The article on dogs visiting hospitals (‘In praise of dogs in hospitals’, March 7) surprisingly failed to elicit negative comments on the Times website.
This was unexpected if one considers the number of people who mistakenly regard dogs as a health hazard. Be that as it may, this subject has sufficient relevance to merit further discussion. This is particularly the case in the context of the proliferation of nursery homes for the aged as people live longer and populations become older.
Losing autonomy and becoming dependent on others for nursing care or being confined to a nursing home is one of the greatest traumas which confront people as they age.
In his book Being Mortal, author and surgeon Atul Gawande gives readers poignant descriptions of the distress suffered by old people when they are consigned to the scrapheaps as typified by so many old-age nurseries.
In this context Gawande recounts the story of an innovative nursing home dir-ector’s approach to over-coming what he referred to as the ‘three plagues’ of nursing home existence – boredom, loneliness and helplessness. He adopted the approach of livening up the institutionalised existence of the nursery home residents by introducing two dogs, four cats, one hundred birds (parakeets – no less) and replacing the artificial potted plants with real green plants in all the rooms.
His philosophy was, rightly, that it was wrong to allocate more priority to (health) ‘safety’ than to quality of life of nursing home residents. Not only did this project go against all nursing home regulations, its creator was also faced with a deeply embedded nursery ’hygiene’ mentality and the fears and inertia of the nursery home staff.
In spite of the bureaucratic and other odds against it, the ‘great experiment’ was put into action.
The result of bringing all these animals into the sterile nursing home environment was nothing short of magical
The project did initially result in what was optimistically referred to as the ‘occasional crisis’ (which included at least one dog-poo on the nursery floor) until a routine for feeding and care of the animals became established and the inmates took over shared responsibility for them.
In the author’s words: “The residents began to wake up and come to life.” Inmates who had been withdrawn and had never spoken or walked started to talk and even offered to take the dogs out for a walk. Each parakeet got a name and the animals became ‘irreplaceable’ in the daily lives of residents, even those with advanced dementia.
The final tally of animals grew to four dogs, two additional cats, a colony of rabbits, a ‘flock of laying hens’ and a burgeoning flower and vegetable garden. Boredom was replaced by spontaneity. The result of bringing all these animals into the sterile nursing home environment was nothing short of magical; the residents had ceased to simply exist and felt able to grab on to something beyond mere existence that made living feel meaningfuland worthwhile.
The number of prescriptions, including tranquillising drugs for agitation, decreased by half. Anticipated deaths decreased by 15%; this was ascribed to fulfilment of ‘the fundamental need for a reason to live’. The results were consistent with those of earlier such experiments.
We should attach more importance to the animals with whom we share our environment, looking at them less in terms of ‘hygiene’ but more in terms of what living fellow creatures can bestow and how they can ‘matter so greatly’ to people who have been deprived of a purpose in life through old age and infirmity.
Gawande’s book should be essential reading for all health carers, particularly those who look after our old. It provides much food for thought and out-of-the-box ideas.
George Debono is lead author of the think tank report “The Environmental Dimension of Malta’s ill-Health and action to prevent Obesity, Diabetes, Cardiovascular Disease and Dementia”.