Connected horses connecting people

ELAINE CHAN / COURTESY

Connected Horse Project works to help dementia patients, caregivers

Dementia affects about 50 million people worldwide, and is expected to reach 82 million in 2030. Unlike other global health priorities, dementia itself is not a disease. It is a term describing symptoms such as a decline in memory and other thinking skills severe enough to interfere with daily life. Alzheimer’s disease is the most common form of dementia, accounting for over half of all cases, followed by vascular dementia. It’s a condition with no cure, whose causes are variable and still under research. Those with dementia are not the only ones affected by its symptoms.

“When a loved one is affected with Alzheimer’s disease, it creates a lot of stress on their family, particularly their primary caregiver, which is usually their spouse but can be an adult child or somebody else, even, in the family,” said Dr. Sarah Farias, an associate professor of neurology at UC Davis. “And so one of the aims of the program is to facilitate communication between the person with dementia and the caregiver and then also to help alleviate caregiver stress.”

Caregivers are often people close to the patients, and it can be difficult, emotionally and sometimes physically, to take care of a loved one with dementia. The relationship between the caregiver and the person with dementia is vital for the mental health of both, and it is this balance that the Connected Horse Project focuses on.

The Connected Horse Project brings together people with dementia and their caregivers by teaching them how to take care of horses. The program began as a pilot study at Stanford, and is now collaborating with the Alzheimer’s Disease Center and Center for Equine Health at UC Davis to provide research-based evidence for their therapeutic program for dementia patients and their caregivers. The study evaluates both the caretaker and person with dementia for different emotional and behavioral measures such as anxiety, depression, behavioral changes, sleep, and self-perceived stress both before the workshops and several months afterwards.

“That’s what’s really important about this project; not only is it assessing whether or not the dementia patients have long-term, positive outcomes from this type of collaborative experience, but it’s also assessing whether caregivers benefit,” said Claudia Sonder, the director emeritus of the Center for Equine Health. “And what I mean by that is this interaction involves teamwork, and the hope is that when these dementia patients and their caregivers have this experience around a horse, that there are lasting benefits to their relationship when they’re not around the horse.”

The program consists of a series of workshops where people with dementia and their caretakers come together, practice mindfulness and learn to take care of a horse. At one session, an elderly couple was brushing a calm, whiskery old horse named Joe. When they tried to clean Joe’s front hooves, however, he wouldn’t budge. After a few tugs on his forelock, he shifted — only to delicately raise his back hoof. The woman scolded him lightly for his mischief, but saw that Joe didn’t want his feet cleaned and decided to let him be, taking him for a walk with her husband instead. An experienced horsewoman may have known that Joe’s feet were sore that day, but the woman had little-to-no experience with horses. She had made the decision by reading Joe’s body language. This attention and intuitive cooperation is what the program hopes people with dementia and particularly their care partners will take away from these sessions.

“[There’s] an acceptance and an awareness that their relationship has shifted,” said Paula Hertel, the co-founder and president of Connected Horse. “And at least for me — and this is just observational, not necessarily in the data — the pairs tend to come in with these really rigid roles of ‘I’m the caregiver and therefore this is my role, and you’re the person that has this disease and therefore this is your role,’ and very quickly those roles diminish, because they’re doing something new together. The horses don’t define them by those roles.”

While interacting with animals is known to be therapeutic, this program goes beyond stress relief or short-term emotional benefit. The care partner and their loved one with dementia practice mindfulness, spend time with others like them, and learn how to communicate nonverbally. Horses are highly intelligent, sensitive animals and respond to the body language and attitude of the people they interact with, rather than their words. The fact that many people are unfamiliar with or nervous around horses isn’t a problem for the program or its participants; it’s an advantage. It inspires confidence to approach a 1,200-pound animal and interact with it. And the horse in turn will pick up on the fear, calmness, or confidence of whoever approaches it and give it back to the person.

“The physicality involved with approaching a horse, the sort of mental focus involved with reading the horse, being able to reach down and pick up a foot for example,” Sonder said. “We watch dementia patients come in minimally verbal and they leave this program speaking full sentences.”

Programs like these not only benefit the patients but also the horses. Outside of sports and ranching, owning a horse is rare. When a horse becomes too old for activities like racing or dressage, he must retire. Horse therapy programs could help support barns and give retired or injured horses new purpose.

“There’s no other animal that we have in domestication that can do for a PTSD patient, someone who’s lacking confidence or leadership, or a dementia patient what a horse can,” Sonder said. “So my hope is that this is a way for the unwanted or elderly horse to become relevant again in today’s society. It’s the geriatric horse helping the geriatric human.”

Younger and younger people are being diagnosed with dementia, leaving them with few options for care. The age group most at risk are 85 or older, but the youngest participant in the program was only 53. Connected Horse members hope that the research results from their study will further validate the program so that they can teach it to other barns and facilitators, making help for people affected by dementia more readily available.

“We’re hoping that this early intervention will tie in with the science where we’re getting diagnosed earlier,” said Nancy Anzelmo, the co-founder and educational director of Connected Horse. “And then having those tools to take them into the journey, hopefully someday it’ll be paid for by insurance as an activity that they can do together.”

 

 

Written by: Kira Burnett — science@theaggie.org