Study on the Effects of Dog-Assisted Therapies on Physical and Psychological Well-Being in the Institutionalized Elderly, Year II

Project location: ITALY, Rome
Project start date: December 2009 - Project end date: May 2010
Project number: 2010-27
Beneficiary: ANUCSS


Thanks to a one-year grant by the Nando Peretti Foundation (year 2008) the association has conducted a pilot experience on AAT. Results are very promising and show that in the socialization sessions, the activities performed with the dog have been extremely successful and engaging. These sessions are a fundamental time for elderly individuals to meet with the others and socialize in a structured way. The presence of the dog increases responsiveness facilitates mental alertness and enhances an outward focus on the environment. The atmosphere in the presence of the dogs becomes fresh and colored favoring positive thinking also in those subjects that have a tendency to be more isolated and that show a depressed mood. Indeed, this activity is able to stimulate cognitive function in those elderly subjects which are characterized by a certain degree of dementia, reducing the sense of isolation often characterizing subjects living for long periods in nursing homes.
In addition, physiological data indicate that stress hormones are reduced in the presence of the dog. Results obtained in the course of this study have been presented at the Course organized by ISS "Terapie e Attività Assistite in Italia: attualità, prospettive e proposta di linee guida", and are now being published in the Rapporto Istisan, an online publication by ISS.

This project received a grant from the NPF. Its objectives are the following:

Develop innovative and standardized methodologies based on human-animal interactions for the care of the institutionalized elderly. Considering the preliminary data collected during the previous year, funding for an additional year will allow to increase the sample size and verify previous observations suggesting an important effect of dog-assisted therapies in preventing the isolation and stress characterizing institutionalized elderly people.

Three elderly nursing homes (Residenza Sanitaria Assistenziale, RSA) in the Lazio Region of Italy will be invited to take part in the project.
Multidisciplinary and integrated Pet therapy Group. The Staff of the Associazione Nazionale Utilizzo del cane per scopi sociali (ANUCSS ONLUS) organized in couples of conductors-therapy dogs and made of selected personnel with a high degree of experience in Pet therapy (psychologists, professional teachers, veterinarians, social workers) will be in charge of the planning and realization of the Assisted Therapies with animals. The association has a long-standing (more than ten years) experience in the field of AAT and is experienced in elderly subjects in nursing homes.

Time frame
Phase I (1-6 months)

Elderly subjects, age ranging between 60 and 80 years, will be recruited with the collaboration of general practitioners or nurses operating within the facilities, selected and subdivided into two groups, homogeneous for age and clinical condition. In an initial selection procedure, those residents presenting major somatic deterioration (non-autonomous elderly) or significant cognitive impairment, as revealed by the mini mental state examination (MMSE), will be excluded.

The elderly residents admitted to the trial will be randomly subdivided into two groups:
a) control group (no AAT);
b) exposed to AAT.
The two groups will be matched in terms of age and educational level.

At time 0 (T0) the participants will be administered a number of tests (by a psychologist enrolled under the supervision of Istituto Superiore di Sanità) in order to evaluate their previous experiences with Pets and the presence of psychopathological symptoms (Pet history questionnaire (PHQ), to evaluate the effects of previous pet ownership on the efficacy of the therapies; STAS, STAI questionnaires for the evaluation of anxiety state and the perceived stress scale (PSS) will allow to measure the stress perceived by the subject). In addition, salivary levels of stress hormones -cortisol-, pro-inflammatory cytokines (such as Interleukin-1 and Interleukin-6) as well as neuropeptides involved in affiliative behavior will be measured. The use of the MMSE will allow to evaluate any improvement in cognitive abilities. Based upon previous experiences of ANUCCS, dog-assisted therapies are expected to halt deterioration or even improve cognitive abilities of the elderly. In addition, exploiting routine blood screening performed on the subjects, more sophisticated analysis of immune system function will be performed (in collaboration with other groups at the Istituto Superiore di Sanità). All these tests will be conducted only after obtaining informed consent from the patients and approval by the ISS Ethical Committee.
Sessions will be administered once each week. Each AAT session will last 2 hrs and will be performed by 2 couples of dog-pet operator and 3 professionals with an expertise in dog-assisted therapies.

Phase II (6-12 months)

During Phase II of the Project
Test administration and physiological measurements will be collected at the end of the project and compared with scores obtained at T0 by means of Student's t test, as well as multivariate analysis.
Experienced veterinarians will monitor the physical well being of the dogs involved in the project.

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