DOGS AT WORK

ANIMAL THERAPY

Dondi Austin, CNM, MSKaiser Permanente, Downey

GDD Tomay

Working Dogs

Guide DogsService DogsAssistance DogsHearing DogsSkilled

Companion DogsFacility Dogs

Psychiatric Service

DogsTherapy DogsSeizure Alert

DogsOlfactory

Research Dogs

Working Dogs… Other Jobs

Police Dogs – K9 unitsExplosive Detection DogsDrug Sniffing DogsSearch & Rescue Dogs / Cadaver

Dogs

Americans with Disabilities Act (ADA)

Rehabilitation Act of 1973 Prohibited discrimination on the basis of a disability

Americans with Disabilities Act (1990) Expanded coverage to anyone with a “physical or

mental impairment that substantially limits one or more of the major life activities” entitling them to protection under the law, against discrimination in employment, housing, transportation & other areas of public life.

Under the ADA

Businesses & organizations that serve the public MUST allow people with disabilities to bring their service animal into all areas of the facility where customers are normally allowed to go.

Applies to ALL businesses including: Restaurants Hotels Taxis/shuttles Hospitals/medical offices Grocery/dept stores Theatres Health clubs Parks & zoos

Americans with Disabilities Act

Businesses MAY ask if an animal is a service animal and/or what tasks the animal has been trained to perform

Businesses MAY NOT ask about the persons disability nor require special ID for the animal

*puppies in training are not covered by the ADA; puppy raisers are taught to ask permission

Americans with Disabilities Act

People with disabilities who use service animals CANNOT be Charged extra fees Isolated from other patrons Treated less favorably than other patrons

They may be charged for damages in the same manner as other patrons if damages are caused by the service animal

Americans with Disabilities Act

A person with a service animal CANNOT be asked to remove the service dog from the premises UNLESS:

The animal is out of control & the owner does not take effective action to control it (e.g. a dog barking repeatedly during a movie)

The animal poses a direct threat to the health or safety of others.

* allergies or fear of animals are NOT valid reasons

Americans with Disabilities Act

A business is NOT REQUIRED to provide care or food for a service animal or to provide a special location for the animal to relieve itself

Canine Companions for Independence (CCI)

Founded in 1975

Non-profit organization that enhances the lives of people with disabilities by providing highly trained assistance dogs & ongoing support to ensure quality partnerships

Canine Companions for Independence

Headquarters - Santa Rosa, CARegional Center – Oceanside, CA (southwest)Largest non-profit provider of assistance dogsBreeding programVolunteer puppy raisers

CCI Assistance Dogs

4 types of Assistance Dogs:1. Service Dog = assists with physical tasks to

increase independence of a disabled person by reducing reliance on other people

Disabilities may include: spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida, arthritis

SERVICE DOGS … OPEN DOORS

CCI: Types of Assistance Dogs

2. Skilled Companions = dogs trained to work with a child/adult with a disability, under the guidance of a facilitator (parent, spouse, or caregiver) who are responsible for customizing the training needs.

Can also serve as a social bridge for people who are not used to relating to a person with a disability

Disabilities may include: cerebral palsy, muscular dystrophy, Down syndrome, autism

Cory with Skilled Companion “Melly”

“I used to be the kid in the wheelchair, now, I’m the kid with the amazing dog.”

CCI: Types of Assistance Dogs

3. Hearing Dogs = alert the deaf and hard of hearing to sounds such as a doorbell, telephone, alarm clock, someone calling a name or a smoke alarm

Customized training may include E-mail message alert, text alert, microwave timer, dropped keys (retrieval)

Disabilities served: hearing impairment

CCI: Types of Assistance Dogs

4. Facility Dogs = taught over 40 commands designed to motivate & inspire clients with special needs

Generally work in healthcare & educational settings

CCI Facility Dog Millie

“ Millie gives patients a sense of wellbeing, a connection to their home life, a bridge to trusting hospital staff & motivation to get out of bed.”

-Jennifer Johnson, Child Life Specialist

CCI: Wounded Veterans Initiative

Providing assistance dogs to veterans with physical disabilities resulting from military service: Service dog Hearing dog Skilled Companion dog Facility dogs

To visit & work directly with veterans through therapy professionals

“The most advanced technology capable of transforming the lives of people with disabilities has a COLD NOSE & a WARM HEART.”

Psychiatric Service Dogs (PSDs)

A service dog trained individually to mitigate the effects of their disabled partner’s psychiatric disabilities by performing certain tasks

Disabilities served: panic disorders, post traumatic stress disorder, depression, bipolar disorders & agoraphobia

Psychiatric Service Dogs

Job Description: Guide a handler disoriented by anxiety Conduct a room search (to alleviate fear of

intruder) Interrupt a panic attack & seek help for an

incapacitated handler Provide tactile stimulation to bring partner back

to awareness Can interrupt repetitive behaviors Can provide an excuse to leave an upsetting

situation

Psychiatric Service Dogs

Other therapeutic behaviorsBring medications, portable phone or

beverage, answer doorbellCall 911 (large button – pre-programmed

with speaker phone – dog barks @ speaker)Summon help – nudge another household

member or carry a note

Psychiatric Service Dogs

Handlers report the presence of their dog helps them feel calm, relaxed & more willing to interact with others eliminating feelings of isolation

A PSD is a trusted companion & can therefore serve as a bridge between the handler & his/her environment

Psychiatric Service Dogs

The Depression & Bipolar Support Alliance (DBSA)

“strongly believes that Psychiatric Service Dogs have afforded many disabled individuals to reach a new level of wellness & opportunity to lead happy & productive lives.”

Caring for a dog helps maintaining a routine which can help to manage daily tasks & activities

Caring for a dog can lead to feelings of self confidence, self reliance & improved self esteem

How do you get a PSD??

Working through Behavioral Health Professionals

Adopt from a program that specifically trains PSDs NEADS = National Education of Assistance Dogs

Encourage partner to write out a job description for PSD

Includes partner’s lifestyle, type of housing, location, job, hobbies, travel, and level of activity

Psychiatric Service Dogs for Veterans

Long history of pairing service dogs with physically disabled vets

PSDs are now being paired with vets dealing with Post Traumatic Stress Disorder (PTSD)

PTSD a disorder characterized by recurrent & intrusive

distressing recollections of a past event Symptoms include: hallucinations, flashback imagery,

recurring dreams, feeling that the events are still happening

Behaviors include: anxiety, extreme wariness, irritability, anger, sleep disorders, which can lead to substance abuse

Psychiatric Service Dogs for Veterans

Psychiatric Service Dogs – are specially trained to help traumatized veterans leave the battlefield behind as they re-integrate into society.

Job Description for PSDs assisting PTSD partners:(87 different commands)

“Block” – dog stands perpendicularly in front of the person in order to keep others at a safe distance

“Get my back” – dog sits facing backward by person’s side Trained to jolt a soldier from a flashback Sense a panic attack before it starts

*Caring for the dog renews a veterans sense of responsibility, optimism & self awareness

Lt. Colonel Jay Kopelman with “Lava”

Psychiatric Service Dogs for Veterans

For the Battle Scarred, Comfort at Leash’s End

“Just weeks after Chris Goehner, 25, an Iraq war veteran got a dog, he was able to cut in half the dose of anxiety & sleep medication he took for PTSD. The night terrors & suicidal thoughts that kept him awake for days on end ceased.”

“Aaron Ellis, 29, another Iraq veteran with PTSD scrapped his medications entirely soon after getting a dog, and set foot in a grocery store for the first time in 3 years.”

Lorber, J. (April 2, 2010) The New York Times

Psychiatric Service Dogs for Veterans

Dozens of interviews with veterans & therapists report drastic reductions in PTSD symptoms & in medication use but… does scientific evidence support anecdotal reports on dogs speeding recovery?

Federal Government – currently spending several million $$ to find out SB written by Senator Al Franken (D. Minn) Pilot program run by the Dept. of Veterans Affairs,

gives veterans with PTSD a service dog (est. cost $20,000/dog)

“Mya” and Jacob

Puppies Behind Bars (PBB)

Program founded in 1997 by Gloria Gilbert Stoga, NYC woman working for Mayor Guilliani’s Youth Commission

1991 – she adopted an 18 month old puppy from Guiding Eyes for the Blind (Yorktown, NY) released for health reasons

4 yrs later she read a newspaper article about prisoners in Ohio who raised guide dog puppies for the blind

Got the “go ahead” from Bedford Hills Correctional facility, but had no puppies (none of the Guide Dog schools agreed)

Puppies Behind Bars

Stoga bought 5 puppies “rejected” by Guiding Eyes for the Blind @ $500 each to board with inmates as a pilot program

3 weeks later –Guiding Eyes for the Blind agreed to give the puppies free of charge

2 out of the first 5 puppies went on to graduate & become working guide dogs

*current success rate for puppies raised by inmates = just > 50%

Puppies Behind Bars

“Inmates are very motivated & raise very well behaved dogs, as good as those of our best raisers”

Puppy raiser inmates are chosen based on: Clean disciplinary record x 1 yr Interview with prison officials, Stoga, & other puppy

raisers

2 raisers/puppy: primary & back-up

Puppies Behind Bars

Dogs live in a crate in the inmates cellDogs spend 20 months with the raiser & are

taken everywhere including prison jobs, dental appts etc.

Raisers attend 6 hrs training /weekDogs are furloughed out to volunteer families

2-3 weekends/month to provide experiences the prison environment cannot (e.g. shopping malls, car travel, children, household appliances)

Puppies Behind Bars

Quotes from inmates

“To watch them grow & learn & to know that you’re responsible – well, that goes deep … you get confidence & you believe that you can do something good.”

“I’ve seen 6’2”/250lb guys rolling around the floor kissing & talking in high voices to their dogs. We don’t care what anybody thinks, its all about what’s good for the dogs. We owe them. They did what nothing or nobody could do… they took away our selfishness.”

Puppies Behind Bars

“The dogs have had a calming, humanizing effect on the entire staff, me included. They’ve broken these inmates down, taken their hard shells & cracked them open. Their level of love & commitment to these dogs is something I never expected to see.”

Jim Hayden - Asst. Deputy Superintendant of Programs Fishkill Correctional Facility, Beacon, NY

Puppies Behind Bars

1997 -began with 5 puppies @ Bedford Hills Correctional Facility training guide dogs for the blind now @ 6 different correctional facilities

After Sept. 11, 2001 – at the request of law enforcement agencies, Explosives Detection Canines (EDCs) were added

2006 – began training service dogs for adults & children with other disabilities

DOG TAGS: Service Dogs for those who’ve served us. Training dogs to be placed with the wounded soldiers returning from Iraq, including PSDs

Canine Support Teams (CST)

Founded in 1989 by Carol RoquemoreTo provide specially trained dogs to people

with disabilities other than blindnessService dogs are placed with people who use

wheelchairs, walkers, crutches or canesDogs are taught to assist their partners by

pulling wheelchairs, turning lights on & off, retrieving dropped items & opening/closing doors & drawers, barking to get help or providing stability for walking

Canine Support Teams

Jennifer and “Ike”

Canine Support Teams

Prison Pup Program – makes use of available puppy raisers, with “lots of time” Has shortened the waiting list for partners

2002 California Institute for Women – became the first prison in the state of CA to have a service dog training program

> 85% of CST dogs placed have been trained through the Prison Pup Program

Canine Support Teams

PAWZ for Wounded Vets Program provides service dogs for men & women who have

sustained disabling injuries, including PTSD, as a result of service in the military

Effects of Human-Animal Bond

Contact has been shown to: Lower BP, pulse & respiratory rates Reduce perception of painReduce wound healing timeReduce recovery timeDecrease medication useIncrease survival rates for individuals with

chronic illnesses

THERAPY DOGS

Hospital / Nursing Home visitors Hospice visitors Physical Therapy Programs Schools – (special needs students; ADHD,

Autism) Public Libraries –Animal Reading Friends

(ARF) Court system – to support victims preparing

to testify

THERAPY DOGS

Animal Assisted Therapy (AAT)Animal Assisted Activity (AAA)

Scientific dataMarx, M. et al. (2010). The Impact of Different Dog – related

Stimuli on Engagement of Persons with Dementia. Am J Alzheimer’s Disease & Other Dementias.

Conclusion: AAT is well suited for nursing home residents with

dementia. Provides social interaction not dependent on level

of cognitive functioning.

THERAPY DOGS

Kawamura, N., Niiyama, M., & Niiyama, H. (2009). Animal Assisted Activity (AAA); Experiences of Institutionalized Japanese Older Adults. Journal of Psychosocial Nursing. participants descriptions of experiences were analyzed based on Collazi’s

phenomenological methodology

Summary: 6 themes1) Positive feelings about the dog2) Confidence in oneself (r/t sense of responsibility)3) Recalling of fond memories4) A break from the daily routine5) Interacting with other residents through the dogs6) Enhanced communication with volunteers

THERAPY DOGS

Multiple other studies show positive effectsIncreasing social behaviorIncreasing verbal interactionsDecreasing agitated behavior & loneliness

AAA with residential geriatric patients demonstratedDecreased BPDecreased HRDecreased depressionIncreased life satisfaction

Charlie and “Molly”

Therapeutic Riding – Equestrian TherapyCharlie & Angelique

THERAPY DOGS

Dr. Ray Sacks & Ella Kaiser San Diego - Orthopedics

THERAPY DOGS

COULD YOUR DOG BE A THERAPY DOG ??

Delta Society Volunteer organization specializing in human health through service

& therapy animalsCurrently > 30,000 therapy dogs certified in the US

Qualifications: calm, friendly, at least 1 year old & well behaved around strangers

Training: 12 hr course; partner taught how to handle dog in a variety of situations (IVs, wheelchairs, etc.)

22 part evaluation – obedience, skills & controlVet certificate of health

THERAPY DOGS

Therapy Dogs Inc.Therapy Dogs International

** Canine Good Citizen

THERAPY DOGS

“It doesn’t matter if you have disabilities, can’t read very well or are old & sick – the dog loves & comforts you anyway.”

Linda Buettner – Professor UNC, Greensboro

Therapy Dogs: Infection Control

DiSalvo, H. et al. (2006). Who let the dogs out??? Infection control did: Utility of dogs in health care settings & infection control aspects. Am J Inf Control.

Animal Assisted Therapy Advantages

well documented Disadvantages/ Potential Risks

pt. phobias Allergies Bites – usually NOT a major threat Zoonoses – dogs viewed as lowest risk for transmission Animal caused injuries

Therapy Dogs: Infection Control

Policies for dogs in health care settings: 3 categoriesService Dogs – covered by ADA Therapy Dogs *Visitation Dogs *

*NOT permitted in multibed unit if any pt objects in isolation/immunocompromised pt rooms Some ICUs (usually allowed in burn centers, rehab &

trauma units)

Therapy Dogs: Infection Control

ConclusionBenefits greatly outweigh risksDevelop pet therapy policies emphasizing

different categories of dogs

JCAHO standard IC.4.10 “reduction of risks associated with animals brought into

the hospital”

Can Dogs Smell Cancer?

Tumors release tiny amount of chemicals different than those of healthy tissue

Early 2000’s British researchers taught 6 dogs to identify the smell of bladder cancer in urine samples in a “meticulously controlled/ double blinded/ peer reviewed study”… “The results are unambiguous. Dogs can be trained to recognize

& flag bladder cancer”The Lancet (1989) – reported dog detecting malignant

melanomaPine Street Foundation (reprint from Integrated Cancer

Therapies) reported dogs accurately distinguishing breath samples of lung & breast cancer patients from controls.

Seizure Alert Dogs

Alerts pt/family member BEFORE a seizure begins allowing appropriate steps to be taken for safety

DO NOT at this time understand how dogs might be able to do this OR how good they are at it

Seizure Response Dogs

Responds to a person having a seizure by alerting others remaining with the pt – to help avoid injury reassuring & reorienting a pt as they awaken

from seizure

Seizure Dogs

Epileptic seizure studies – dogs performance poor

Non-Epileptic seizures – dogs behavior more predictive thought to reinforce psychogenic event

Seizure Dogs

While the role of seizure alert dogs has not been scientifically validated at this time, the dogs do provide important emotional support, which is seen as beneficial to patients with chronic illnesses. Their companionship can be reassuring & their ability to obtain help may be life-saving.

Guide Dogs

A dog specially trained to provide mobility & independence to the blind & visually impaired.

The Seeing EyeFounded in 1929 (celebrating 81 years)15,000 dogs assisting ~ 8,000 men & womenHeadquarters in Morristown, NJ

Morris Frank and “Buddy”

Guide Dogs … cont

Morris Frank Read about dogs being trained as guides to assist

blinded veterans of WWI Dorothy Harrison Eustis – American training

shepherds in Switzerland agreed to help Mr. Frank if he would return to the US & “spread the word”

1928 Mr. Frank returned to New York City & demonstrated the abilities of his dog “Buddy” to a group of reporters

His one word telegram back to Mrs. Eustis read “SUCCESS”

Guide Dogs

Guide Dog Schools: California Guide Dogs for the Blind – San Rafael, CA (Boring,

OR) first on the west coast – 1942 Started out in order to help returning servicemen (WWII) Graduated >10,000 teams to date

Guide Dogs of America (GDA) - Sylmar, CA Founded in 1948 originally named International Guiding

Eyes

Guide Dogs of the Desert Founded in 1972 Palm Springs CA (Whitewater) Has graduated > 1000 teams

GDD “Bailey”

Guide Dogs

Puppy Raisers Takes 8 week old puppies into their home House trains, crate trains, socializes pups Exposes them to the environment – malls, restaurants,

grocery stores, clinics, office buildings, elevators Returns the dog to the school @ 18-20 months for

formal training

Guide Dog Training

Formal guide dog training - “Harness Work”

4-6 months with certified trainer 28 day partner training; blind recipient & dog

work with trainer on campus with the dog sharing the room

Graduation On-going support – including in home

Guide Dogs

Breeders Adopted by host family – with same rules as puppy

raisers Return to facility for mating & whelping Females remain with puppies to nurse x 8 weeks Puppies adopted by puppy raisers – breeder returns to

hostAmbassadors

Represent the Guide Dog program @ public events, schools, fundraisers, etc.

Career Change Dogs “Working dog changes job”

Graduation