“Those with dementia are still people and they still have stories and they still have character and they are all individuals and they are all unique. And they just need to be interacted with on a human level.” – Carey Mulligan
Or, would it help to meet them at an animal level?
After pouring more than 400 national and international journal articles on equine-assisted activities or therapies for her research assistantship, Beth Fields found just one that addressed people with dementia and equine assisted therapy (Dabelko-Schoeny et al., 2014).
“Adults with dementia are often disengaged, depressed and lose functional abilities,” said Fields. “I wanted to see if quality of life could be improved for institutionalized adults with dementia through the use of animal assisted interventions (AAIs)…specifically, equine assisted interventions.”
The National Alzheimer’s Association asserts that there are more than 5.4 million individuals with Alzheimer’s disease in the U.S. (2016) with that number expected to increase three-fold by 2050. Caring for loved ones with dementia can be heartbreaking and even unsafe if they are prone to forgetfulness, wandering or aggressive outbursts. As a result, many caregivers rely on day treatment programs or residential assisted living facilities to provide more experienced care.
Fields began with studies related to AAIs for institutionalized adults with dementia, all of which incorporated dogs in the intervention. Many of these studies showed that persons with dementia participating in AAIs experienced reductions in agitation, irritability, depression, anxiety and sleep disturbance as well as increases in social engagement and communication (Berry et al., 2012; Bernabei et al., 2013; Friedmann et al., 2015; Kanamori et al., 2001).
“If these benefits can be obtained from working with dogs,” Fields wondered, “what about working with horses?”
Fields worked with one other Ph.D. student and one M.S. student on the study that described the influence of an AAI program entitled Riding in the Moment (RM) on the lives of institutionalized adults with dementia. With funding from the Carl and Caroline Swanson Foundation, the team worked under the guidance of Wendy Wood, Professor of Occupational Therapy at Colorado State University who is also the Director of Research at the Temple Grandin Equine Center.
In addition to the canine assisted intervention literature related to persons with dementia, Fields also searched for theories and information related to occupational science, environmental gerontology and psychology, and quality of life.
The study was conducted in August, 2016 and ran for eight weeks. The team collaborated with Seven Lakes Memory Care and Hearts and Horses Therapeutic Riding Center in Loveland, Colorado. She instantly loved both programs and knew this would be a great match.
The study was a mixed methods exploratory study that used direct behavioral observation and a quality of life indicator called Activity in Context and Time developed by her mentor, Wood, that examined the participants’ involvement in activities within the facility as well as with horse interactions.
Fields looked at elements like engagement, gaze, position and movement, communication, apparent affect and agitation during in-facility activities and during the Riding in the Moment program. She also conducted interviews with staff from both facilities to gather staff perspectives of equine-environmental influences on quality of life. She wanted to know if there was a significant association between positive quality of life indicators and the Riding in the Moment in comparison to other typical activities offered in residential assisted living facilities such as music and exercise groups. She is currently in the process of analyzing the findings and finalizing her dissertation. Preliminary findings suggest that Riding in the Moment is conducive to positive quality of life experiences for older adults with dementia. Ultimately, she hopes that the findings will advance knowledge of equine-environmental influences on quality of life for older adults with dementia and guide enhancements to programming that foster unique opportunities to maximize functioning and optimal well-being for institutionalized adults.
She does not intend to stop here. Her future interests are related to functional outcomes in older adults, equine-assisted occupational therapy and with individuals with Alzheimer’s disease and related dementias. Who wouldn’t benefit from interactions on an animal level? Fields intends to find out.