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A dog on prescription Imagine that a pharmaceutical company introduced a new drug that, without any side effects whatsoever, relieves depression, improves memory and increases motivation for physical activity; a drug that also improves self-esteem and the ability to interact with others.

INGEBORG HÖÖK

These are just some of the benefits of a “dog on prescription”.

This may sound like a miracle cure peddled by a snake-oil salesman in a western, but although the achievements of the therapy dog teams seem miraculous, they are for real.

• The Professional Therapy Dog •

Ingeborg Höök, initiator of the Swedish Care Dog School project, has written Sweden’s first book on healthcare using dogs. It is a book for everyone who is curious about the health effects a dog can give and it offers a broad range of applications in healthcare.

A Care Dog on Prescription

Ingeborg Höök

The Professional Therapy Dog A Care Dog on Prescription

The Professional Therapy Dog – A Care Dog on Prescription

Ingeborg Höök Photography: Linus Höök Translation by Gunilla S. Ekberg

Contents Foreword

5

Preface

6

Care Dogs and the Care Dog School

8

Man’s Best Friend

11

Swedish Therapy Dogs

13

Characteristics of a Therapy Dog

16

The Amazing Abilities of the Therapy Dog

20

Man’s Dear Friend

35

Recognized Benefits of Living with Companion Animals

36

The Many Uses of Therapy Dogs

43

Training Tools

56

Dogs Not Drugs

70

The Importance of Longing

78

Preparing for the Arrival of the Therapy Dog

88

Respecting Allergy Sufferers

90

Introducing a Therapy Dog

95

A Cheaper Alternative

102

Man's Old Friend

104

The Link to a Normal Life

108

Showing Respect

1 16

Animal Companionship and Healing

122

Therapy Dogs in a Wider Perspective

127

Therapy Dogs and Children

Further Reading

128 136

Foreword In our family, we take for granted that our dogs are always around, whether we’re at home, travelling, waking up or going to bed. Many people share this sentiment, shown by research to have been part of the human experience for tens of thousands of years.

My hope is that everyone will have the opportunity to experience this sense of affinity and enrichment of life, especially as we grow old and increasingly dependent on others for our wellbeing.

The Care Dog School project was launched in Sweden in 2008 and represents a major step towards increasing public awareness of the enormous potential benefits of companion animals, especially dogs.

I hope that this book will help to make it possible for motivated staff to bring along a four-legged workmate to a care home or other place of work.

This would allow the elderly to enjoy, once again, the friendship and company of a dog, even if only for a short while every day.

Ulf Uddman, Chief Executive, Swedish Kennel Club

5

Preface When I saw, for the first time, what dogs could achieve in the Swedish healthcare system, I was overwhelmed. Suddenly, happy laughter was heard in the usually rather bleak common room.

Animated conversations could be heard, people who had lost the ability to speak began to talk in complete sentences, and previously troubled souls were able to enjoy a moment of calm tranquillity. In time I came to realise just how much dogs could contribute.

Using the experience of international pioneers and the expertise of several Swedish patient organisations, the Care Dog School has developed its own particular Swedish model. What makes this approach unique (in addition to the training of handlers and their dogs) is the development of a training programme tailored for professional healthcare staff, such as doctors, physiotherapists and nurses, on how to integrate the therapy dog into everyday clinical work.

The Care Dog School was founded with the support of the notfor-profit association, Nature of Health (H채lsans Natur), in turn funded by the Swedish Inheritance Fund. The aim of The Care Dog School is to offer experienced therapy dog teams to the healthcare system, schools and rehabilitation centres.

6

Additional financial support from the National Board of Health and Welfare to healthcare units working with therapy dogs has made a real difference to the success of our project. But the most important contribution to the development of the professional therapy dog teams has been the commitment shown by management and staff of many local authorities around the country.

By the time this book reaches the printers, the first therapy dogs will have been working for over three years in various healthcare settings across Sweden. In this book you will be able to follow some of these teams in their daily contact with patients, and see for yourself the benefits of “dogs on prescription”.

This is not a manual for prospective therapy dog handlers. This book serves as an introduction for those who are curious about the benefits of working with the animal long recognised as “man’s best friend.”

Ingeborg Höök, founder of the Swedish Care Dog School

7

Care Dogs and the Care Dog School: The Swedish Model for Professional Work with Therapy Dogs When we started the Care Dog School (Swedish: Vårdhundskolan) in February 2008, we chose to create a new word, Care Dog (Swedish: vårdhund). We did this to distinguish the work done with therapy dogs in Sweden from the tradition in most other countries, which by and large is volunteer work, or involves professionals including a dog in their private practice. In our vision, we wanted a Care Dog Team to become a new profession, either employed in a healthcare institution, or working as paid consultants for interventions with a care dog.

As I write this (April 2011), a search on the web for vårdhund gives 219,000 hits. Some 160 people have completed, or are about to complete, a Care Dog course. Care Dog teams work in some 60 care units in about 45 of Sweden’s 280 municipalities. To put this into perspective: Sweden has a population of 9.4 million. We’re off to a good start – but much remains to be done.

What, then, is a “Care Dog ”? And why do we call it the “Swedish model”? Three specific factors define a Care Dog team:

l

8

The dogs and handlers, and other healthcare professionals who work with them, are specially trained.

l

Qualified healthcare professionals prescribe Care Dogs.

l

Care Dog teams are on the paid, permanent staff. In other words: they are not unpaid volunteers.

We think our concept takes “animal-assisted intervention” a step further. The potential health benefits of dog interventions will be even more fully realized. The healthcare professionals who have now observed Care Dogs at work in a structured manner agree.

And so does research, although it is still scant and in its beginning phases.

For the above reasons, we have chosen to introduce the new term Care Dog. We have started construction of an official Swedish standard through the Swedish Standards Institute (www.sis.se), which will define the basic requirements for dogs, handlers, educators and so on, as well as establish definitions and terminology.

At the same time, we are involved in discussions about the development of an international standard, and perhaps an organization, for Animal Assisted Intervention.

CV – Ingeborg Höök Ingeborg Höök has been a registered nurse since 1976, with a specialty in psychiatry and an MA in Caring Sciences. She has worked for many years in geriatric care and substance abuse treatment, as well as in psychiatric care, first as an employee and since 1999 as a manager. Ingeborg Höök is licensed by the Delta Society in the United States to work as an instructor for Pet Partners. Since 2008 she has been the training manager at the Care Dog School, www.vardhundskolan.se/en. A second book on the subject was published in 2011: Better care with a Care Dog – ABC for therapy dogs.

9

Man’s Best Friend Imagine that a pharmaceutical company introduced a new drug that, without any side effects whatsoever, relieves depression, improves memory and increases motivation for physical activity, a drug that also improves self-esteem and the ability to interact with others.

These are just some of the benefits of a “dog on prescription”.

This may sound like a miracle cure peddled by a snake-oil salesman in a western, but although the achievements of the therapy dog teams may sound miraculous, they are not miracles. Science will eventually find an explanation for most of the health benefits of a “dog on prescription”. In recent years, research in this field has been conducted in the United States, United Kingdom, Japan and other countries, and at long last, several studies have recently been initiated in Sweden.

In these early days, we are constantly baffled by the ability of the therapy dog to enrich the everyday life for vulnerable individuals.

Author’s note: Many different terms are used for those who live in care homes or rehabilitation units: healthcare consumers, clients, guests, residents or patients. To simplify, the terms “user,” and occasionally “patient” will be used throughout to identify those individuals whose lives are described in this book.

11

“A small pet animal is often an excellent companion for the sick, for long chronic cases especially.�

Florence Nightingale

Swedish Therapy Dogs For many years, healthcare workers at certain care homes for the elderly in Sweden have brought their dogs to work. In some places, residents are allowed to bring their own dog or cat when they move in. Other animals, like cage birds or tropical fish, are also common.

Although the use of therapy dogs in care homes is not a new phenomenon in Sweden, their use has lacked a formal structure. The beneficial effects of therapy dogs in hospitals and care homes had not been evaluated, their introduction into individual units was unplanned and unstructured, and criteria for the testing and selection of suitable dogs have only recently been developed. Most notably, healthcare professionals did not receive any training on the use of therapy dogs. This has not been the case for other groups of working dogs, such as assistance, service and signal dogs, drug dogs and search-and-rescue dogs. These dogs and their handlers are selected through comprehensive aptitude tests and receive extensive training before being deployed.

13

This situation changed in 2008 when the Care Dog School was established, and therapy dog aptitude tests and training programmes were introduced. These methods were developed in collaboration with a number of patient organisations, ethologist Lars Fält, and experienced dog instructors. The training method is unique for Sweden. The primary objective is to train dog owners and their dogs for interventions in healthcare settings. However, unlike in other countries, the Care Dog School also holds courses for healthcare professionals such as nurses, doctors and occupational therapists on the use of “dogs on prescription”.

These courses attracted a lot of interest and proved popular from the very beginning. Interest increased as patient organisations, healthcare providers, families and friends of patients, managers and legislators became involved. Today, proposals to involve professional therapy dogs and their handlers in hospitals and care homes are regularly put forward, both in local councils and in Parliament.

Several conferences on the use of animals in healthcare have recently been arranged in Sweden. In October 2007, the Swedish University of Agricultural Sciences (SLU) in Uppsala awarded the first honorary doctorate to the doyenne of animal-assisted healthcare in Sweden, Professor Emerita Barbro Beck-Friis.

The Care Dog School has hitherto focused on two groups of healthcare users – people with dementia and people with acquired brain injury, including stroke. This book is about their lives and the therapy dogs that work with them.

14

In the United States, therapy dog teams are often called “the smile brigade�. Animals have an unusual ability to inspire good conversation.

15

Characteristics of a Therapy Dog A prospective therapy dog is carefully selected, and is tested for its suitability for intervention work in healthcare settings. For six months to a year, the dog owner, assisted by qualified dog instructors, learns how to train the dog to perform the required tasks.

During the next step of the training programme, the handler will learn more specifically how the dog can work with patients. This aspect of the programme includes a range of activities focusing on physical, psychological, cognitive and social training. Finally, the handler and the dog undergo a practical aptitude test to足 gether in a healthcare setting.

The handlers and dogs that successfully pass the final test for diploma are certified as professional therapy dog teams. After referrals by doctors, occupational therapists or physiotherapists, the teams go on to work with patients, offering them new ways of physical, psychological and social training, and improved wellbeing.

16

A dog on prescription Imagine that a pharmaceutical company introduced a new drug that, without any side effects whatsoever, relieves depression, improves memory and increases motivation for physical activity; a drug that also improves self-esteem and the ability to interact with others.

INGEBORG HÖÖK

These are just some of the benefits of a “dog on prescription”.

This may sound like a miracle cure peddled by a snake-oil salesman in a western, but although the achievements of the therapy dog teams seem miraculous, they are for real.

• The Professional Therapy Dog •

Ingeborg Höök, initiator of the Swedish Care Dog School project, has written Sweden’s first book on healthcare using dogs. It is a book for everyone who is curious about the health effects a dog can give and it offers a broad range of applications in healthcare.

A Care Dog on Prescription

Ingeborg Höök

The Professional Therapy Dog A Care Dog on Prescription