By Elizabeth Landsverk, MD
Someone in the United States develops dementia every 66 seconds1. Alzheimer's disease, which currently afflicts 5.4 million Americans1, is devastating for those who have the disease and also imposes a crushing emotional and financial burden on their families. With the aging of the population and projections that by 2050 as many as 16 million people will have the disease, Alzheimer's has become the healthcare challenge of our time. While researchers work to find ways to prevent or slow the progression of the disease, we are also improving our understanding of how to live with Alzheimer's. By actively managing the disease, we can improve the quality of life for both patients and caregivers. One of the most interesting and innovative programs is one that gives patients and their care partners the opportunity to experience non-riding activities with horses. A recent study, has confirmed that the powerful horse-human connection helps reduce stress, improve confidence, and enhance overall well-being for those affected by early-stage dementia.
There have been many attempts to use non-pharmacological approaches to improve well-being in elders and their caregivers. Music has been shown to have a powerful effect. Other interventions have included aroma therapy, tai chi, and socially engaging activities. It has long been known that animals have a great deal to offer and that they have the instinctive ability to help us heal. Horses in particular are herd animals and have relied for centuries on their ability to sense what others around them feel and to utilize the interdependence of the herd to thrive. Horses' behaviors often reflect the emotions of people they interact with. Their nonjudgmental, unconditional interactions have been found to be therapeutic for many populations. For people suffering the stress and anxiety of dementia, the connection to horses can lead to deeper contentment and the joy of connection outside the boundaries of “dementia patient” or “caregiver”.
The Connected Horse Project (www.connectedhorse.com),the brain child of Nancy Shier Anzelmo, gerontologist, and Paula Hertel, elder care consultant, offers equine-guided workshops that support people affected by early-stage dementia. Trained facilitators lead participants through a variety of activities including observing horses in pastures or stalls, over-the-fence introduction to horses, grooming, leading, and group exercises on how horses teach us to gain awareness, relax and self-regulate our responses.
The Equine Guided Support Study was a pilot project undertaken in 2015 as a collaborative effort by the Connected Horse Project, the Stanford Red Barn Leadership Program, and the Stanford School of Medicine. The study recruited and screened patient-caregiver pairs who participated in three-day equine-guided workshops and were tested before and after the workshops for stress, burden, mood/depression, behaviors and social support. The goal was to assess the effectiveness of the human-horse interactions on stress reduction and quality of life indicators. I served as medical advisor for the research study. Having worked with elders, many with dementia, for more than twenty years, I was amazed at how powerful the connection with horses proved to be. All the participants showed an improved mood and affect after interacting with the horses and sharing the day outside the confines of their disease role. For both patients and caregivers, the labels, stigma, and distress of their roles were removed and they were able to enjoy a novel, pleasant, experience that touched their deepest emotions. The results of the study were presented at the Alzheimer's Association International Conference, the world's largest forum for the dementia research community, in Toronto in July 2016.
With the dramatic growth of the elder population and the associated growth in the number of people with dementia, we must go beyond medicine to find ways to enhance the quality of life for patients and caregivers. Experiencing the nonverbal responses and behaviors of horses, in social groups not confined by the role of the disease helps people achieve clarity, strength, and healing.
1. Alzheimer's Association – 2016 Facts and Figures, http://www.alz.org/facts/overview.asp