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Pets as Healers
A Team of "Hearts" Creates Efficient & Effective Care
Geriatric Care Managers, Where Are You?
Pets as Healers
by Rona S. Bartelstone, LCSW, BCD, CMC, C-ASWCM
Older adults and persons with chronic disabilities sometimes become socially isolated. Limited mobility, cognitive changes, transportation challenges or emotional concerns could lead someone to become isolated.
It has been documented that social isolation can cause changes in mood and functional capabilities that lead to excess disability. What this means is that someone can appear to be even more functionally or cognitively limited than they really are as a result of the loss of positive social interactions. In addition depression, anxiety and agitation can be exacerbated by these same losses.
For many people, especially those who had household pets in the past, having a pet again can create significant positive changes. Pets have been shown to help lower blood pressure, reduce anxiety and depression, increase social interaction with other people and increase physical activity.
One of our elderly clients, who is bed bound has a cat who is her “favorite person in the whole world!” Yes, she feels close to her home healthcare aides and her care manager, but her cat is the only one who truly loves her unconditionally and always comes when she is needed. The cat has provided incentive to get out of the hospital more quickly and to return home after a hurricane. While her family lives a full country away, her cat is always by her side.
Another client, who started with us during rehabilitation after a stroke, always did better in physical therapy on the days that his dog was allowed to visit. It also helped the client to become more social in the rehab environment because other patients on the floor wanted to visit with the dog, as well. As a result, the owner made a special effort to get out of his room and visit with other patients when his dog was with him. Knowing that the dog was waiting at home gave this individual a bigger incentive to work hard on his rehabilitation, so that he could be with the dog more. Once at home, the dog became his constant companion and protector.
We worked with one woman who we referred to as “the bird lady” because she always came to the office with her parakeet on her shoulder. Her bird was her constant companion and led her into social interactions with people she ordinarily would not have met. She even taught her home healthcare aide to become a “bird person” because of her love of her pet. The bird lady was always smiling when Perty was on her shoulder!
Pets can also help people with dementias, who sometimes become agitated because of fear of knowing that they are loosing abilities without being able to express their concerns. One elder was always comforted, no matter what was going on around him, when his old pal, Danger came into the room. It was in this relationship that our client felt safe, accepted and comforted because this was the one constant in his life.
During heart month, it might be a good idea to give your heart away to a pet to get back more love than you could ever imagine!
Things to consider before taking home your ideal pet:
- Do you live in a place that allows pets? Some communities limit the ability to have pets or pets above a certain weight.
- Can you afford to keep the pet and care for its needs? Some elders would rather buy food and medicines for their pets than themselves. It is important to be realistic about the cost of pet care, including medical needs. If the person cannot afford a pet themselves, is there someone who can help with the costs?
- Making the right match. Puppies can be a lot of work. Often an older dog or animal, which is already trained and out of the “puppy stage” is more appropriate for someone with a disability or age related health concerns.
- The size of the dog (or other pet) may not be as important as it’s natural temperament. Be sure that the personality of the potential pet is not too high energy or aggressive for the new owner.
- Before adopting a new pet, have it examined by a veterinarian to assure that it is healthy when you take it home. Unusual or unnecessary veterinarian expenses should be avoided, especially when adopting from a rescue service.
- Are you physically able to care for a pet? A dog is not the pet of choice for everyone because of the need for more physical care. Consider the choice of the pet carefully. Sometimes a cat, bird or other small pet can provide the same benefits.
- If you can’t have a pet yourself, can you access a pet therapy program in your community? Most communities have programs that provide pet therapy or companion services for persons with disabilities or elders. Some even have programs to help people with special needs to afford their pet.
- Research before you adopt. Talk to others about their experiences and include your family in this decision before taking home a new love. You may find that people are willing to help in ways that you didn’t expect.
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A Team of "Hearts" Creates Efficient & Effective Care
This caregiving story illustrates how three caregivers working together can create efficient and effective medical care that focuses on the needs of the patient. The caregiving team in this case included: one primary physician, a care manager and the home health aide, all of whom provide services to Mrs. Sweetheart.
The home healthcare aide noticed that Mrs. Sweetheart seemed suddenly disoriented, weak, with little appetite and generally not her usual self. The aide called the Care Manager, Sandy Goldberg who instructed the aide to call 911 and get her to the hospital. Unfortunately, the closest hospital was one at which her primary physician does not have privileges. The Care Manager was aware of this fact and wanted to be sure that the hospital had as much information as possible about Mrs. Sweetheart’s pre-existing conditions, so that they could treat her appropriately. Ms. Goldberg also wanted to be assured that the primary physician was kept informed of all care being provided to Mrs. Sweetheart.
Since the Care Manager works for their client not the hospital, she was able to meet Mrs. Sweetheart at the hospital emergency room and provide their staff with the client’s medical history, her medication list and other pertinent information, including the variety of co-morbidities. Part of what Ms. Goldberg related to the emergency room physician helped the doctor to avoid an entire series of costly tests. As a nurse, Ms. Goldberg pointed out the symptoms of a urinary tract infection, so that the hospital could treat the reason for her medical decline without putting her through an unnecessary, comprehensive work up. As part of this process, the Care Manager put Mrs. Sweetheart’s primary care physician in contact with the emergency room physician so that they could appropriately coordinate her care.
During this process, the aide, was able to remain with the Mrs. Sweetheart and provide her with emotional support and comfort by letting her know that the Care Manager and both physicians were working together to provide her with appropriate medical care. Having the aide, who she knew well and trusted, helped Mrs. Sweetheart to remain calm and reassured during all of the hours in the ER despite her temporary confusion. When Mrs. Sweetheart was finally admitted with the diagnosis of a urinary tract infection, dehydration and anemia, she was treated with antibiotics, IV therapy, and 2 pints of blood.
Mrs. Sweetheart was spared unnecessary and costly medical tests and the stress that goes with them. Her primary physician was able to be included in her care and her aide was
with her so that she wouldn’t be alone and frightened. Because of the efficiency of the diagnosis and treatment, Mrs. Sweetheart made a good recovery from these conditions. When she was ready for discharge the Care Manager worked with the discharge planner from the hospital to assure that she would get the appropriate follow up care and equipment at home.
Mrs. Sweetheart made a good recovery from this episode, despite her other pre-existing conditions. Her memory was restored and she regained her energy. The Care Manager continues to have close, teamwork approach to providing services along with the primary physician and the home healthcare aide. The physician recognizes that Ms. Goldberg’s intimate knowledge of Mrs. Sweetheart’s conditions and needs extends his ability to care for his patient into the home and even into a hospital at which he does not have privileges! Because of the success of this relationship the Care Manager and the primary care physician are better able to care for mutual clients. Mrs. Sweetheart is happy with her team of “caring hearts” and is very happy to be back at her Home “Sweet” Home.
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Geriatric Care Managers, Where Are You?
By Marilynn Larkin
"Larkin's Links"
Age Beat Online Newsletter of the Journalists Exchange on Aging (JEoA)
Feb. 12, 2008 -- Volume 8, Number 4
What should probably be the most vocal and available group right now turns out to be a best-kept secret. A few years ago, when it was clear that my mother needed some kind of help or monitoring, my brother and I were at a loss, until a colleague on the age beat pointed me to the RONA BARTELSTONE agency (www.rbacare.com). Through the agency, we secured a wonderful geriatric care manager in Florida, who oversaw my mother's care until we moved her into an assisted living facility (Encore Senior Village - a gem).
But if I hadn't known someone who knew of such an agency, I would not have known where to turn. This was brought home to me recently, when a long-time friend e-mailed me that a mutual acquaintance had Parkinson's disease and was in a nursing facility here in New York City. Trouble is, he doesn't belong in a nursing facility - he's cognitively intact and may not even have Parkinson's. I visited him and was appalled by his situation in a facility that leaves much to be desired. What to do? I called my mother's former care manager; he recommended a colleague - also a geriatric care manager - who is now overseeing my friend's move to another, more appropriate facility.
But if my other friend hadn't happened to mention it in an email, our mutual colleague would still be languishing. Here's the kicker: Both are certified social workers, but neither was aware of a profession known as geriatric care management. Why? At a time when so many of us are dealing with ailing parents both nearby and afar, shouldn't this resource be more widely known? I also learned about the National Association of Care Managers (http://www.napgcm.org). My mother's former care manager told me it's important to choose a care manager who is not paid by facilities for "placements." Reporters need to let the public know about this and other criteria we should look for in a care manager - and how to put these professionals "front of mind" for those of us who are not doing direct care.
Marilynn Larkin regularly contributes "Larkin's Links" to Age Beat Online.
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