The Case for Robotic Companion Pets in Dementia Care

A woman with dementia and her care partner interact with a robotic companion cat.

We’ve known the benefits of pet therapy for decades; however, care settings may be concerned about safety issues and commitment to maintaining an animal on site. Research on therapeutic assistive robotic pets has emerged in the last decade. Robotic companion pets offer an alternative to, or complement traditional pet therapy and have been shown to have similar positive effects.

Robotic companion pets provide a useful alternative when live animals aren’t feasible. Live pets in care settings bring both benefits and risks. Often the risk prohibits live pets or limits them to only occasional visits. Robotic companion pets have minimal risk associated with them, and research has shown that people with dementia experience similar benefits as interacting with live animals. Used on-demand, robotic pets eliminates scheduling issues. As a result, elders enjoy the benefit of a relationship with a Pet as they desire it.

Benefits of Companion Pets:

These beneficial effects were reported in research studies and observations described by care partners.

Increased Interaction with Others and the Surroundings

  • Increased social interaction between elders when sharing time with the Pet.
  • Some showed greater interest in what was happening in their surroundings.
  • The conversation became more spontaneous.

 Connection to Memories

  • The Pet stimulated sharing memories of the experience with family pets.

Increased Feelings of Self Worth

  • The Pet seemed to restore a sense of purpose while caring for it through brushing, petting, and talking to it.

Decreased Anxiety and Agitation

  • Interacting with the Pet seemed to ease anxiety and, in turn, lessened challenging behavior.

Improved Mood

  • Exhibited playfulness.
  • Facial expression brightened with a smile.

 Physical Response

  • Movement increased while reaching for, holding, and petting the Pet.
  • Elders responded to the tactile (sense of touch) stimulation of the Pet.
  • One study found oxygen saturation increased while interacting with the Pet, apparently from increased motor activity, talking and otherwise interacting with the Pet, resulting in increased respiration.

Reduced Care Partner Burden

  • Some elders cooperate more easily during routine ADL following interaction with the Pet.
  • Many enjoy lingering positive effects following interaction with the Pet and can participate in other activities with more considerable attention.

With Alzheimer’s disease and other forms of dementia on the rise worldwide, there’s a greater need for creative approaches to improve well-being and ease distressed behavior so typical in people with dementia.  Robotic companion pets could play an essential role in the emotional and social wellbeing of people living with dementia in nursing homes, home care, day memory support, hospitals, and hospice settings.

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

Loneliness in Older Adults: What’s the Impact?

 

In the past, I assumed that people living in long term care were most vulnerable to feeling lonely. But a situation that arose at a Compassionate Touch workshop taught me otherwise. We were at a large, upscale retirement community.  Some lived in beautiful three bedroom houses.  We typically worked with people in skilled care.  But this particular day, we visited people who lived independently. Therefore I was concerned the training attendees wouldn’t have the desired experience. One participant returned from her visit, visibly shaken.  She reported that the woman she visited had a beautiful home and was well-dressed, but she seemed extremely isolated, lonely, and depressed.  We can’t assume that because an elder still lives “independently” that they are engaged with other people or lead meaningful lives.

The University of California San Francisco completed a study that confirms that loneliness in older adults leads to more rapid physical and mental decline and even death.  According to the study, “The lonely seniors had a 59 percent greater risk of suffering a decline in function, which was defined as being less mobile or less able to take care of daily activities like bathing.”

I often hear isolation and loneliness used together. What’s the difference? Isolation is simply having little contact with other people. It’s an objective measure of the quantity of interaction.  Loneliness is a subjective experience. Lonely people feel distressed by lacking the desired companionship. The key is feeling distressed. Research from the National Institute on Aging suggests that simply living alone doesn’t always lead to loneliness. The experience is quite individual. Some people live alone but lead satisfying lives, while others have others around them, but still, feel lonely.

Seniors living in their own homes may suffer most from isolation. Our society does not foster the idea of caring for our older neighbors. Families today scatter across the country. Lots of older people look forward to doctor’s visits because it’s the highlight of their week.

We will all be older. Maybe we can create some goodwill that will be paid forward to us if we pay attention to our elder neighbors now. We don’t have to look far to visit an elder in need of companionship.

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

 

Is it Possible for Doctors to Provide Compassionate Care?

The Physician’s Oath promises to approach all patients with integrity, candor, empathy, and respect.  I believe that most doctors take their oath seriously.  I believe most doctors study very hard because they truly want to help other people and make a positive difference in the field of medicine.  Doctors have a tremendous responsibility in today’s messy healthcare environment.  They work long hours, have many patients and deal with lots of complications to ultimately deliver the care that their patients need.  So, is it really possible for doctors to provide compassionate care?

I will speak only from a patient and patient advocate perspective, after having been a caregiver to my aging parents for many years.  Most doctors want to listen to their patients and get to know them beyond their medical conditions.  I really believe that.  I think most doctors would agree that the complexities of healthcare take away from the time they would like to spend with their patients and families so that they can be a source of compassion and guidance.

For doctors to provide compassionate care, they must have time.  Unfortunately,  this is rarely a luxury, if at all.  Treating patients medical needs is first and foremost when it comes down to it.  Having the time to converse and get to know their patients is almost unheard of these days.  So how can doctors provide compassionate care when the odds are stacked against them in so many ways.

In dementia training, we teach the importance of eye-to-eye contact,  slowing down, speaking with respect to another person, gently holding one’s hand to provide comfort among other simple gestures. These are signs of compassionate care that take no more time than the alternative.  Sometimes a smile or caring concern is all it takes to quickly make another person feel like they are important to another person – even if it’s brief.

Doctors are fixers, and it’s natural in their hurried days to be focused on fixing what’s wrong.  And no doubt that is monumentally important.  As healers, though, a doctor can and should practice compassionate care even though the odds are often stacked against you.  Compassionate care can be taught, learned and passed on to others. It’s an emotional, spiritual and transformational gift that you give another person shown with the simplest of gestures.

Compassion can be felt by another just by the gift of your genuine presence.

Pam Brandon is President of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the Dementia Live® Simulation and Awareness Program.  

The NICHE difference: Preparing Our Long-Term Care Workforce for Tomorrow

We are thrilled to have recently announced our collaboration with NICHE – Nurses Improving Care for Healthsystem Elders, a nation-wide nursing education and consultation program designed to improve geriatric care in healthcare organizations through education and mentorship.

The NICHE Acute Care Program, founded in 1992 is part of NYU Rory Meyers College of Nursing.  The program promotes the use of evidence-based clinical interventions and establishes nurses as leaders to effect positive change in caring for the growing aging population.  NICHE empowers front-line nurses to build a team and develop organizational and workforce competencies to improve the health and wellbeing of older adults they serve.

The NICHE long-term care(LTC) program prepares nurses and certified nurse assistants (CNAs) to achieve organizational goals for the care of older adults patients.  The NICHE-LTC promotes the use of evidence-based clinical interventions and establishes nurses as leaders to bring about changes in the quality of care delivered to older adults in LTC and PAC (post-acute care) facilities.

The LTC curriculum is designed around the Centers for Medicare and Medicaid Services (CMS) Five-Star Quality Rating System so organizations uphold the nationally recognized standards for LTC.  A few examples of Quality Measures include:

  • Ability to move independently and participate in activities of daily living
  • High-risk residents with pressure ulcers
  • Re-hospitalizations, emergency department visits, and discharge to the community
  • Moderate to severe pain
  • Falls with major injury
  • Antipsychotic medications

NICHE resources include highly engaging webinars, Need to Know patient and family consumerism, LTC Leadership Training, Implementation Courses, and Clinical and Quality Improvement Modules, and an Evaluation and Recognition Process.

Our shared mission that quality training empowers staff will lead to higher CNA retention and improved care:

  • Nursing homes whose nursing staff have enhanced knowledge and skills perform better on quality metrics.
  • CNA’s who receive specialized training on common health issues experienced by older adults are capable of providing better care to residents and feel more confident in performing their work.
  • Opportunities for CNAs to participate in training programs not only empower them with knowledge and skills to carry out their work but also reinforce their important role in achieving organization-wide quality improvement goals.
  • CNA’s who receive high-quality training are more likely to report that they are satisfied with their jobs and job satisfaction is directly linked to CNA retention.

Quality elder care is critically important and NICHE programs provide the tools and resources that elevate Acute and Long-Term care organizations to a level of excellence.  As the need for dementia training increases, our relationship with NICHE will serve to better prepare the workforce for the special needs of those living with cognitive differences.

Pam Brandon is President/Founder of AGE–u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  Pam is the creator of the Dementia Live® Sensitivity Awareness Training program and led the development of  the Compassionate Touch® training for persons living with Dementia and End-of-Life care.  

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