in forgiveness. Wiesenthal was a prisoner in a concentration camp when a dying Nazi called Wiesenthal to his bedside and asked him for forgiveness for his crimes. Wiesenthal was dumb-founded and left the room without saying anything.
Thirty years later, he wrote this book about his experience. In the book, he also poses a simple question to theologians from around the world including the Dalai Lama and Archbishop Desmond Tutu. He asks them, “What would you have done?” It is eye-opening to see the various perspectives and insights about forgiveness.
After finishing the book, I asked myself the same question: Can I forgive? My answer is yes, absolutely, but it is no longer an automatic response. In my healing, I have recognized my power with forgiveness.
I have stopped saying ‘It’s ok’ and instead say ‘thank you for apologizing’.
I have stopped beating myself up for not immediately being able to forgive someone who has not apologized or taken any accountability for the wrongdoing to me.
I have found freedom in eventually letting go – forgiving in my own time – without carrying a grudge or hoping for some karmic boulder to come the person’s way.
What I’ve Learned on My Forgiveness Journey
1. Forgiveness is not a single action that you begin and complete in a short period of time. Forgiveness comes on your own terms…in time, when you are ready. Honor your truth about not being in a place to forgive.
2. Forgiveness requires accountability, a commitment to amend the wrong, and a sincere apology.
3. Forgiveness doesn’t mean restoring a toxic relationship. You can forgive and move on. Forgiveness does not equal reconciliation.
4. Forgiveness means you have made a choice to move on from the negative experience. It means you have decided to put the focus back on yourself rather than the other person. Forgiveness is about you.
5. Forgiveness is not denying or minimizing your hurt. It doesn’t mean you condone what happened.
6. Forgiveness allows you to let go of being a victim and to move on to becoming someone who has shown courage and has overcome adversity.
7. Forgiveness can’t change the past but it can enlarge the future.
Do you struggle with forgiveness? How do you let go and move forward? What do your beliefs direct you to do with regard to forgiveness?
5 Qualities to Look for in a Caregiver
Guest Post by Monta Fleming
Senior care is a difficult sector to hire for. Not only do prospective employees have to meet the educational and background requirements, but they also need to have a heart for the elderly. When conducting interviews for an open position, make sure you are looking for the following five qualities:
- Listens –It is very important that a caregiver listen to the seniors they are caring for. It has to be more than get in, get out, get on with the next person. A real caregiver wants to spend tie getting to know the seniors and supporting them physically and emotionally. Not having someone who cares to talk to is often one of the most comment complaints senior have.
- Follows Directions –You want to hire someone who can follow directions. Whether it is for a fire drill or just for meal times, they need to be able to understand, remember, and follow the directions that are given to them, even in a chaotic situation. A level head and a quick mind are very important.
- Knows the Rules – Not only should they be able to follow directions, they should also know the rules. From simple things like medication to more complex ideas like privacy issues, it is important that the caregivers understand and follow the guidelines set forth. Legal issues are a huge hardship on everyone involved. The more you can avoid, the better off everyone will be.
- Helpful –This is a no brainer. A caregiver should be helpful, above and beyond the call of duty. From sitting and talking to helping with physical movement to coming up with activities, a caregiver should always be willing to lend a hand and contribute to the community.
- Kind and Patient –There will be a lot of hard and boring times as a caregiver. They have to be able to handle slowing down and not push the seniors to move beyond their pace. A gentle spirit and a heart of kindness are also appreciated by everyone, seniors and co-workers alike.
Senior care can be a hard job to hire for, and is also a hard job to perform well. But there are candidates out there that meet all these requirements. All it takes is a little searching and an awareness of the qualities to look for. Finding one great employee is worth more than hiring three average ones.
Monta the mother of three children serves as an Expert Advisor on multiple household help issues to many Organizations and groups, and is a mentor for other “Mom-preneurs” seeking guidance. She is a regular contributor of “gonannies.com”. You can get in touch with her at montafleming6Atgmail dotcom.