Survivors of trauma, illness and injury often find comfort and support from companion animals during their rehabilitation.
Dogs, amongst many other animals, have long been companions of people of all ages. Dogs are well known for combatting loneliness, boosting activity levels, reducing stress and depression and unlocking memories.
The benefits of dog therapy
For those living with neuro conditions, dogs can provide lots of benefits:
- Relief from loneliness: living with a neuro condition can be an isolating experience, especially if it affects communication, and dogs can bring comfort and company.
- Motivation to move: dogs can be an incentive for people to move and work on their movement as part of rehabilitation.
- Calming influence: dogs offer love and motivation, and provide a calming and comforting effect on dog lovers, that can help with mental health.
Dog therapy at Exemplar Health Care
Exemplar Health Care provides specialist nursing care for adults living with complex needs, including those with a neuro condition or disability.
Many of our homes use dog therapy as part of people’s care.
Helen is a Physiotherapist at Tyne Grange care home in Newcastle upon Tyne. She takes her therapy dog, Indie, into the home every week.
She shares: “Indie has been coming to Tyne Grange every Friday since the home first opened in 2020, when she was around seven months old.
“It’s brilliant having Indie at the home – she really lifts the mood and brings so much energy and excitement to the home.
“When she was a puppy I would make sure that she spent time with each service user, just having cuddles and playing with toys so she became familiar with them all (and vice versa).
“As she’s grown (she’s now 18 months!) and everyone has got used to Indie being around, she’s become quite the favourite – service users ask about her all the time and look forward to Fridays for ‘Indie cuddles’.
Increasing social interaction at the ‘dog café’
“Most Fridays we do a ‘dog cafe’ where all service users come down to our communal area and Indie (and sometimes Bella – our Home Manager’s dog) will be there to play with. This increases social interaction between service users and puts a smile on everyone’s face.
“The service users enjoy going out and buying treats and toys for her and will practice training her with tricks.
“Our more mobile service users come with me to take her for walks on Fridays, which is great for additional exercise.
Improving emotional wellbeing
“One particular service user here has Korsakoffs Syndrome and has expressive dysphasia, which means that she struggles with communication and finding the right word to use – but as soon as she sees Indie, she gets on the floor with her to play and is able to communicate using appropriate words – she will say things like “beautiful doggy” and “lovely puppy”, which always takes us all by surprise.
“Another service user waits in bed for Indie to wake her up on a Friday morning – Indie will jump on the bed with Linda and wake her up with licks and cuddles. Linda’s face will just light up; it’s her favourite wake up call!
Boosting activity levels
“Indie also takes part in the Pilates sessions that I run, which make everyone laugh when she’s crawling under arms and licking faces.
“She also helps to encourage more outdoor activities; sometimes just playing in the garden or longer walks down to the local park. She brings people together and acts as a buffer for conversation and social interaction between service users who will laugh together at Indie’s ‘zoomies’ or her performing her tricks.
“She’s can also be a calming influence for some service users when she has ‘quiet time’, she will sit on the sofa with people and just lie they being stroked and cuddles. This can be really calming for service users if they’re feeling anxious or overwhelmed.”
Complex care at Exemplar Health Care
Exemplar Health Care provides specialist nursing care for adults living with a range of complex and high acuity needs.
Our specialist nursing homes and OneCare services provide person-centred care and rehabilitation that focuses on maximising independence, building everyday living skills and empowering people to live as fulfilled lives as possible.
Read more about our care at www.exemplarhc.com
Setting global standards in neurorehab
With a global reputation for its work in brain and spinal cord injury rehabilitation, Craig Hospital has delivered life-changing outcomes for thousands of patients for 65 years. Deborah Johnson meets Jandel Allen-Davis, CEO of the pioneering US hospital, to learn more about its work
With an unrelenting focus on rehabilitation, underpinned by world-leading technology and led by a team who pride themselves on being by their patients’ sides every step of the way, Craig Hospital has built a global reputation for its work.
Having offered neurorehabilitation since 1956, supporting over 34,500 brain and spinal cord injury patients during that time, Craig is known the world over for its pioneering and brave programmes which empower patients and maximise their independence.
From its base in Denver, Colorado, Craig attracts patients from across the United States – and often internationally, too – with its ‘Craig graduates’ routinely building a lifelong affection with the hospital and its team, forever indebted to the life-changing impact they have made.
Led by Dr Jandel Allen-Davis, who became CEO of Craig in 2018, Craig’s reputation for pushing the boundaries of possibility for its patients through intensive rehabilitation is one she is committed to taking forward even further.
“We work hard, we’re healing bodies, minds and spirits,” Jandel tells NR Times.
“The people we care for woke up with one reality and went to bed with a very different one – but there is life after brain injury or spinal cord injury, and we will show them that is possible.
“The interesting thing about Craig is that typically in United States acute rehab, you’ll get two or three hours a day (of rehabilitation). Here at Craig, it’s between four and six, and it’s usually six.
“The day generally starts at 9 and ends at 4, and that hard work could be physical for brain injury and spinal cord injury patients, or cognitive for brain injury patients.
“We only have 93 beds, so it’s a precious resource and there is way more demand than we have beds.
“They have got to come here ready to work. On the first day here, we’ll get them fitted for a wheelchair if that’s needed, we start work on day one and work hard from there.”
But the concept of hard work is something welcomed by Craig patients, with the outcomes of countless Craig graduates showing what can be possible for those living with brain and spinal cord injury.
“We achieve stellar outcomes,” says Jandel.
“In 2020, 82 per cent of our patients were discharged to their homes, and about 48 per cent of our SCI and BI patients returned to work or school within one year after discharge.
“Our patients require significantly fewer hours of daily attendant care than those who don’t come here – we strive for independence.
“I love it when I hear patients say ‘I do what I used to do, but now I do it differently’. Often they say they wouldn’t go back to their life before their injury – and often that’s because they have discovered new resilience and determination in themselves they had no idea existed.
“It’s pretty remarkable and shows us every day there is life on the other side of spinal cord injury and brain injury, a good life.”
With therapy programmes devised around the exact needs of each patient, Craig’s use of technology and equipment – partly funded by the “magical generosity” of donors through its associated Craig Foundation – is genuinely world-leading.
Its work in transcutaneous electrical stimulation for spinal cord patients in particular is globally significant, having begun in pilot in 2019, and is now helping people to regain the power of movement.
“We are helping people to get their function and movement back, even years after injury, it is really amazing,” says Jandel.
“But the physician in me totally believes and knows that technology is like a scalpel and pills, they are tools, enablers, not the be all and end all.
“We start with the basics and then look at how technology can advance their rehab. It’s a holistic approach, of which technology is a part.”
But the part technology plays is without doubt a key component in Craig’s offering – from exoskeletons to EyeGaze, VR to robotics, as well as gaming which proves especially popular in its Teen Rehab groups.
And through its work in research and paving the way for new innovation, the potential for its patients – both current and future – is increasing all the time.
“We have the most amazing equipment, there are some really cool things,” says Jandel.
“It starts here at Craig where we have the most highly-skilled therapists who understand neuroscience and body mechanics, we’re learning more about neuroplasticity and the ability to regenerate. We have things being created on 3D printers by our therapists which can support people in living independently.
“Human ingenuity and the quest for innovation will never be complete, and that thirst will never be quenched, thank God.
“Neurorecovery is a big frontier in an exciting way, in the way that brain plasticity can recover, and neuroregeneration through spinal cord injury transplant of tissue – these things are super new, the data is not yet solid, but the cool thing is that as we have a research unit at Craig, we stay in the game all the way.”
But for Jandel, while technology and therapy are of course fundamental in Craig’s offering, the factor that underpins its reputation, outcomes and work is the dedication of its team.
“This place is so unique. I’ve never worked in a place which lives and breathes patient and family-centred care like this. A lot of places talk about it, but this is truly standout – and I can say this with 40-plus years in healthcare,” says Jandel, whose background is in obstetrics and gynaecology, and admits a move into neurorehabilitation was “completely off the beaten path”.
“It’s team-based care. We have psychologists, PT, OT, speech and language and the ‘angels’ who are the clinical care managers.
“I’ll have been at Craig for three years in October and it still feels new. I think that speaks volumes about what a difference it makes to bring your whole self to work, with team mates who bring their whole selves to work. It is a privilege and an honour to serve at Craig.
“From the folks in the environmental services team, through to the frontline caregivers, everyone gives their all. Some of the leadership team have been here for 30-plus years, they are Craig veterans, and everyone plays their role.”
Leading from the front, Jandel is often to be found walking the floors at Craig, getting to know patients and their families and discovering the impact her team’s work is having on their lives.
“I love walking the floors and talking to patients, they gush about this place and the relief that washes over them when they come here,” says Jandel.
“We hear from families what a wonderful place this is, and I say ‘It was like this when I got here’.
“It’s not just about the patient; as with brain injury and spinal cord injury, they are probably going to need an attendant to help them. So we deliver family-centred care.
“The patient and family are at the centre of a myriad of services and people that surround that patient, and we customise a care delivery programme.
“When I’m walking around, I joke to patients ‘Did we beat you up today?’ They say we have and I say ‘Well, our work is done’.
“Craig graduates always come back, many come to get their ‘tune ups’, get their wheelchair checked, and so on. But we offer lifelong care and support for patients and their families, so we do hope they will come back.”
As a hospital working at the forefront of neurorehabilitation, but with only 93 beds, Craig is a great believer in the power of empowering people in their own homes and communities, with the COVID-19 pandemic highlighting the importance of enabling that.
“I’m interested in what potential lies ahead for distanced medicine,” says Jandel.
“With people living longer, we have to think about delivering care for everyone, it’s less about the ages and stages. As an example, spinal cord injury patients do age more quickly, and there are parts that telehealth can enable.
“Home health needs a huge lift, people live in tiny communities – how do they access the support and neurorehabilitation they need? This is where their life happens so it’s more natural for people if they can do this where they live.
“If we can figure out how that works, then do we need to add a whole ton of new beds? We have to think about these sorts of things. The economics of it would enable us to lessen the burden on resources, while enabling people to be more independent.
“Rehab is always going to be part of the deal, so we need to do the right things.”
While Craig’s work continues to develop, with ongoing innovation and progress for its patients made by the day, it will continue to hold its place as one of the world’s leading neurorehab centres.
But for Jandel, the ultimate dream is that no patients would need to access such a place, and that prevention could get to such a stage that such intensive neurorehabilitation would not be needed.
“The big dream is that we wouldn’t need a place like this,” she says.
“Nobody wakes up in a morning and says ‘I want to go to Craig’.
“We’re in a space now where we’re thinking more about prevention, how to prevent sports injuries, workplace injuries. I think it’s so important to use our voice in the prevention space, alongside the work we’re doing now in treating.”
Marching to a different beat
NR Times reports on how Chroma is helping amputees prepare for prosthetics through neurologic music therapy (NMT).
Dog visits help support therapy provision during pandemic
Mental health hospitals have faced significant challenges over the past 18 months, trying to find ways to keep patients engaged and motivated amidst ongoing restrictions and limited visits from friends and family.
So staff at Heatherwood Court, a forensic mental health hospital in Pontypridd, have involved their canine friends to help meet the challenge.
Service users at Heatherwood had previously enjoyed dog walking through connections with local animal shelters, but lockdowns and COVID-19 restrictions meant they had been left disappointed when they couldn’t take part in their usual activities which formed part of the hospital’s pet therapy course.
When Paul Sutton, quality and development manager at Ludlow Street Healthcare, which runs the hospital, heard about this, he offered his dog, miniature schnauzer Daisy May, to help bridge the gap until the kennels were open again.
Paul explained: “We have found that the presence of the dogs helps service users feel more relaxed and at ease so they start to open up to us about their fears and concerns. They become far less guarded which really helps with their treatment and recovery.”
Dr Penny McCarthy, clinical associate at Ludlow Street Healthcare, also brings her two dogs, Larry and Buddy, along to sessions at the hospital.
Dr McCarthy said: “From a clinical perspective, pet therapy rapidly builds positive working relationships, establishing rapport, trust and engagement with the therapeutic pathway.
“Time spent with animals in a clinical setting can also increase motivation to recover, decrease patient anxiety levels, bring a sense of calm, reduce incidences on the ward, increase self-esteem and confidence, as well as reducing boredom and feelings of isolation, especially after the tough lockdowns we have endured over the past 16 months.
“Although pet therapy might not be for everyone, research has shown that stroking dogs and increased exercise that comes with dog ownership, also helps reduce blood pressure, improve cardiovascular health and diminish physical pain, potentially helping reduce medication required to control conditions which our mental health patients are particularly vulnerable to.”
Sarah House, operations director at Ludlow Street Healthcare, said: “Just before COVID hit we launched our co-produced Recovery College at Heatherwood.
“With input from patients we offer courses that will promote wellbeing and rehabilitation as well as practical skill-based courses that will aid patients to successfully transition back into the community.
“Pet therapy was one of our most popular courses but had to be postponed due to COVID. Having staff bring in their own dogs has been a brilliant way of filling the gap and the patients look forward to the dog’s scheduled visits.”
Heatherwood Court is owned and run by healthcare specialists, Ludlow Street Healthcare.
Established in 2005, Ludlow Street Healthcare has supported and cared for over 800 people. More information about Heatherwood Court and Ludlow Street Healthcare is available on their websitewww.heatherwoodcourt.co.uk.
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