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"Being in the present": the meaning of the interaction between older persons with Alzheimer's disease and a therapy dog
Sophiahemmet University.ORCID iD: 0000-0002-0781-3771
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The number of persons with Alzheimer’s disease is increasing world-wide and the disease affects the persons, their families, the health care system and the economy within society worldwide. The symptoms and behaviours caused by Alzheimer’ disease may be difficult to manage for the person and their caregivers. Alternative methods are recommended before pharmacological treatment. The presence of a therapy dog has been described as beneficial, in for instance increasing well-being and alleviating symptoms and dementia behaviours. The overall aim of this thesis was to gain a deeper understanding of the influence of therapy dogs on persons with Alzheimer’s disease from the person’s and the dog handler’s perspectives. Further, adopting a longitudinal perspective, the study investigates the therapy dog’s influence on activity and sleep for persons with Alzheimer’s disease. Video observations of five persons with Alzheimer’s disease interacting with a therapy dog (I, II), as well as interviews with nine dog handlers (III) were gathered and transcribed. Data was analyzed using a phenomenological hermeneutical method (I, II, III). Registration of activity and sleep was conducted over a period of 16 weeks using an Actigraf that generated curves, and were then analysed using descriptive statistics (III). The time spent with the dog revealed memories and feelings resulting in existential thoughts of oneself and life, which then connected to the present situation (I). Distancing oneself from the symptoms of the disease when interacting with the dog showed a person functioning in the present with the dog, striving for the dog’s best and putting the dog before and above oneself (II). The therapy dog’s presence showed no pattern of effect on the patients’ daytime activity and sleep. The findings instead pointed to a great variety of possible different effects, bringing about increased activity at different time points, for example during night-time sleep (III), creating a respite from illness and contributing wordlessly to an existence but thoroughly directed by the dog handler, where the person was comfortable and took the initiative (IV). In conclusion, the therapy dog team’s presence with the person with Alzheimer’s disease induced meaning that allowed the person’s hidden qualities and abilities to develop and, when observed from a person-centred perspective, also brought out the individual in each person

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2015. , 69 p.
Keyword [en]
Animal-assisted therapy, Alzheimer's disease, Descriptive statistics, Lifeworld, Memories, Person-centred care, Phenomenological hermeneutics, Therapy dog
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-1828ISBN: 978-91-7549-847-8 (print)OAI: oai:DiVA.org:shh-1828DiVA: diva2:801099
Public defence
2015-04-17, H3 blå, Alfred Nobels Allé 23, Huddinge, 09:00
Opponent
Supervisors
Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2016-06-09Bibliographically approved
List of papers
1. Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?
Open this publication in new window or tab >>Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?
2015 (English)In: International journal of older people nursing, ISSN 1748-3743, Vol. 10, no 2, 84-93 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.

AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.

METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach.

RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.

CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia.

IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

Keyword
Alzheimer's disease, Caring, Existence, Memories, Phenomenological hermeneutics, Therapy dog
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-1599 (URN)10.1111/opn.12053 (DOI)24814254 (PubMedID)
Available from: 2014-06-11 Created: 2014-06-11 Last updated: 2015-06-10Bibliographically approved
2. 'Stepping out of the shadows of Alzheimer's disease': a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dog
Open this publication in new window or tab >>'Stepping out of the shadows of Alzheimer's disease': a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dog
(English)Article in journal (Refereed) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-1826 (URN)
Available from: 2015-04-01 Created: 2015-04-01 Last updated: 2015-04-08Bibliographically approved
3. A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease: a case study
Open this publication in new window or tab >>A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease: a case study
2014 (English)In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 2, no 4, 80-93 p.Article in journal (Refereed) Published
Abstract [en]

Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease.

Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics.

Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep.

Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.

Keyword
Alzheimer's disease, Animal-assisted therapy, Activity, Nursing, Sleep
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-1689 (URN)10.5430/cns.v2n4p80 (DOI)
Available from: 2014-09-18 Created: 2014-09-18 Last updated: 2015-04-08Bibliographically approved
4. 'Bringing respite in the burden of illness': dog handlers experience of visiting older persons with dementia together with a therapy dog
Open this publication in new window or tab >>'Bringing respite in the burden of illness': dog handlers experience of visiting older persons with dementia together with a therapy dog
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 15-16, 2223-31 p.Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To illuminate meanings of the lived experiences of dog handlers' when visiting older persons with dementia with their therapy dog.

BACKGROUND:

Studies indicate that care of persons with dementia should focus on a person-centred approach with the person's interests in the centre. Animal-assisted therapy using a therapy dog in the care of persons with dementia has been shown to increase well-being and decrease problematic behaviours associated with the illness.

DESIGN:

A qualitative lifeworld approach was adopted for this study.

METHODS:

Data were collected from open-ended interviews with nine dog handlers, and the analysis conducted using the phenomenological hermeneutical method.

RESULTS:

The structural analysis resulted in one theme, 'Respite from the burden of illness for persons with dementia'.

CONCLUSIONS:

Visiting a person with dementia can be seen as an act of caring, providing temporary respite from their illness, and creating a special relationship between handler and patient. A therapy dog visit can represent a moment of communion between the handler and the person with dementia.

IMPLICATION FOR CLINICAL PRACTICE:

Dog handlers use their skills and knowledge to promote a situation that reduces symptoms of illness and encourages healthier behaviour. The results of this study may be of interest to researchers, clinical practitioners, caregivers and dog handlers who care for persons with dementia using therapy dog teams on prescription as an alternative method to minimise behavioural and psychological symptoms of dementia.

Keyword
Caring; Dementia; Dog handlers; Person-centredness; Phenomenological hermeneutics; Therapy dog; Well-being
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-1827 (URN)10.1111/jocn.13261 (DOI)27277921 (PubMedID)
External cooperation:
Available from: 2015-04-01 Created: 2015-04-01 Last updated: 2016-09-02Bibliographically approved

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