[dropcap]An explosion in Afghanistan in May 2010 robbed a now 26-year-old Sergeant John Peck of all four limbs and his ability to do things many people take for granted, like playing football, tinkering with his car or holding hands. His loss makes even bending to pick up dropped keys or a wallet difficult, but reassurance comes in the form of a highly intelligent and well-trained service dog named Nasar.[/dropcap]

Unlike any dog Peck owned before, Nasar offers more than just companionship. He offers a helping hand.

Though his responsibilities are unique, Nasar is among the many animals serving in medically aligned professions.

Seventy years ago, guiding eye dogs were the only animals recognized for their service in health care, but today thousands of animals work with patients in a physical and emotional capacity. They offer comfort, help people overcome physical and psychological barriers, offer peace of mind and provide a better quality of life.

Fur Coats to Lab Coats
From canines and miniature ponies to rabbits, hedgehogs, cats and horses, animals and their handlers have been working in hospitals, educational settings, nursing home facilities, stables, hospices and other locations, assisting with formal and informal treatment.

Animals highly involved in treatment or improving a person’s quality of life: assistance animals and service facility dogs are required to undergo extensive training. Therapy animals in most cases must be registered with a national organization before they can work with patients.

Assistance Animals
Considered the most highly trained and task-oriented animals in the medical field, assistance animals—typically dogs and sometimes miniature ponies—are bred for service and to improve a person’s quality of life.

Revisions to the Code of Federal Regulations for the Americans with Disabilities Act, which define the responsibilities of service animals, brought attention
to the work animals can do and gave credibility to the use of animals in health care, explains Ellen Torop, regional program manager for Canine Companions
for Independence.

Assistance animals can serve as guides, assisting people with visual impairments; hearing dogs, aiding people who are deaf or hard of hearing; and service
animals, assisting people with a variety of issues
including post-traumatic stress disorder (PTSD),
panic attacks, frequent seizures, diabetes, autism and physical impairments.

Many service animals respond to more than 30 commands and can be trained to retrieve objects, serve as a touch point for a person with poor balance, open doors and drawers, pull wheelchairs, alert to a medical crisis and more.

While there are several types of assistance animals, each type has different responsibilities and training. Most go through approximately two years of training, completing the first portion with puppy raisers who prepare them for careers as assistance animals.

During assistance training, they learn specific commands and are exposed to situations that they may encounter as assistance animals so they can perform without distraction.

Each service animal has a “handler,” who is often the person benefiting from the animal’s assistance. The handler must see that the animal continues training, and committees regularly evaluate animals to make sure they are meeting certain standards, Torop says. “A dog’s training is only as good as the person’s consistency when handling that dog.”

Nasar, a service dog, can retrieve items for Peck, turn on lights, open doors and more.  Like other service animals, Nasar provides a level of independence and increased confidence, Peck explains.

Atypical of most assistance animals, Godrick, a guiding eye dog in training, serves in a therapeutic role at Atlantic Shores Retirement Community in Virginia Beach. Currently in the first stage of training, he is learning manners from Resident Services Director Kathy Parks and Atlantic Shores residents. He is the last of three dogs that began their training there, providing companionship to residents.

Symptom-sensing and Disease-detecting Dogs

Less commonly recognized in the arena of
assistance animals are dogs that detect the symptoms
of chronic disorders and diseases and cancer. Research into this type of service animal is relatively new
and experimental.

Diabetic-alert dogs can signal significant changes in blood sugar levels, while seizure-alert dogs respond to impending seizures. It is commonly believed that dogs are responding to unusual smells in these situations, explains the website for 4 Paws for Ability, an assistance dog training program.

It is unclear what cancer-sensing dogs are responding to when they identify cancerous tumors and moles; however, there have been several reported cases of dogs alerting their owners to cancerous growths. Researchers have just begun studying this phenomenon.

Facility Animals
There is more than one way to define “facility animal.”

According to many pet therapy and assistance dog training programs, a “facility animal,” also known as a “service facility animal,” spends most of its time working with groups of people at a hospital, rehabilitation facility, school or courthouse. Like other service animals, facility animals have two years of task-specific training, allowing them to respond to more than 30 commands.

Other organizations like Pet Partners, formerly known as the Delta Society, define “facility animals” as those without formal training who spend most or all of their time at a particular facility. These animals may be the pet of a facility worker and may informally serve as a pet for all community members.

Pecos, a service facility animal at Children’s Hospital of The King’s Daughters (CHKD) in Norfolk, provides support for children and adults in distress by reading and responding to emotional triggers, says Torop, who met Pecos during his assistance dog training with Canine Companions for Independence.

Pecos responds by drawing closer or putting his head in the lap of a grieving child who is talking to the forensic interviewer, she says.

He attends to children and adults who feel distressed or isolated, and improves the morale of CHKD employees he encounters, explains Michelle Thames, forensic interviewer and Pecos’ primary handler.

At Riverside Rehabilitation Institute (RRI) in Newport News, Ekko, Saint Francis Service Dogs’ first facility dog, motivates patients by making the often mundane therapy tasks more meaningful. Instead of using weights and other gym equipment to improve strength and balance, patients can play tug of war with Ekko, who uses a controlled pull; patients can also play ball with Ekko, who waits patiently for the throw, says Anthony Franz, a certified therapeutic recreation specialist and one of Ekko’s primary handlers. Ekko also helps patients with speech therapy and sequencing exercises in which patients must correctly order and verbalize commands. “To me, she’s just another therapist. She does a really good job of making people happy,” Franz says.

Patients with a flat affect (the inability to express emotion) following a stroke or brain injury often smile for the first time after working with Ekko, Franz observes. Patients who have difficulty standing are able to stand for twice as long.

“If they have something else to focus on, they can go for longer,” adds Wendy Bunting, director of therapy services at RRI and the handler with whom Ekko lives. “What was a chore is now a fun game…We’ve all been a little humbled by what this dog can do.”

Service facility dogs like Ekko and Pecos are specially chosen for this type of work. Their intelligence, work ethic, intuition, training and experience allow them to work effectively with patients in a professional capacity.

At this time, only dogs are working as service facility animals in major area hospitals.

Therapy Animals
Therapy animals and their owners provide companionship and emotional support in a variety of contexts, visiting hospitals, assisted-living facilities, schools, libraries, hospice facilities, shelters, disaster sites and more.

Studies show that visits from therapy animals can lower blood pressure in patients and lower a patient’s heart rate, says Greg Raver-Lampman, public relations manager at CHKD, where therapy dogs visit the hospital on a daily basis.

They give patients a break from their situation and something to look forward to, says Marsha Smith, owner of therapy animals Tillie and Weezie, who visit CHKD, Chesapeake Regional Medical Center, Sentara Norfolk General Hospital and Moyock Middle School. Visits from therapy dogs help patients focus on something other than pain or the stress of an upcoming operation, Smith says. “That is the sort of job that therapy dogs do.”

Schools and libraries can benefit from visits with therapy dogs, who help instill confidence in children learning to read, adds Janet Cornell, owner of five therapy dogs, including Ellie and Scout, who visit Nansemond Suffolk Academy and have just begun visiting area libraries. During the visits, Ellie and Scout sit on pillows in the middle of reading circles, where children read to them.

“Dogs don’t care if [children] are mispronouncing a word. They are just glad to have the children read to them,” Cornell says.

Dogs can also help children with social and emotional disorders, explains Fletcher Means of Williamsburg, owner of therapy dog “Woody.”

In addition to visiting three Peninsula Cancer Institute locations and Morningside Assisted Living in Newport News, Woody recently visited Bright Beginnings, a summer program for children with social and emotional disorders including autism. During the visit, Woody played games and spent one-on-one time with the children; by the end of the session, many felt confident enough to pet Woody.

“They know these animals are totally loving without condition and are easier to start touching and hugging,” Means explains. “It’s just another tool to get these kids starting to love… All a puppy and therapy dog wants to do is to love you.”

Therapy horses can also benefit children and adults with social, emotional and physical disorders. While learning to ride, children and adults invest in a unique hobby, giving them a sense of confidence and something to discuss with friends, explains Jill Haag, executive director of Equi-Kids Therapeutic Riding Program in Virginia Beach. Riding helps increase communication skills, especially in autistic children who learn to communicate with the horse and horse leader. Riders also build strength as they engage muscles they may not ordinarily use.

In Suffolk, Sentara Obici Hospital uses horses to help patients recovering from breast cancer treatments. “They are just soulful healers,” explains Patient Navigator Pat Thornton.

The idea for the program came when Thornton treated a cancer patient to a free one-hour riding session and was amazed at how relaxed the woman became. Thornton wanted all of the cancer patients to benefit from a similar experience, so she raised enough money to provide six women with six weeks of riding lessons. “[The horses] helped to heal the women emotionally and physically,” Thornton says.

One patient told Thornton, “We have not thought about breast cancer the whole time we’ve been here.”

At Peninsula Cancer Institute, the use of therapy dogs is part of an integrative treatment plan, in which health care providers focus on treating the mind, body and spirit, explains Sofia Mikac, integrative oncology manager for all three PCI facilities.

At Riverside PACE MacTavish in Richmond, a facility that serves as an alternative for nursing home-eligible individuals who want to remain in the community, Recreation Therapy Manager Shannon Marling witnessed the benefits of using dogs during a six-week group therapy session. During the session, Marling saw a decrease in participants’ depression symptoms, more facial expression and improved memory.

In addition to working with participants in group therapy, dogs visit the PACE facility one to four times a month. Working with the dogs may cause PACE participants to recall positive memories they had with their pets, increasing endorphins, blood flow and oxygen exchange, which can cause better clarity of mind and attention to detail, Marling explains. Marling has observed better overall health and social engagement in dementia patients working with the dogs.

There are several thousand animals registered nationally with Canine Companions for Independence, Therapy Dogs International and Pet Partners.

Therapy animals must be registered and have updated shot records before they can enter many of the major hospitals and medical facilities in the area.

Evaluators assess the temperament and manners of therapy animals and their owners, explains Patty Allen, owner of obedience school Pawsitive Attitudes and certified evaluator for Therapy Dogs International.

There is no specific training for therapy dogs, Allen says. “Some dogs are just naturally gifted.”

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