The range of services provided by assistance and therapy dogs has steadily increased over the past few decades and it now appears that these canine service providers can add Alzheimer's and dementia assistance to their resume. While everybody is familiar with guide dogs for the blind, and there is a growing awareness of hearing assistance dogs and dogs that help people with limited mobility, the public is just becoming aware of the role of dogs providing help for individuals suffering from mental problems. One reason such dogs are becoming better known is because of the extensive media coverage of the study funded by the US Congress to determine the effectiveness of assistance dogs for war veterans suffering from Posttraumatic Stress Syndrome.
Because of the effectiveness of contemporary healthcare, and increasing nutritional standards, populations living in developed countries are living considerably longer. One of the major problems for elderly individuals is the decline of cognitive ability and memory associated with Alzheimer's disease and various forms of dementia. For the United States estimates are that around 15% of people older than 65 will suffer from some form of dementia, and an additional 10% will suffer from Alzheimer's disease. This amounts to around 5.5 million people.
Most forms of dementia do not have a sudden onset, and in the beginning and middle stages of the diseases people can still have a useful, functional, and somewhat independent life if they have adequate assistance and support services. However even in the early stages there are intermittent problems associated with memory loss and a dimming of cognitive abilities. For example dementia sufferers can forget to take their medication, or even to eat. It is easy for them to get lost and not to be able to find their way home and as a result they experience feelings of frustration, isolation, anger and a sense of helplessness. Ultimately they find themselves to be effectively prisoners in their own homes and are completely dependent on the assistance of other people to allow them to go outside.
In the past few years two groups of individuals have started to train dogs to assist people with Alzheimer's and dementia. The first is in Israel and was the brainchild of Dafna Golan-Shemesh, a social worker with expertise in caring for Alzheimer’s patients and her partner Yariv Ben-Yosef, a professional dog trainer. More recently a similar project was initiated by students at Scotland’s Glasgow School of Art’s Product Design Department and then further developed by a partnership between Alzheimer Scotland, Dogs for the Disabled and Guide Dogs Scotland. Although the types of dogs used by the two programs are different (the Israeli program uses only Smooth Coated Collies) and the specific tasks and techniques that the dogs are trained for differ in some respects, there are important common features in what is required of a dementia-assistance dog.
These dogs do not work on a harness, the way that guide dogs for the blind do, but rather on a six-foot leash so that they can be out in front of the person and actually lead them in an appropriate direction. The main task of the dementia service dog is to bring his charge home when the order "Home" is given. If the patient forgets to give the order to return home, or is lost to the degree that he wanders far from the house and into an unfamiliar area, worried caretakers or family can activate an electronic GPS navigation device that is installed on the dog's collar. This can help locate the missing pair, but in addition it emits a recognizable tone which the dog interprets as an alternate command instructing him to lead his patient home. If, for some reason the patient is not capable of accompanying the dog home, the dog is trained to remain with him and to call attention to the situation by barking. In worst case scenarios, where the patient wanders out of the house without his canine assistant, the dog is trained to track him by his scent.
Dogs love predictability and routine and this is the hook upon which much of the training of the dementia assistance dogs is based. For example Alzheimer's disease can make people confuse day and night or forget basic things such as washing or drinking enough water. The dogs are trained to help guide people through the day, encouraging them to open a cupboard which contains food for the dog and also a prominent note to the owner reminding him that he has to eat as well. In the same way that dogs respond to a sound from their collar meaning "Go home", they are trained to respond to other sound triggers in the home. For example an electronic timer can sound a tone that causes the dog to bring a bite-proof bag of medicine with a note inside reminding the patient to take it, while another tone prompts the dog to walk his owner to the bathroom where he will find a note indicating that he should wash himself and take a glass of water. The dogs are also trained to trigger an alarm in the house should the patient fall and not get up within a reasonable amount of time or if they hear a choking sound.
Almost as important as the direct services provided by these assistance dogs, like all of other therapy dogs, these animals also provide companionship and friendship for their owner. They create a psychological anchor to reality by maintaining a meaningful daily routine which thus adds to the quality of life. The very fact that the dogs must be walked every day promotes exercise for the patient and encourages social interaction between the dementia sufferer and other people. Research has shown that an individual who walks with a dog is more likely to be engaged in conversation by other people along the way. An important fact is that such interactions are very predictable with questions like "What is your dog's name?" and "How old is he?" These positive and predictable social interactions reduce the sense of loneliness and isolation experienced by people with dementia. The very fact that they are out and about with their dog also provides a sense of independence to the patient and reduces the feelings of helplessness and dependency which can lead to some of the severe forms of depression which are often encountered in Alzheimer's and dementia sufferers.
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Stanley Coren is the author of many books including: The Wisdom of Dogs; Do Dogs Dream? Born to Bark; The Modern Dog; Why Do Dogs Have Wet Noses? The Pawprints of History; How Dogs Think; How To Speak Dog; Why We Love the Dogs We Do; What Do Dogs Know? The Intelligence of Dogs; Why Does My Dog Act That Way? Understanding Dogs for Dummies; Sleep Thieves; The Left-hander Syndrome
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