Dog‐assisted interventions in care homes: A qualitative exploration of the nature, meaning and impact of interactions for older people

Abstract

Dog-assisted interventions (DAI) have been shown to have a wide-range of potential benefits for older adults living in care homes. Yet, there is a lack of published qualitative research which explores the experiences of care home residents, staff and dog-owner volunteers involved in DAI to fully understand its meaning, impact and value. This study aimed to explore the impact of a DAI on the social and emotional wellbeing of older residents living in care homes. The research employed a qualitative study design comprising overt, naturalistic researcher observation of weekly DAI sessions with 54 older adult residents across four participating care homes in the South East region of England over 3 months in 2018. Data were also collected through focus groups with 12 care home staff and 7 dog-owner volunteers. The data from the observations and focus groups was individually coded followed by thematic analysis across the three data sources. Findings demonstrated there were clear benefits for older people who engaged with DAI, as well as for dog-owners and to some extent for care home staff members. Benefits included sensory, emotional stimulation and opportunities for social interaction, reminiscence on early life experiences and these were supported by the development of some new social relationships. While there were some environmental challenges to implementing DAI, the findings confirm its value for care home residents, with minimal drawbacks from an organizational standpoint. As a low cost intervention, adoption of DAI in care home settings appeared to strengthen relationships between residents and staff and enable wider relationships with an external community resource. K E Y W O R D S care homes, dog assisted intervention, older people, participant observation | 1451 JAIN et Al.and community-centred ways of working, support social and emotional wellbeing of older people living in care homes and promote inclusive use of community resources and external partnerships, are highly desirable (Charles & Carstensen, 2010;Waite, 2018).Studies of Animal-assisted intervention (AAI) in care settings have reported a wide range of benefits on wellbeing (Bernabei et al., 2013;Jain et al., 2020) such as improving psychosocial and physiological functioning (Allen et al., 2002), and reduction in levels of stress, depression and compassion fatigue among carers (Coleman, 2016). Yet, few studies on AAI to date have attempted to understand the experience and meaning of the animal-human interaction for older residents living in care homes (Pitheckoff et al., 2018), particularly for people with dementia (Peluso et al., 2018). Two-thirds of older residents in care homes have some form of dementia (Prince et al., 2014).

Effectiveness and sustainability of volunteering with older people living in care homes: A mixed methods systematic review

“…Details of individual studies are reported in Table 1. Fourteen quantitative or mixed methods studies evaluated the impact of volunteering (Baker et al., 2017; Caspar et al., 2019; Clarkson et al., 2007; Di Bona et al., 2019; Lee et al., 2007; Lokon et al., 2017; Low et al., 2015; McNair & Moore, 2010; Sauer et al., 2016; Seitz et al., 2016; Skropeta et al., 2014; van Zon et al., 2016; Westerhof et al., 2018; Xaverius & Mathews, 2004), and 22 reported questionnaire or qualitative data (Biggs & Knox, 2014; Bradley et al., 2000; Damianakis & Wagner, 2007; Filinson, 2003; Gundersen & Johannessen, 2018; Hill, 2016; Hunter et al., 2018; Jain et al., 2020; Kawamura et al., 2009; Keith, 2001; Keith & Schafer, 2002; Landau et al., 2013; Lokon et al., 2012; Ostwald et al., 2003; Persson, 2004; Santini et al., 2018; Schwalbach & Kiernan, 2002; Somers, 2018; Tanner & Brett, 2014; Tinker et al., 2017; Van der Ploeg et al., 2012, 2014). Overall the quality of studies is poor.…”

“…All the quantitative studies were at either high or moderate risk of bias (Table 1). Only four of the qualitative and mixed methods studies scored ‘high’ for reliability (Damianakis & Wagner, 2007; Gundersen & Johannessen, 2018; Hunter et al., 2018; Jain et al., 2020). The four questionnaire studies fulfilled six ( n = 1) and seven ( n = 3) of the twelve categories on which they were judged.…”

“…Twenty studies reported volunteering from children and students, 16 reported volunteering from adults including five studies where some volunteers were in their 80s and 90s (File , Table S3). Eighteen studies reported the inclusion of care home residents with cognitive impairment or dementia (Biggs & Knox, 2014; Bradley et al., 2000; Caspar et al., 2019; Clarkson et al., 2007; Damianakis & Wagner, 2007; Di Bona et al., 2019; Jain et al., 2020; Kawamura et al., 2009; Lee et al., 2007; Lokon et al., 2012; Low et al., 2015; McNair & Moore, 2010; Sauer et al., 2016; Seitz et al., 2016; Skropeta et al., 2014; Tanner & Brett, 2014; Van der Ploeg et al., 2014; van Zon et al., 2016) as participants, 11 of these stated that this included people whose dementia was defined as advanced, severe or late‐stage (Clarkson et al., 2007; Damianakis & Wagner, 2007; Di Bona et al., 2019; Jain et al., 2020; Lee et al., 2007; Lokon et al., 2012; McNair & Moore, 2010; Sauer et al., 2016; Seitz et al., 2016; Skropeta et al., 2014; Van der Ploeg et al., 2014) (File , Table S2). All studies took place in residential care, nursing homes or assisted living facilities.…”

“…One RCT that compared volunteer‐led reminiscence therapy with unstructured volunteer contact (Westerhof et al., 2018) found a reduction in symptoms of depression in both groups at 2 months but not at 8 months, and in loneliness at two and 8 months (again in both groups). Qualitative studies reported evidence of improvements to resident mood from interviews with care home staff (Hunter et al., 2018; Jain et al., 2020), volunteers (Gundersen & Johannessen, 2018; Kawamura et al., 2009), and residents themselves (Santini et al., 2018; Somers, 2018).…”

“…In three qualitative studies, volunteers reported that they had observed improvements in recall in residents with poor short‐term memory or dementia (Damianakis & Wagner, 2007; Gundersen & Johannessen, 2018; Somers, 2018). Encounters with volunteers also prompted residents to reminisce (Di Bona et al., 2019; Jain et al., 2020; Kawamura et al., 2009; Somers, 2018). Qualitative studies reported that volunteers facilitated social activities and interactions with residents which, through regular encounters, helped develop familiarity and relationships that benefitted both residents and volunteers (Biggs & Knox, 2014; Damianakis & Wagner, 2007; Gundersen & Johannessen, 2018; Hill, 2016; Hunter et al., 2018; Kawamura et al., 2009; Lokon et al., 2012; Santini et al., 2018; Skropeta et al., 2014; Somers, 2018; Tanner & Brett, 2014; Van der Ploeg et al., 2014; Westerhof et al., 2018).…”