Memorial Hospital Miramar gets patient assistance from a 'top dog' in their outpatient department.
By Heather E. Flores, PT, DPT, OCS, MTC
December 20, 2012
At Memorial Hospital System in Broward County, FL, it's not uncommon to see six furry Golden Retrievers punching in to start their workday. These full-time employees make their rounds through the floors in the acute care areas, inpatient rehabilitation, outpatient waiting areas, staff and administration areas, and uniquely, at Memorial Hospital Miramar, Miramar, FL, in outpatient rehabilitation.
Memorial Healthcare System is a large hospital system and includes an inpatient rehabilitation hospital, a children's hospital, a nursing home, and a Level 1 trauma center, as well as several acute care community hospitals. As part of Memorial's healing experience program, a program centered in holistic, patient/family centered care, and using the arts to complement the medical treatment provided, the hospital system has committed to placing a facility dog in each community hospital, the children's hospital and the rehabilitation hospital.
It's well established in the literature that having an animal involved in the healing process is very beneficial. However, animals in the medical setting have traditionally been used in inpatient rehabilitation programs and long-term care facilities. At Memorial Hospital Miramar they are breaking new ground by using their facility dog in their outpatient rehabilitation department.
Compass, a golden retriever, was only 16 months old when he was placed at Memorial Hospital Miramar in June 2010 by East Coast Assistance Dogs (ECAD), a non-profit organization established by Lu Picard and her husband Dale.
Compass' five handlers, all employees, underwent an intensive weeklong training, during which Lu evaluated their handling skills and selected the dog that best suited the handlers and the environment in which they were working.
Compass arrives for work each weekday morning at 8:30 a.m. and stays the entire day, working in various areas of the hospital. In fact, the only places Compass does not go are food service areas, the intensive care unit, and the surgical areas.
A True Rehab Professional
As one of Compass' handlers, I was thrilled at the prospect of having him in the outpatient department for part of the day, but I had no idea of the tremendous contribution he would make to the department and the patients. I use Compass to challenge the adult patients' balance by having him fetch a ball for them while they are working on balance and proprioceptive activities, such as while single-leg standing on a foam pad.
Stroke patients are encouraged to move their arm in a functional manner by having them brush or pet him. Compass might simply be used as a comfort tool, as patients with adhesive capsulitis are stretched into new ranges. As the patient focuses on the dog and perhaps has a conversation about his or her own experiences with animals, the physical or occupational therapist can often achieve more range of motion than they would have if the patient were more focused on the discomfort caused by the stretching.
Compass also gives the patients something to look forward to and lifts spirits. As one patient said, "Every time I get discouraged and want to quit, they roll out the dog!"
Real-Life Success Stories
In the outpatient pediatric neuro-developmental pediatric program, Compass has changed lives in a way none of the rehabilitation team expected.
A 22-month-old girl with bilateral hip dysplasia was resistant to weight bearing in standing and preferred to crawl everywhere. Compass motivated her to stand, and after one session working with Compass, she stood on her own. Her mom and everyone in the immediate area were overcome with joy. Immediately after that session she began pulling herself up to a standing position at home, and two months later was able to walk with hand-held assistance or independently with a walker. Her physical therapist, Nancy Destin, PT, was thrilled with the progress.
A 16-month-old boy was in speech therapy for developmental delay and feeding issues. The boy was resistant to eating and the speech pathologist wanted him to eat Cheerios, but he refused. Compass was brought in and provided sensory stimulation by licking the boy's hand. The boy fed him some Cheerios -- Compass' favorite treat. After washing up, the patient then proceeded to feed himself about two dozen Cheerios without resistance.
Karen Acosta, SLP, was working on getting a young patient to identify body parts, but the boy resisted. Once Compass was brought in, he more easily began to name different body parts on the dog, compared to himself or to Acosta.
A young girl was in physical therapy secondary to a series of femur fractures due to a congenital condition. She had been casted for the better part of a year, and tried to avoid weight bearing on the affected side at all costs until Compass was worked into the sessions. Destin shifted her patient into desired positions while the patient focused on brushing or petting Compass, or throwing a ball for him to fetch. Destin believes her weight bearing increased by 50 percent with much less active resistance when Compass was there to participate in the treatment sessions.
A young autistic boy was unable or unwilling to descend stairs reciprocally. The boy was instructed to observe how Compass descends the stairs, and the patient spontaneously went down in a step-over-step fashion for a total of six stairs for the first time, and with no resistance.
Donna White, MS, OTR/L, was working with a 13-year-old girl with autism who would come to therapy unmotivated and socially inappropriate. Donna used maximum motivation with each task she attempted to get the patient to perform, and was often unsuccessful in getting her to complete it. The first time Compass worked with the patient, it was like a light
went on in therapy. Donna used Compass as part of the session, which included tug-of-war, tunnel activities and tabletop activities. The patient became 100-percent self-motivated and happily performed all that Donna asked of her.
The patient's mother was so impressed that she is considering getting the patient a dog of her own -- perhaps an assistance dog. As a member of the school system in the county, she also remarked on the need to have dogs such as Compass in the special education programs in the schools, considering the remarkable changes seen in her daughter when Compass was present.
Compass in Acute Care
Compass also makes daily rounds on the hospital floors, and responds to all requests for visits that he receives on his own "bark line."
He routinely brings life and hope to patients and their families. Nurses frequently remark how patients smile or sit up voluntarily for the first time since admission when Compass is on the floors visiting.
Compass has also been used in acute care physical therapy to increase greater gait distances and encourage out-of-bed activities.
It's not all work and no play for Compass, however. He has scheduled down time, including free play time in an outdoor fenced enclosure and intermittent tug-of-war or fetch games to de-stress him. To ensure his health and safety, he works out on the treadmill three to four times a week, and is not given food as a reward for a job well done -- just the love and affection of those who are touched by his healing spirit.
Visit Compass and all of the Memorial Dogs on their Facebook Page: www.facebook.com/memorialpettherapy
Heather E. Flores is a full-time physical therapist at Memorial Hospital Miramar, Miramar, FL.