Exploring the Effect of Pet

Visitations on Long-term Care

Residents With Dementia

Rebecca Savage RN
Bethel College
Abstract
More that 7 million Americans living with dementia
(Alzheimers Association, 2013).
Every 68 seconds someone is diagnosed.
Many become a burden to family leads to Long-term
placement.
High incidence of depression, decrease socialization
and engagement.
Goal is to improve overall well being.
CDC reports 3.2 million residents reside in LTC. (CDC,
2013).
Often lack skills for successful communication
Often placed in LTC because families can not manage
dementia related behaviors (Kolanowski, 2006).
Inactivity or low levels of engagement contribute to
poor overall well being (Buettner-Fitzsimmons, 2011)
Statement of the Problem
Decreased social interactions
Depression
Decreased Engagement
All affect overall well being. (Gonzalez-Salvador,2000).
Conceptual Framework of Pet
Visitations
Overall
wellbeing
of
Residents
Engagement
Socialization
Depression
Purpose of the Study
Explore the effect of pet visitations.
Improve social interactions
Decrease signs and symptoms of depression.
Improve overall well-being.
Find alternative ways to reduce negative behaviors.
Variables affecting residents
overall well-being


Pet Visitations
Independent
Variable
Engagement
Socialization
Decrease signs/symptoms
of depression
Overall wellbeing improved
Independent
Variables
Research Questions
1. Based on the theory of human energy field, will
providing scheduled pet visitations decrease signs and
symptoms of depression?
2. Can providing pet visitations increase socialization
by decreasing the occurrence of negative behaviors in
dementia patients?
3. Can providing pet visitations improve engagement
in patients with dementia?

Hypotheses
Ho= Pet visitations will improve the well being in
residents with dementia by decreasing signs and
symptoms of depression, decreasing incidences of
socially unaccepted behaviors and improving residents
engagement.
H1 = Pet visitation will not improve the well being in
residents with dementia by decreasing signs and
symptoms of depression, decreasing incidences of
socially unaccepted behaviors and improving residents
engagement
Definition of terms
Well-being= defined in terms of health and happiness.
Engagement= the act of involvement in your
surroundings, participation (Worden, 2013).
Socialization= participation, the act of learning or
positively engaging with others.
Depression= depressed mood or loss of interest or
pleasure in usual activities. May display negative
behaviors.
Theoretical Framework
Martha Rogers philosophy of unitary thinking.
The patient and their universe interact as a whole
(Rogers, 1970).
Believed everything in patients universe impacted
health and well-being.
Proposed research= introducing a pet into the patients
universe to improve overall well-being..
Literature Review
Ebscohost and CINAHL database.
Key words= dog therapy, nursing home residents,
dementia, engagement, pet visitation, elderly,
engagement, depression, socialization, activities, and
behavior management.
42 articles reviewed.
Full text articles, written or translated in English.
Theoretical Literature
Managing behaviors in dementia is challenging aspect
to care (Gitlin, 2010)
Pharmacological treatments often treatment of choice.
90% dementia residents experience some behavior or
psychological symptoms
Restlessness, depression, anxiety, hallucinations,
delusions and psychosis common (LTCCC, 2013)
Cont.
Antipsychotic use can be harmful.
Increase in sedation, dizziness which leads to falls.
Strong link between negative behaviors and decrease
in socialization (Cipriani, 2011).
50% of dementia patients suffer depression (Sink,
2005).
Study suggested pleasurable stimuli can increase
engagement (Cohen-Manfield et al, 2010)
Empirical Literature
ENGAGEMENT
Kolanowski studied using Rogers methodology.
30 LTC residents with dementia, 12 days, 20 minute
activity sessions.
2 control groups, planned activities vs. no planned
activities.
Study showed improvement in engagement influences
overall well-being.
Depression
Sink et al, studied the impact of animal-assisted
therapy on eight female LTC residents with dementia.
Used state assessment tool.
No significant difference in mood or depression,
improvement noted in apathy.
63% of participants wanted to continue activity, stated
they liked the dogs.
Pilot study in Australia
Group setting
6 week long study
Variety of animals used in study.
No improvement noted in depression.
Participants verbalized a decrease in loneliness.
Socialization
Hall and Malpus (2002) examined effects of pet therapy with
psychiatric patients.
4 residents where chosen and sessions were video taped.
Coders tallied the presence of designated behaviors.
Behaviors targeted were noted decreased.
Animal assisted therapy has potential to improve overall
wellbeing (Sellers,2008).
The literature shows range of benefits from pet therapy.
Improved engagement (Kolanowski, 2006)
Social interactions (Motomura, 2004)
Play, laughter, comfort and enjoyment (Hall and
Malpus, 2002)
Methodology
Research Design
This study will be correlational quasi-experimental.
Use Martha Rogers theory of human energy field as
guidance.
Data collected pre and post pet visitations.
Pet visitations will last 12 weeks, 2 one hour visits each
week.

Intervention
Experienced volunteers
Canine Good Citizen certifications
Same pet and handler each week.
Pet will be between 50-60 lbs.
Group setting consisting of 24 residents.
Sampling
Purposive sampling
Inclusive criteria, diagnosis of dementia and reside on unit.
Exclusion criteria, residents admitted to unit after study has
started and/or no consent on file.
Average age 67-92 years old.
20 female participants, 4 male
20 Caucasian, 3 African Americans and 1 Hispanic.

Setting
Will be conducted in Elkhart, IN.
All participants reside in LTC facility and are on secure
unit.
Instrumentation
Minimum Data Set (MDS)
Contains items to measure:
Physical well-being
Current clinical issues
Psychological factors like dementia or depression
Psycho-social functioning
Documented behaviors
Mini mental state examination (MMSE)
Personal Health Questionnaire (PHQ-9)
Daily activity attendance records.
Monthly behavioral flow records.
PRN psychotropic medication usage
Data Collection/Analysis
Procedure
Data will be collected on 2 occasions.
One week prior to pet visitations (baseline).
2 weeks after the pet visitations completed.
Researcher who is RN will obtain data.
McNemar analytical analysis of data.
Independent variable (Pet visitations) can be affected
by the dependent variables (depression, engagement
and socialization).
Protection of Human Rights
Will not be conducted until approval received from
Bethel College IRB.
Voluntary participation.
Will obtain written consents from all participants power
of attorney (POA).
Known risks- allergy to dog, fear of dog.
All participants will be assigned a number to protect
confidentiality.
Cont.
Researcher to keep confidential code book.
No identifying data will be reported.
Data collected will be kept in locked file for a minimum
of three years.
Study and information pertaining to it will be kept on
password protected flash drive.
Significance of Study
Number of those diagnosed with dementia continues to
grow.
Explore non-pharmological interventions
Improve overall well-being, while keeping them safe.

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