1. DOGS AT WORK ANIMAL THERAPY Dondi Austin, CNM, MS Kaiser Permanente, Downey

2. GDD Tomay

3. Working Dogs Guide Dogs Service Dogs Assistance Dogs Hearing Dogs Skilled Companion Dogs Facility Dogs Psychiatric Service Dogs Therapy Dogs Seizure Alert Dogs Olfactory Research Dogs

4. Working Dogs… Other Jobs Police Dogs – K9 units Explosive Detection Dogs Drug Sniffing Dogs Search & Rescue Dogs / Cadaver Dogs

5. Americans with Disabilities Act (ADA) Rehabilitation Act of 1973  Prohibited discrimination on the basis of a disability Americans with Disabilities Act (1990)  Expanded coverage to anyone with a “physical or mental impairment that substantially limits one or more of the major life activities” entitling them to protection under the law, against discrimination in employment, housing, transportation & other areas of public life.

6. Under the ADA Businesses & organizations that serve the public MUST allow people with disabilities to bring their service animal into all areas of the facility where customers are normally allowed to go. Applies to ALL businesses including:  Restaurants  Hotels  Taxis/shuttles  Hospitals/medical offices  Grocery/dept stores  Theatres  Health clubs  Parks & zoos

7. Americans with Disabilities Act Businesses MAY ask if an animal is a service animal and/or what tasks the animal has been trained to perform Businesses MAY NOT ask about the persons disability nor require special ID for the animal * puppies in training are not covered by the ADA; puppy raisers are taught to ask permission

8. Americans with Disabilities Act People with disabilities who use service animals CANNOT be  Charged extra fees  Isolated from other patrons  Treated less favorably than other patrons They may be charged for damages in the same manner as other patrons if damages are caused by the service animal

9. Americans with Disabilities Act A person with a service animal CANNOT be asked to remove the service dog from the premises UNLESS: The animal is out of control & the owner does not take effective action to control it (e.g. a dog barking repeatedly during a movie) The animal poses a direct threat to the health or safety of others. * allergies or fear of animals are NOT valid reasons

10. Americans with Disabilities Act A business is NOT REQUIRED to provide care or food for a service animal or to provide a special location for the animal to relieve itself

11. Canine Companions for Independence (CCI) Founded in 1975 Non-profit organization that enhances the lives of people with disabilities by providing highly trained assistance dogs & ongoing support to ensure quality partnerships

12. Canine Companions for Independence Headquarters - Santa Rosa, CA Regional Center – Oceanside, CA (southwest) Largest non-profit provider of assistance dogs Breeding program Volunteer puppy raisers

13. CCI Assistance Dogs 4 types of Assistance Dogs: 1. Service Dog = assists with physical tasks to increase independence of a disabled person by reducing reliance on other people Disabilities may include: spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida, arthritis

14. SERVICE DOGS … OPEN DOORS

16. CCI: Types of Assistance Dogs 2. Skilled Companions = dogs trained to work with a child/adult with a disability, under the guidance of a facilitator (parent, spouse, or caregiver) who are responsible for customizing the training needs.  Can also serve as a social bridge for people who are not used to relating to a person with a disability Disabilities may include: cerebral palsy, muscular dystrophy, Down syndrome, autism

17. Cory with Skilled Companion “Melly” “I used to be the kid in the wheelchair, now, I’m the kid with the amazing dog.”

18. CCI: Types of Assistance Dogs 3. Hearing Dogs = alert the deaf and hard of hearing to sounds such as a doorbell, telephone, alarm clock, someone calling a name or a smoke alarm  Customized training may include E-mail message alert, text alert, microwave timer, dropped keys (retrieval) Disabilities served: hearing impairment

19. CCI: Types of Assistance Dogs 4. Facility Dogs = taught over 40 commands designed to motivate & inspire clients with special needs  Generally work in healthcare & educational settings

20. CCI Facility Dog Millie “ Millie gives patients a sense of wellbeing, a connection to their home life, a bridge to trusting hospital staff & motivation to get out of bed.” - Jennifer Johnson, Child Life Specialist

21. CCI: Wounded Veterans Initiative Providing assistance dogs to veterans with physical disabilities resulting from military service:  Service dog  Hearing dog  Skilled Companion dog  Facility dogs To visit & work directly with veterans through therapy professionals

22. “The most advanced technology capable of transforming the lives of people with disabilities has a COLD NOSE & a WARM HEART.”

23. Psychiatric Service Dogs (PSDs) A service dog trained individually to mitigate the effects of their disabled partner’s psychiatric disabilities by performing certain tasks Disabilities served: panic disorders, post traumatic stress disorder, depression, bipolar disorders & agoraphobia

24. Psychiatric Service Dogs Job Description: Guide a handler disoriented by anxiety Conduct a room search (to alleviate fear of intruder) Interrupt a panic attack & seek help for an incapacitated handler Provide tactile stimulation to bring partner back to awareness Can interrupt repetitive behaviors Can provide an excuse to leave an upsetting situation

25. Psychiatric Service Dogs Other therapeutic behaviors Bring medications, portable phone or beverage, answer doorbell Call 911 (large button – pre-programmed with speaker phone – dog barks @ speaker) Summon help – nudge another household member or carry a note

26. Psychiatric Service Dogs Handlers report the presence of their dog helps them feel calm, relaxed & more willing to interact with others eliminating feelings of isolation A PSD is a trusted companion & can therefore serve as a bridge between the handler & his/her environment

27. Psychiatric Service Dogs The Depression & Bipolar Support Alliance (DBSA) “strongly believes that Psychiatric Service Dogs have afforded many disabled individuals to reach a new level of wellness & opportunity to lead happy & productive lives.”  Caring for a dog helps maintaining a routine which can help to manage daily tasks & activities  Caring for a dog can lead to feelings of self confidence, self reliance & improved self esteem

28. How do you get a PSD?? Working through Behavioral Health Professionals  Adopt from a program that specifically trains PSDs NEADS = National Education of Assistance Dogs  Encourage partner to write out a job description for PSD  Includes partner’s lifestyle, type of housing, location, job, hobbies, travel, and level of activity

29. Psychiatric Service Dogs for Veterans Long history of pairing service dogs with physically disabled vets PSDs are now being paired with vets dealing with Post Traumatic Stress Disorder (PTSD) PTSD  a disorder characterized by recurrent & intrusive distressing recollections of a past event  Symptoms include: hallucinations, flashback imagery, recurring dreams, feeling that the events are still happening  Behaviors include: anxiety, extreme wariness, irritability, anger, sleep disorders, which can lead to substance abuse

30. Psychiatric Service Dogs for Veterans Psychiatric Service Dogs – are specially trained to help traumatized veterans leave the battlefield behind as they re-integrate into society. Job Description for PSDs assisting PTSD partners: (87 different commands)  “Block” – dog stands perpendicularly in front of the person in order to keep others at a safe distance  “Get my back” – dog sits facing backward by person’s side  Trained to jolt a soldier from a flashback  Sense a panic attack before it starts * Caring for the dog renews a veterans sense of responsibility, optimism & self awareness

32. Lt. Colonel Jay Kopelman with “Lava”

33. Psychiatric Service Dogs for Veterans For the Battle Scarred, Comfort at Leash’s End  “Just weeks after Chris Goehner, 25, an Iraq war veteran got a dog, he was able to cut in half the dose of anxiety & sleep medication he took for PTSD. The night terrors & suicidal thoughts that kept him awake for days on end ceased.”  “Aaron Ellis, 29, another Iraq veteran with PTSD scrapped his medications entirely soon after getting a dog, and set foot in a grocery store for the first time in 3 years.” Lorber, J. (April 2, 2010) The New York Times

34. Psychiatric Service Dogs for Veterans Dozens of interviews with veterans & therapists report drastic reductions in PTSD symptoms & in medication use but… does scientific evidence support anecdotal reports on dogs speeding recovery? Federal Government – currently spending several million $$ to find out  SB written by Senator Al Franken (D. Minn)  Pilot program run by the Dept. of Veterans Affairs, gives veterans with PTSD a service dog (est. cost $20,000/dog)

35. “Mya” and Jacob

36. Puppies Behind Bars (PBB) Program founded in 1997 by Gloria Gilbert Stoga, NYC woman working for Mayor Guilliani’s Youth Commission 1991 – she adopted an 18 month old puppy from Guiding Eyes for the Blind (Yorktown, NY) released for health reasons 4 yrs later she read a newspaper article about prisoners in Ohio who raised guide dog puppies for the blind Got the “go ahead” from Bedford Hills Correctional facility, but had no puppies (none of the Guide Dog schools agreed)

37. Puppies Behind Bars Stoga bought 5 puppies “rejected” by Guiding Eyes for the Blind @ $500 each to board with inmates as a pilot program 3 weeks later –Guiding Eyes for the Blind agreed to give the puppies free of charge 2 out of the first 5 puppies went on to graduate & become working guide dogs *current success rate for puppies raised by inmates = just > 50%

38. Puppies Behind Bars “Inmates are very motivated & raise very well behaved dogs, as good as those of our best raisers” Puppy raiser inmates are chosen based on:  Clean disciplinary record x 1 yr  Interview with prison officials, Stoga, & other puppy raisers 2 raisers/puppy: primary & back-up

39. Puppies Behind Bars Dogs live in a crate in the inmates cell Dogs spend 20 months with the raiser & are taken everywhere including prison jobs, dental appts etc. Raisers attend 6 hrs training /week Dogs are furloughed out to volunteer families 2-3 weekends/month to provide experiences the prison environment cannot (e.g. shopping malls, car travel, children, household appliances)

40. Puppies Behind Bars Quotes from inmates “To watch them grow & learn & to know that you’re responsible – well, that goes deep … you get confidence & you believe that you can do something good.” “I’ve seen 6’2”/250lb guys rolling around the floor kissing & talking in high voices to their dogs. We don’t care what anybody thinks, its all about what’s good for the dogs. We owe them. They did what nothing or nobody could do… they took away our selfishness.”

41. Puppies Behind Bars “ The dogs have had a calming, humanizing effect on the entire staff, me included. They’ve broken these inmates down, taken their hard shells & cracked them open. Their level of love & commitment to these dogs is something I never expected to see.” Jim Hayden - Asst. Deputy Superintendant of Programs Fishkill Correctional Facility, Beacon, NY

42. Puppies Behind Bars 1997 -began with 5 puppies @ Bedford Hills Correctional Facility training guide dogs for the blind  now @ 6 different correctional facilities After Sept. 11, 2001 – at the request of law enforcement agencies, Explosives Detection Canines (EDCs) were added 2006 – began training service dogs for adults & children with other disabilities DOG TAGS: Service Dogs for those who’ve served us. Training dogs to be placed with the wounded soldiers returning from Iraq, including PSDs

43. Canine Support Teams (CST) Founded in 1989 by Carol Roquemore To provide specially trained dogs to people with disabilities other than blindness Service dogs are placed with people who use wheelchairs, walkers, crutches or canes Dogs are taught to assist their partners by pulling wheelchairs, turning lights on & off, retrieving dropped items & opening/closing doors & drawers, barking to get help or providing stability for walking

44. Canine Support Teams Jennifer and “Ike”

45. Canine Support Teams Prison Pup Program – makes use of available puppy raisers, with “lots of time”  Has shortened the waiting list for partners 2002 California Institute for Women – became the first prison in the state of CA to have a service dog training program > 85% of CST dogs placed have been trained through the Prison Pup Program

46. Canine Support Teams PAWZ for Wounded Vets Program  provides service dogs for men & women who have sustained disabling injuries, including PTSD, as a result of service in the military

47. Effects of Human-Animal Bond Contact has been shown to: Lower BP, pulse & respiratory rates Reduce perception of pain Reduce wound healing time Reduce recovery time Decrease medication use Increase survival rates for individuals with chronic illnesses

48. THERAPY DOGS  Hospital / Nursing Home visitors  Hospice visitors  Physical Therapy Programs  Schools – (special needs students; ADHD, Autism)  Public Libraries –Animal Reading Friends (ARF)  Court system – to support victims preparing to testify

49. THERAPY DOGS Animal Assisted Therapy (AAT) Animal Assisted Activity (AAA) Scientific data Marx, M. et al. (2010). The Impact of Different Dog – related Stimuli on Engagement of Persons with Dementia. Am J Alzheimer’s Disease & Other Dementias. Conclusion:  AAT is well suited for nursing home residents with dementia.  Provides social interaction not dependent on level of cognitive functioning.

50. THERAPY DOGS Kawamura, N., Niiyama, M., & Niiyama, H. (2009). Animal Assisted Activity (AAA); Experiences of Institutionalized Japanese Older Adults. Journal of Psychosocial Nursing.  participants descriptions of experiences were analyzed based on Collazi’s phenomenological methodology Summary: 6 themes 1) Positive feelings about the dog 2) Confidence in oneself (r/t sense of responsibility) 3) Recalling of fond memories 4) A break from the daily routine 5) Interacting with other residents through the dogs 6) Enhanced communication with volunteers

51. THERAPY DOGS Multiple other studies show positive effects Increasing social behavior Increasing verbal interactions Decreasing agitated behavior & loneliness AAA with residential geriatric patients demonstrated Decreased BP Decreased HR Decreased depression Increased life satisfaction

52. Charlie and “Molly”

53. Therapeutic Riding – Equestrian Therapy Charlie & Angelique

54. THERAPY DOGS Dr. Ray Sacks & Ella Kaiser San Diego - Orthopedics

55. THERAPY DOGS COULD YOUR DOG BE A THERAPY DOG ?? Delta Society Volunteer organization specializing in human health through service & therapy animals Currently > 30,000 therapy dogs certified in the US Qualifications: calm, friendly, at least 1 year old & well behaved around strangers Training: 12 hr course; partner taught how to handle dog in a variety of situations (IVs, wheelchairs, etc.) 22 part evaluation – obedience, skills & control Vet certificate of health

56. THERAPY DOGS Therapy Dogs Inc. Therapy Dogs International ** Canine Good Citizen

57. THERAPY DOGS “It doesn’t matter if you have disabilities, can’t read very well or are old & sick – the dog loves & comforts you anyway.” Linda Buettner – Professor UNC, Greensboro

58. Therapy Dogs: Infection Control DiSalvo, H. et al. (2006). Who let the dogs out??? Infection control did: Utility of dogs in health care settings & infection control aspects. Am J Inf Control. Animal Assisted Therapy Advantages  well documented Disadvantages/ Potential Risks  pt. phobias  Allergies  Bites – usually NOT a major threat  Zoonoses – dogs viewed as lowest risk for transmission  Animal caused injuries

59. Therapy Dogs: Infection Control Policies for dogs in health care settings: 3 categories Service Dogs – covered by ADA Therapy Dogs * Visitation Dogs * *NOT permitted  in multibed unit if any pt objects  in isolation/immunocompromised pt rooms  Some ICUs (usually allowed in burn centers, rehab & trauma units)

60. Therapy Dogs: Infection Control Conclusion Benefits greatly outweigh risks Develop pet therapy policies emphasizing different categories of dogs JCAHO standard IC.4.10 “reduction of risks associated with animals brought into the hospital”

61. Can Dogs Smell Cancer? Tumors release tiny amount of chemicals different than those of healthy tissue Early 2000’s British researchers taught 6 dogs to identify the smell of bladder cancer in urine samples in a “meticulously controlled/ double blinded/ peer reviewed study”…  “The results are unambiguous. Dogs can be trained to recognize & flag bladder cancer” The Lancet (1989) – reported dog detecting malignant melanoma Pine Street Foundation (reprint from Integrated Cancer Therapies) reported dogs accurately distinguishing breath samples of lung & breast cancer patients from controls.

62. Seizure Alert Dogs Alerts pt/family member BEFORE a seizure begins allowing appropriate steps to be taken for safety DO NOT at this time understand how dogs might be able to do this OR how good they are at it

63. Seizure Response Dogs Responds to a person having a seizure by alerting others remaining with the pt – to help avoid injury reassuring & reorienting a pt as they awaken from seizure

64. Seizure Dogs Epileptic seizure studies – dogs performance poor Non-Epileptic seizures – dogs behavior more predictive  thought to reinforce psychogenic event

65. Seizure Dogs While the role of seizure alert dogs has not been scientifically validated at this time, the dogs do provide important emotional support, which is seen as beneficial to patients with chronic illnesses. Their companionship can be reassuring & their ability to obtain help may be life-saving.

66. Guide Dogs A dog specially trained to provide mobility & independence to the blind & visually impaired. The Seeing Eye Founded in 1929 (celebrating 81 years) 15,000 dogs assisting ~ 8,000 men & women Headquarters in Morristown, NJ

67. Morris Frank and “Buddy”

68. Guide Dogs … cont Morris Frank  Read about dogs being trained as guides to assist blinded veterans of WWI  Dorothy Harrison Eustis – American training shepherds in Switzerland agreed to help Mr. Frank if he would return to the US & “spread the word”  1928 Mr. Frank returned to New York City & demonstrated the abilities of his dog “Buddy” to a group of reporters His one word telegram back to Mrs. Eustis read “SUCCESS”

69. Guide Dogs Guide Dog Schools: California  Guide Dogs for the Blind – San Rafael, CA (Boring, OR)  first on the west coast – 1942  Started out in order to help returning servicemen (WWII)  Graduated >10,000 teams to date  Guide Dogs of America (GDA) - Sylmar, CA  Founded in 1948 originally named International Guiding Eyes

70. Guide Dogs of the Desert  Founded in 1972  Palm Springs CA (Whitewater)  Has graduated > 1000 teams

71. GDD “Bailey”

72. Guide Dogs Puppy Raisers  Takes 8 week old puppies into their home  House trains, crate trains, socializes pups  Exposes them to the environment – malls, restaurants, grocery stores, clinics, office buildings, elevators  Returns the dog to the school @ 18-20 months for formal training

73. Guide Dog Training Formal guide dog training - “Harness Work”  4-6 months with certified trainer  28 day partner training; blind recipient & dog work with trainer on campus with the dog sharing the room  Graduation  On-going support – including in home

74. Guide Dogs Breeders  Adopted by host family – with same rules as puppy raisers  Return to facility for mating & whelping  Females remain with puppies to nurse x 8 weeks  Puppies adopted by puppy raisers – breeder returns to host Ambassadors  Represent the Guide Dog program @ public events, schools, fundraisers, etc. Career Change Dogs  “Working dog changes job”

75. Graduation