Older adults in long-term care facilities face a unique set of challenges. Fullerton and colleagues (2009) assert that more individuals in nursing homes have non-dementia mental illnesses (24%) than those who have solely dementia (18%). Other studies have produced similar findings; specifically, Choi, Ransom, and Wylie (2008) found that 55.4% of residents were diagnosed with depression, 7.8% with bipolar disorder, and 15.6% with an anxiety disorder.
Symptoms of depression in nursing homes can be due to a variety of stressors. Residents report the severe effects of the loss of autonomy, independence, freedom, and privacy, as well as their struggles watching the health of others around them deteriorate (Choi et al., 2008).
Many residents report missing their families upon moving into the institution (Choi et al., 2008). Similarly, leaving one's home to enter long-term care may result in the dissolution or hindrance of relationships with neighbors and friends, contributing to feelings of isolation (Webster et al., 2016). Though residents may receive visits from their spouses, children, and other members of their family, pets are also a significant member of the family (Mueller, Fine, & O'Haire, 2015). According to Banks and Banks (2002), 93.3% of residents in nursing homes state the reason they do not have a pet with them is because animals are not allowed at the facility. 100% of those residents are bothered by this and would like to have a pet.
"For nursing home residents, most of whom are in their last decade of life, making efforts to improve their psychosocial wellbeing is ... an ethical and moral imperative" (Choi et al., 2008, p. 536). One way to offset the negative effects stemming from the transition to elder care is through animal-assisted interventions. An animal-assisted intervention (AAI) can be defined as the intentional use of a human-animal team to produce physical, psychological, social, and/or cognitive therapeutic outcomes. This is also called a human-animal interaction. These interactions can be further classified into animal-assisted therapy (AAT), animal-assisted education (AAE), and animal-assisted activities (AAA). While AAT and AAE are formal and structured interactions designed to accomplish specific goals, AAA is generally more unstructured and the goals are less specific (International Association of Human-Animal Interaction Organizations, 2014, pp. 5).
Extensive research suggests that animal-assisted activities may be beneficial to older adults in a variety of ways including reduced loneliness (Banks & Banks, 2002; Banks et al., 2008; Calvert, 1989), decreased depression scores (Grubbs et al., 2016; Le Roux & Kemp, 2009; Moretti et al., 2010), increased positive mood (Lutwack-Bloom et al., 2005), and a self-reported calming effect (Moretti et al., 2010). Grubbs and colleagues (2016) observed an increase in physical activity in the residents when therapy animals visited the facility.
Animal-assisted activities are also associated with social benefits in older adults. Berstein and colleagues (2000) found that residents were more likely to initiate conversation and participate in longer conversation when participating in animal-assisted activities. Similarly, Fick (1993) observed an increase in verbal interactions and Berstein and colleagues (2000) observed an increase in touch.
Even residents with dementia showed an increase in social interactions and vocal expressions (Churchill et al., 1999; Greer et al., 2001; Mossello et al., 2011; Richeson, 2003), touch (Churchill et al.., 1999), pleasure (Mossello et al., 2011), physical activity (Friedmann et al., 2014), and a self-reported calming effect (Moretti et al., 2010), as well as a decrease in depressive symptoms (Friedmann, et al., 2014; Menna, Santaniello, Gerardi, Di Maggio, & Milan, 2016) and general sadness (Mossello et al., 2011).
Some benefits of animal-assisted activities in older adults seem to be specific to those with dementia. Animal-assisted activities have been associated with an improvement in dementia symptoms (McCabe, Baun, Speich, & Agrawal, 2002) and decreases in agitation (Churchill et al., 1999; Richeson, 2003), aggression (Kanamori et al., 2001), and anxiety (Kanamori et al., 2001; Mossello et al., 2011). Some studies have suggested that individuals with dementia experience changes in cognition, including an increase in general alertness (Mossello et al., 2011) and cognitive function (Menna et al., 2016). Another study even found an increase in nutritional intake and body weight when a fish tank was placed in their dining area (Edwards & Beck, 2002).
According to Barker, Pandurangi, and Best (2003), once exposed to animal-assisted activities, 71% of their participants reported wanting to partake in animal-assisted interventions again. Similarly, according to a study by Moretti and colleagues (2010), 100% of participants would recommend animal-assisted activities to other older adults, and 80% were interested in continuing the interventions. The purpose of this study is to analyze the potential benefits and drawbacks that older adults in long-term care facilities experience as a result of animal-assisted interventions.
The participants in the present study were freshmen college students enrolled in a two-semester honors course sequence comprised of FYE 1220H: Animal-Assisted Therapy, and FYE 1410H: Animals, Kids, and Families. Students in the honors program could choose between several mandatory course options, including the Animal-Assisted Therapy course sequence. The students were of various majors (including biology, psychology, education, nursing, and engineering), and consisted of thirty-nine females and seven males (N = 46).
Course Structure and Service-Learning
The Animal-Assisted Therapy course sequence focused primarily on the various facets of human-animal interactions (HAI) with a specific emphasis on using animals in a therapeutic setting. This was highlighted by the students' participation in service-learning. Service-learning can be defined as an enhanced educational experience in which students collaborate with the community in order to apply academic knowledge and skills (Berea College, 2004). As such, service-learning is reciprocal in nature; the community receives a service to assist with an identified need, and the students gain knowledge and experience beyond what is provided in the traditional classroom setting (Vogel & Seifer, 2011).
The course sequence utilized a service-learning facilitator to coordinate students to work with local therapy horses or dogs. The students who worked with therapy dogs were further assigned to work with a specific handler at one or more facilities. Students visited a total of twelve long-term care facilities in the local area. There were nine assisted living facilities, two rehabilitation facilities, and one club for individuals with Alzheimer's. Of the nine assisted living facilities, six had memory care units.
Twenty-four dogs participated in the service-learning visits over the course of six years. All dogs were certified therapy dogs through organizations such as Pet Partners or Therapy Dogs International, or were in training to become certified. Dogs ranged in age and size, but were groomed and trained according to their certifying agency's standards. Breeds include German Shorthaired Pointer, Golden Retriever, German Shepherd, Australian Shepherd, Cavalier King Charles Spaniel, Shih Tzu, Bichon, Border Terrier, Border Collie, Great Dane, Dalmatian, and various mixes. All dogs were accompanied by a trained handler. Most students were familiar with dogs; however, many students were not familiar with interacting with older adults in a long-term care facility, and almost no students had experience visiting with therapy dogs in any setting. One student wrote, "During my service-learning, I learned many things about myself. At first, I was dreading working at the nursing home, but I ended up forming a bond with many of the residents we visited."
Though faculty interpret and implement service-learning in different ways, one consistent component of service-learning is reflection, by which students reflect on their service experience (Anderson, Boyd, Marin, & McNamara, 2019). In order to fulfill the reflection component, students in the Animal-Assisted Therapy class were required to write five blog posts each semester within two days of completing their service learning visit. Instructions were given to include details about the events that occurred during their experience, as well as the students' reaction to the interactions. The specific instructions in part are listed below.
Blog posts should conform to the following specifications:
Due within 48 hours of interactions with community partner.
Must be posted to the course blog with the title, "Service Learning Reflection: Week of_[date]_" with the week beginning on Monday; for example, "Week of 9/11/2017"
Must include: name, date of visit, time range for visit, and specific location(s) of visit.
Must be a minimum of two paragraphs including:
What happened during the interaction?
What was your reaction to the experience?
How did this experience relate to the class? Include a minimum of one citation in APA format from either the text or your research articles that directly relates to the content of the blog post and explain how it relates.
Do you have any questions or concerns about the experience?
Students are required to include a minimum of one photograph of the service-learning visit for at least three of their blog posts.
A total of 196 blog posts from the past six academic school years (2012-2018) describing visits with at least one handler and therapy dog to long-term care facilities such as nursing homes and assisted living facilities were analyzed. Three students deleted their blogs during data collection, resulting in a total...