Horses Are Good Therapy for Alzheimer’s Patients

101_0313The Ohio State study found that being with horses lifted the person’s mood.

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 They can become depressed, withdrawn—even aggressive.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

http://myhorse.com/blogs/english-and-western-riding/riding-lessons/therapeutic-riding/study-horses-are-good-therapy-for-alzheimers-patients/

The Spiritual Gift of Caregiving

I have to say that some of the most compassionate people in my life have worked in elder care. The desire to create places and support people who provide care is huge – and a vision and task that is never finished, somehow in this imperfect system we often fall short.  I am honored to know directors of programs who are the tireless advocates for the elders they serve. Despite differences of opinions, and sometimes lack of resources, they inspire their teams to be with clients, to understand that each person carries a sense of self and a personal story that we should learn about, not judge.   Paula

 

by Donald Koepke

I believe that caregiving is one of the most vital tasks in which a person can become engaged. Day in and day out caregivers touch the lives of loved ones when they feel the most vulnerable and thus the most open to change.

No one likes to feel vulnerable and helpless. In the book, Tuesdays with Morrie, a man by the name of Morrie Schwartz is stricken with ALS, or Lou Gehrig’s disease where the nervous system deteriorates to the extent that the person becomes trapped in his or her own body. Early in his disease, Ted Koppel, a famous TV newscaster and professional interviewer interviewed Morrie. Ted Koppel was in Morrie’s living room videotaping for his next show. “The two men spoke of the afterlife. They spoke about Morrie’s increasing dependency on other people. Morrie already needed help eating and sitting and moving from place to place. What, asked Ted Koppel, did Morrie fear the most about his slow, continual, never-stopping decay? Morrie paused. He asked if he could say this certain thing on television. Koppel said go ahead. Morrie looked straight into the eyes of the most famous interviewer in America. “Well, Ted, one day soon, someone’s gonna have to wipe my ass.” (Tuesdays with Morrie, Mitch Albom, p. 22).

No one likes to feel vulnerable and helpless. Everyone wants to be in control, strong, capable. To be vulnerable is to feel on the edge, in danger of being hurt, exposed, open to ridicule or shame (or worse). To be vulnerable can cause a loved one to withdraw, become defensive, even angry because they want to feel safe again getting some distance between themselves and this illness that is providing such dis-ease. They want to again feel in control.

So much of whom we feel ourselves to be is wrapped up in our bodies. In fact, our bodies are our selves. What does advertising and TV tell us about the body? Youth is good, age is bad. Shapely-ness is good, too much weight is bad. Strength is good, dependence is bad. I think advertising tells us that if we don’t have strong bodies that are beautiful, even sexy, that we are less of a person and have less value. That is why so many people despair over loss of bodily function, especially bowel and bladder. Some of us can even remember when we first began to have control over bowel and bladder. How excited our parents were. How much praise we were given. We were now big girls or big boys. We were important, capable, valued. We were finally like mama and papa!

And thus, to lose that ability to control oneself, to require the use of “adult undergarments”, often means a loss of dignity and self-image. Thus a loved one can become ashamed, not over something that they can or can not do, but because of what they have become: less of value, more dependent, less capable. Americans value words like “I can, I will, I must.” They often feel shame when they are forced to say, “I can not, I need.” Human beings often feel shame when they feel vulnerable.

And this is exactly where the efforts of caregivers enter the picture. Each and every day caregivers touch people lives at the point of their vulnerabilities, at the point of what they can not do. And it is how they are treated, at this tender and open moment, that can make all the difference in the world. Whether it is helping them dress in the morning, or feeding them their lunch, or even changing their “adult undergarments”, caregivers are touching loved ones in their weakness, in their humanity. And if this moment is treated with respect, if the one-who-is-weak, incapable, limited, is received with dignity, they will feel renewed, even empowered by the presence and service of the caregiver. But if the caregiver treats this moment with disrespect or even an “I don’t care” attitude, our care-receivers will feel exposed, threatened, even shame not by what is done to them, but in how it is done.

Touching persons at their weakest moments can be likened to changing their diapers. During this time caregivers are physically touching them more intimately than perhaps any other human being, except perhaps their mothers or fathers. In changing their diapers, and, in the words of Morrie Schwartz, wiping their asses, caregivers are touching their souls, because, as we have said before, we are our bodies. Within the task of caregiving, our loved ones are literally naked before the caregiver. And in that act of care, caregivers convey more powerfully than any sermon by a priest or rabbi that they are of great worth, or are worthless; that they are of great value, or of no value at all; that they are of great importance, or are simply one more task to be done before the caregiver is able get on with what they really want to do. Why can’t the act of changing diapers, or providing any assistance to the weakness of another, be an act of caring that says “You are human! You are alive! You are important in spite of, and perhaps because of, your weakness.”

Wendy Lustbader, in her book Counting on Kindness, writes about an eighty-year-old woman who was hospitalized. She spoke of her caregivers. “I knew the nurses by their hands. There was one with such delicate fingers that I cried a little when I heard her come on duty. She made me feel like she had all the time in the world. The others made me feel like a lump of flesh, like they had to get me out of the way as fast as they could. But those hands! I knew it was going to be a good day when she squeezed my arm in the morning. She would put a fresh gown on me and brush my hair with such tenderness and patience. You can’t imagine how much it meant to me, there in that strange place, to be touched like that.” (Counting on Kindness Wendy Lustbader, p 52-53)

It is through a caregiver’s acts-of-care that can promote shame or pride, and convey value or lack-of-worth, for caregivers touch people when they are the most vulnerable. Caregivers touch them at the point of their weakness, their “I can’ts” and perhaps, for the first time in their lives, to feel vulnerable but still valued.

What a magnificent gift is caregiving.
Donald Koepke
Center for Spirituality and Ethics in Aging
Donald Koepke is the Director of the Center for Spirituality and Ethics in Aging at the California Lutheran Homes, Anaheim, California. Rev. Koepke earned his Master of Divinity from Lutheran School of Theology at Chicago and completed a year-long residency in Clinical Pastoral Care at the UCLA Medical Center in 1995. He also earned a Certificate in Gerontology at the Geriatric Pastoral Care Institute at the Center for Aging, Religion and Spirituality, Minneapolis, Minnesota.

Rev. Koepke is a member of the American Society on Aging, Forum on Spirituality and Religion, and serves on the Forum’s Governing Council as well as the National Council on Aging’s National Interfaith Coalition on Aging, serving as secretary to its Delegate Council. He is a Clinical Member of the Association of Clinical Pastoral Educators, a Board Certified Member of the Association of Professional Chaplains and endorsed by the Evangelical Lutheran Church in America for Specialized Ministry.

He has conducted numerous professional workshops at national and regional conventions of aging, service providers to the elderly, caregivers, churches and other faith communities, families and older adults specializing in spirituality and aging.
Center for Spirituality and Ethics in Aging
891 South Walnut Street
Anaheim, CA 92802
714-239-6267
E-mail: dkoepke@frontporch.net

Healing Horses

 

A horse is the projection of peoples’ dreams about themselves–strong, powerful, beautiful–and it has the capability of giving us escape from our mundane existence. 
– Pam Brown

 

The most therapeutic activity for my mother when she was dying of cancer was being with her animals. They seemed to know when she needed them. A cat would jump onto the bed and softy cuddle, the dogs would lay at her feet and breathe warm air through her toes, another cat would quietly purr in the corner. I could feel the connection; there was no need for words or explanation. So when my sister brought my mother’s beloved tall black horse into her bedroom to just be with her, you can only imagine the strength of the connection, the healing and in this case letting go. I visualized him right then and there carrying her weak body along her journey with her arms wrapped lovingly around his neck. The power of healing and interconnectedness with animals is powerful to witness, as well as being well documented in the research annals.

Equine horsemanship is a growing program especially among children and young adults and now veterans suffering from PTSD. There are equine horsemanship, leadership and therapy programs. All have very specific areas of focus and expertise. The common denominator in each field is that the horse is our teacher and partner in the experience of living in the moment. The benefits of this work include a greater sense of focus, increased confidence, ability to listen, to trust, to have purpose, and to experience the interconnectedness we all have with animals, nature and each other. Although underfunded, I have found the people who work with horses in the horsemanship, leadership and therapeutic programs are exceptional human beings dedicated to doing good work with people and horses.

We are inspired to embark on an exploration of creating an equine horsemanship program for people living with dementia and their families. We are excited to develop a program that supports a group of people who understand what it means to live in the moment and who will benefit from the unconditional connection with horses. If you are interested in learning more about our program please let us know. We welcome feedback and volunteers.

 

Pat Summitt speaks about living with Alzheimer’s

Pat Summitt ESPY Tribute, Speech: Ex-Tennessee Coach Receives Arthur Ashe Courage Award (VIDEO)

From Huffington Post

Pat Summitt Espys

Amidst the slick highlight montages, thehost’s one liners and awkward presenter banter, the ESPY Awards Show is usually good for at least two poignant moments: the awarding of the Arthur Ashe Courage Award and the Jimmy V Award For Perseverance. The 20th edition of the ESPYS was no different, with Pat Summitt and Eric LeGrand inspiring the crowd in Los Angeles and watching at home.

Denver Broncos quarterback Peyton Manning, who first met Summitt during his own stint at the University of Tennessee, introduced a tribute video to the iconic women’s basketball coach and then remained on the stage to present her with the Arthur Ashe Award.

“Tonight I am deeply touched as all of you heard my story, Summitt told the crowd during her acceptance speech. “I’m going to keep on keeping on. I promise you that.”

With 8 national championships and more wins on her resume than any other college in NCAA basketball history, Summitt shocked her fans on and off the court in August 2011 when she revealed that she had been diagnosed with early-onset dementia. After coaching the Lady Vols for one final season, Summitt stepped aside in April, taking the role of Head Coach Emeritus.

As the 60-year-old Summitt continues her battle with Alzheimer’s she wins the award that honors those whose contributions transcend sports. Ashe was a tennis pioneer who left his greatest imprint on the world through his humanitarian work.

http://www.huffingtonpost.com/2012/07/11/pat-summitt-espys-tribute-speech-tennessee_n_1666929.html

Hospitalization can speed cognitive decline in elderly

(USA Today) By Janice Lloyd
Rates of decline occurred twice as fast among elderly patients on average after a hospital stay compared with their previous rate of decline and with older people not admitted to a health care facility. Some mental change is considered a normal part of aging, but advanced decline is associated with risk of disability and loss of independence, dementia and death.

Read the article.

Dementia: a public health priority

(World Health Organization and Alzheimer’s Disease International)

Overview

The report “Dementia: a public health priority” has been jointly developed by WHO and Alzheimer’s Disease International. The purpose of this report is to raise awareness of dementia as a public health priority, to articulate a public health approach and to advocate for action at international and national levels.

Dementia is a syndrome that affects memory, thinking, behaviour and ability to perform everyday activities. The number of people living with dementia worldwide is currently estimated at 35.6 million. This number will double by 2030 and more than triple by 2050. Dementia is overwhelming not only for the people who have it, but also for their caregivers and families. There is lack of awareness and understanding of dementia in most countries, resulting in stigmatization, barriers to diagnosis and care, and impacting caregivers, families and societies physically, psychologically and economically.

The report is expected to facilitate governments, policy-makers, and other stakeholders to address the impact of dementia as an increasing threat to global health. It is hoped that the report will promote dementia as a public health and social care priority worldwide.

Download the report