From the Article:
The Healthy Pleasure of Their Company: Companion Animals
and Human Health
Karen Allen, School of Medicine, State University of New York at Buffalo
Although the idea of the therapeutic value of pets for elderly people has widespread appeal and endorsement from the media, there have been few scientific investigations that actually link the presence of companion animals to changes in physical or mental health status. In a 1984 review paper Beck and Katcher (1984) concluded that most studies had either no impact or demonstrated only small therapeutic gains. Designing and conducting scientifically valid intervention research about the possible influence of pets on elderly people who live in nursing homes is exceptionally difficult. In contrast, a study looking at physiological responses of healthy young people is far easier to carry out, and does not have the ethical concerns inherent in giving something to one group of elderly people but not to another.
Perhaps as a consequence of this difficulty, over the past decade a shift in research approach appears to have occurred. Investigators have begun to place increased focus on understanding how pets may contribute indirectly to health by being part of a positive nursing home environment rather than on how pets can be independently related to improved health. One such study (Winkler, Fairnie, Gericevich, & Long, 1989) looked at the impact of a resident dog on social interactions among and between residents and staff of a nursing home and found that the introduction of a resident pet acted as a catalyst for social interaction. The increased social behavior, however, was short-lived and disappeared within three months. Fick (1993) also explored social interactions, but only among nursing home residents in a group occupational therapy setting. In this study the presence of the dog had a positive effect as an adjunct to another therapy and was associated with a significant difference in verbal interactions.
Another investigation (Hendy, 1987) explored the effects of visits by pets and/or people and found that although individuals responded well to pets alone and to pets with people, interactions with people alone were associated with the greatest number of positive resident behaviors. Despite their findings that pets alone cannot change some realities of nursing homes, studies of this type make important contributions to our understanding of the circumstances and environments in which pets can be beneficial. Such results emphasize the importance of examining multiple social factors in designing nursing home environments and can contribute to improved research designs in future studies.
Although it is difficult to carry out scientific studies about the effects of pets on residents of nursing homes, a recent innovative effort by Thomas (1994) demonstrates it is possible. As medical director of a nursing home, Thomas decided to create a totally new environment for residents. He envisioned home-like surroundings with companion animals, flower and vegetable gardens, visiting school children, and on-site day care for younger children. He committed himself and his staff to the eradication of loneliness, helplessness, and boredom, and built a humane environment he calls the Eden Alternative. Nearly 100 birds (parakeets, lovebirds, finches, and canaries) live in residents' rooms. Two dogs and four cats roam freely throughout the living quarters and interact with residents all day. Outdoors there are rabbits and chickens and Thomas has learned that the more diverse and complex a human habitat becomes, the greater the potential for meaningful interaction.
In order to test the effectiveness of the new environment Thomas compared residents in his nursing home with a control group, i.e., residents in a nearby nursing home who were similar in age and cultural background. Over a two-year period he documented dramatic reductions among the Eden group in the use of psychotropic drugs for mind and mood altering. Such reductions are in marked contrast to high national and regional levels of use in United States nursing homes. Another part of the evaluation of the intervention involved a focus on mortality rate in the two nursing homes. During the first 18 months following arrival of the animals, plants, and children, there were 15% fewer deaths in the Eden group, relative to the control group. As the study progressed, this percentage increased. Residents of both homes had equal levels of function, so people in the Eden group did not just live longer because they were healthier. Instead, Thomas suggests that the difference in death rates is related to the fundamental human need for a reason to live. As a scientist Thomas cannot say with certainty that a patient would not have lived without parakeets, but as a clinician he has observed that the patient's commitment to the animals engendered an intense need to keep living in order to care for them.
Thomas' emphasis on environmental change is an excellent model for future investigations involving elderly people and companion animals. With a small research grant and creative thinking it was possible to simulate a home-like environment and document its effects. This approach makes eminently more sense than repeatedly trying to demonstrate that the presence of a pet changes one small behavior in a nursing home resident's life. Following a pattern similar to that of Thomas, Cookman (1996) suggests that attachments of elderly people to things, places, pets, and ideas in their environment are important sources of security, belonging, and self-identity.
Elderly people who live in rented housing are often prohibited from having companion animals. In order to make a credible case for change in rental policies it is necessary to do research that increases understanding of the potential benefits and nature of relationships between elderly individuals and their pets. The environment of socially isolated elderly women living in their own homes was the focus of a physiology study (Allen, Gross, & Izzo, 1997) in which resting blood pressures were explored over a six-month period. Relative to their counterparts without pets, pet owners had significantly lower systolic and diastolic blood pressures. In addition, elderly pet owners with few (human) social contacts had blood pressures comparable to those of young women. Participants had cats or dogs and, although no species-related differences were found, attachment to the pet was a very important factor. The notable finding here is that, although increases in blood pressure are a normal part of aging, social support provided by people and/or pets can moderate age-related increases.
Another community-based study looked at home environments of elderly people with and without dogs (Dembicki & Anderson, 1996). In this cross-sectional, observational study it was found that dog owners walked significantly longer than non-owners. In addition, increased walking was associated with significantly lower serum triglycerides among elderly pet owners. The authors of this study are social services professionals and suggest that in the context of adult development and aging, pet ownership could be another aid to living that should be encouraged and assisted by local service programs.
Siegel (1990) investigated physician use among elderly individuals with and without pets and found that individuals who owned pets and were experiencing stressful life events reported significantly fewer contacts with doctors than those without pets. Participants in this study reported that their pets, especially dogs, helped them in times of stress. A study of community dwelling elderly people in a rural area (Lago, Delayney, Miller, & Grill, 1989) found that attitudes toward pets and pet ownership were significant predictors of positive morale and self-reported health status. In a ten-month investigation that followed adults who had recently acquired a pet, Serpell (1991) reported a reduction in minor health problems during the first month after pet acqusition. For dog owners, this effect was sustained throughout the study and suggests that pets may influence perceptions of stress.
Finally, in a study by Peretti (1990), friendship bonds between elderly people and their pets were explored. Data collection for this survey study took place over ten months and all participants were walking their dogs in a metropolitan area public park. An open-ended questionnaire asked about personal attitudes and feelings toward pets. An especially revealing finding was the high percentage of participants who said that their dogs were their only friends (78% of men and 67% of females), and that the friendship bonds they had with dogs were as strong as any they had experienced with humans. Descriptive responses about relationships with dogs fell into the following five areas: (1) Companionship; (2) Emotional Bond; (3) Usefulness; (4) Loyalty; and (5) No Negotiation. The notion of a friendship involving no negotiation is especially intriguing. By this the respondents described the straightforward interaction devoid of artificial comments and social dealing that is possible with dogs, but not people. This study adds significantly to understanding and appreciation of the meaning of dogs in the lives of elderly people who often are isolated. It found that pets fulfilled their owners' psychological needs for attachment and nurturance. Although the study did not use health as an outcome measure, given what is known about the relationship between health and social support, the findings are significant.
