People and animals have always had a special relationship. In primitive societies, animals provided some degree of warmth and safety. Today, animals are not only pets that provide social support but also working companions for people with physical and mental challenges. Why are animals so important to us and how do they affect our health and well-being?

Researchers studying the bond between humans and animals are learning that the interdependence benefits both. Pet ownership and human-animal interactions provide physical and psychosocial advantages. In fact, interacting with pets can improve our health and well-being in many ways, including by reducing blood pressure during times of stress and easing the pain of loneliness.

By providing the benefits of human-animal interactions, pet therapy can promote a patient’s health and recovery. And you can use this creative intervention for patients in almost any setting—even patients who don’t have pets.

Visits from the patient’s pet

Pets depend on their owners not only for food and shelter but also for love, exercise, and socialization. And pets provide their owners with emotional support and companionship. As nurses, we must understand that a pet may be regarded as a family member and heavily relied upon for emotional support. When separated from their pets during a hospital stay, patients may experience a sense of loss and sadness that adds to their stress and anxiety.

Patients may express concern for a pet at home and need to know that the pet’s physical and emotional needs are being met. To help such a patient, you can arrange for a responsible person to care for the pet during and after hospitalization. Also, encouraging patients to talk about their pets may help comfort them. And if permitted by your facility, you can arrange for a brief pet visit by acting as a facilitator for a patient, family members, and social workers.

Animal-assisted activity

These animals provide entertainment, diversion, sensory stimulation, and an opportunity for reminiscences. In long-term care facilities, the activity director is usually the person responsible for organizing regular group or individual AAA visits. Hospital visits may be organized by a nurse with an interest in AAA, a nurse manager, or a social worker. Community-health nurses may organize AAA visits for community-dwelling patients in their homes.

In facilities, pet visitation programs may have patients, pets, and their handlers in a designated area. Or the pet and handler may go from room to room for personal visits. Although dogs are the most common visiting pets, cats, horses, rabbits, birds, llamas, and even potbellied pigs have been used!

Animal-assisted therapy

Animal-assisted Therapy (AAT) is an applied science that uses animals to solve problems. Specifically, this interdisciplinary therapy uses animals to facilitate goal-directed interactions as an integral part of the treatment process. For example, to increase arm mobility in a stroke patient, the AAT intervention would be petting or brushing a dog as an active range-of-motion exercise.

Delivered by a healthcare professional, AAT consists of an individually designed program to improve a patient’s physical, social, emotional, and cognitive functioning. The therapy can be provided in many settings, including hospitals, long-term care facilities, palliative care settings, and rehabilitation facilities. To document the outcomes of the interventions, the provider uses assessment and evaluation procedures.

Plan, implement, and evaluate

AAA and AAT programs depend on the needs and resources of the facility and the needs of patients or residents. All components of a program must be carefully planned, implemented, and evaluated. For example, before a visit, the charge nurse must create a list of patients who want (and are permitted) to participate. Patients with isolation precautions or an allergy to animals aren’t eligible. The nurse also obtains verbal consent from the parents of underage patients and from the roommates of patients. Plus, the charge nurse instructs staff, patients, and handlers on the importance of hand washing and places a cloth sheet between the patient’s top sheet and the animal. For AAT, the nurse’s involvement and specific duties should be described in the care plan.

During the visit, a certified dog interacts only with the patients. The coordinator will end a dog visit if the patient shows signs of distress, becomes agitated, or wants the visit to end. A visit also ends if the dog becomes agitated.

The program coordinator conducts an ongoing evaluation of the program and solves problems that arise. Such evaluations include assessing the patient and family responses to the program as well as the patient, staff, hospital, and community perceptions of it. The success of an animal visiting program hinges on the nurses’ interest in and support of the program.

When conducted correctly, AAA and AAT are safe, gentle, loving therapies that benefit both pets and people. The number of these programs is increasing in a wide variety of healthcare facilities in the United States. Research into the human-

companion animal interaction is growing rapidly, with animals being studied in our daily environment in an owner-pet relationship and in a therapeutic context in AAA and AAT. For more information, visit the websites of the Delta Society—http://www.deltasociety.org/—and the College of Veterinary Medicine, University of Missouri-Columbia Research Center for

Human-Animal Interaction—http://rechai.missouri.edu/.

Selected references

Banks MR, Banks WA. The effects of animal-assisted therapy on loneliness in an elderly population in long-term care facilities. J Gerontol A Biol Sci Med Sci. 2002;57(7):M428-M432.

Barker SB, Rogers C, Turner J, Karp A. Suthers-McCabe M. Benefits of interacting with companion animals: a bibliography of articles published in refereed journals during the past 5 years. American Behavioral Scientist. 2003;47(1):94-99.

Centers for Disease Control and Prevention/Healthcare Infection Control Practices Advisory Committee. Guideline for environmental infection control in health-care facilities, 2003. www.cdc.gov/ncidod/dhqp/gl_environinfection.html. Accessed March 7, 2008.

Nimer J, Lundahl B. Animal-assisted therapy: a meta-analysis. Anthrozoos. 2007;20(3):225-238.

Sehulster LM, Chinn RYW, Arduino MJ, et al. Guidelines for Environmental Infection Control in Health-Care Facilities. Recommendations from CDC and the Healthcare Infection Control Practices Advisory Committee. Chicago, IL: American Society for Healthcare Engineering/American Hospital Association; 2004. www.cdc.gov/ncidod/hip/enviro/guide.htm. Accessed March 7, 2008.

Charlotte McKenney is a Project Director and Assistant Director at the Research Center for Human-Animal Interaction at the College of Veterinary Medicine at the University of Missouri in Columbia. Rebecca Johnson is Millsap Professor of Gerontological Nursing at the Sinclair School of Nursing and Director at the Research Center for Human-Animal Interaction at the College of Veterinary Medicine at the University of Missouri in Columbia.