After Brain Injury: The Power of Pets in Rehabilitation
Assistance animals and family pets make great rehab coaches.
Posted Mar 26, 2012
Want a rehabilitation partner who offers unconditional love, acceptance, and motivation? Get a dog! Highly trained assistance, therapy, and service dogs have been in the news as companions for wounded service members, autistic children, and disabled adults. Melissa Fay Greene's powerful story, "Wonder Dog," in The New York Times followed the Winokur family as they integrated Chancer the golden retriever into their family to help their son Iyal. Chancer was custom trained by the wonderful nonprofit corporation 4 Paws for Ability to attach to Iyal and help him reduce the fearsome rages that resulted from fetal alcohol syndrome.
Family pets have their own valuable role in helping a person recover after brain injury. When my husband Alan suffered a severe anoxic brain injury following a heart attack and cardiac arrest, our dog Molly became his steadfast rehab partner and constant companion.
Molly the rehab coach
Alan was hospitalized for four months of intensive medical treatment and brain injury rehab. When he came home, he was just starting to regain his abilities to read, write, walk, speak, and remember. He struggled to relearn all the self-care activities we take for granted, including organizing his morning routine, and following through on a task. Apraxia, the inability to perform complex motor movements due to memory loss, made it harder to put clothes on in the right order.
Alan talked to Molly all day. One morning I called upstairs to Alan, "Honey, put your clothes on and come downstairs for breakfast." As I flipped pancakes in the kitchen I heard Alan conferring with Molly.
"Molly, did you hear what Janet just told me to do?" he said. "Well, that's not easy you know. First you have to put on socks and make sure they match. You have to get your shoes on the right feet, but not until your pants are on. And hold the railing so you don't fall down the stairs."
On and on he went, as Molly sat attentively by with her head cocked to hear every word. Alan was right about the complexity of the task. Getting dressed activated several areas of his brain. The instruction was processed in the parietal lobe and sequenced in the temporal lobe. His working memory kicked in as he sequenced his clothes, and walking down the stairs required motor skills controlled by the cerebellum. By talking to Molly, Alan learned to cue himself. They both showed up for breakfast with brains in high gear.
Molly the psychotherapist
Molly was also gave Alan an enormous amount of emotional support. When he felt anxious, he talked it over with Molly. When I returned from a quick errand, Alan said, "Molly was worried, but I wasn't. I told her you said you'd be back in 20 minutes. I told her we'd be safe."
A few weeks after Alan came home, he fell into the throes of post-traumatic stress disorder caused by all of the trauma, pain, and loss he'd experienced. For several nights, Alan sat bolt upright in the bed, hyperventilating and screaming, "They're trying to kill me, they're choking me!" His eyes were as large as saucers, and sweat soaked his body. Alan had been resuscitated for almost one hour, intubated and on a ventilator, and forcibly restrained many times during his early recovery. Now his body and mind were paying for those experiences.
If I had not been a psychiatric RN, I might not have recognized Alan's night terrors as PTSD. Each time it happened, I put the lights on, sat him on the edge of the bed with his feet on the floor, and wrapped my arm around his shoulders. I said gently, "You're OK, Alan. You're safe in our home. I'm here with you. Take a breath. Nothing bad can happen to you." I stroked his back softly until he became oriented and calmed down. An extra dose of anti-anxiety medication helped him get back to sleep.
During this time period, Molly slept at the foot of our bed. One night we were awakened by Molly yipping and flailing around in a dream. I asked, "Alan, do you want me to put Molly on the floor so you can sleep?"
He said, "Oh no! This is what I do for my dog. You watch." Alan lifted Molly on to his lap and stroked her fur, and said, "You're OK, Molly. Daddy's here. Nothing bad is going to happen to you." When Molly was alert and calm, Alan gently moved her to her spot on the bed.
"See, that's how I take care of my dog," he said as he dozed off. By soothing Molly in the same way I soothed him, Alan also learned how to soothe himself. We used several approaches to treat Alan's PTSD (more in future posts), but Molly was an irreplaceable part of the treatment.
Molly the personal trainer
Molly also featured prominently in Alan's goals. One of the first goals he set was to be able to walk Molly safely by himself. First, we worked on crossing the street to the local park and finding his way home. When he mastered that, he and Molly became walking pals. Each time Alan bent down to fasten her harness, he asked, "Do you trust me, Molly?" Do you feel safe with me?" Her wagging tail signaled assent, so off they went. They both enjoyed the exercise and stimulation of their walks.
Molly contributed to Alan's healing process in multiple ways that only a devoted and intuitive dog could.
Janet Cromer, author of Professor Cromer Learns to Read: A Couple's New Life after Brain Injury, speaks nationally on compassion fatigue, brain injury and family caregiver issues. Visit www.janetcromer.com.