A little Magic works wonders.
MAGIC IS AN 8-YEAR-OLD GOLDEN RETRIEVER. A FORMER showdog, he was specially trained to patrol the 88-bed Saul Alzheimer's Special Care Unit of the Jewish Home and Hospital in the Bronx, N.Y., preventing residents, most with mid-stage Alzheimer's disease, from wandering off the unit or into unsafe areas.
Magic responds to a bell that sounds when a resident approaches an exit door. When he hears a bell, he goes to the appropriate door, positions his body between the resident and the exit, and doesn't move. He is trained to stand his ground calmly and unaggressively, even if a resident tries to push through. Magic's mere presence is usually sufficient to distract residents from continuing their efforts to elope. If a resident persists in her attempted elopement, however, Magic uses his snout to nuzzle and direct the resident to turn around and proceed back in the other direction.
Has Magic ever been unsuccessful? "Not to my knowledge," says Kenneth Sherman, administrator of the facility. Sherman, a 28-year veteran of the Jewish Home and Hospital, reports that Magic single-handedly reduced episodes of wandering from 50 to 60 encounters per month down to three or four. "We did not expect that significant a decrease, but it happened," remarks Sherman.
Hiring Magic five years ago was a staff initiative and particularly the idea of then nurse manager Mary Shelkey, RN. "We did a lot of research before Magic, trying to come up with a solution to patient wandering," recalls Sherman. "Short of locking the doors, which is against the law in New York City, we didn't feel anything out there produced significant results." Sherman says they used alarms on the doors, which successfully curbed wandering, but created a lot of extra stress for staff members, who had to respond each and every time an alarm sounded.
Judith Nicholson, associate administrator, explains, "We believed that a lot of the wandering that Alzheimer's patients do is because they are not active enough. They don't have constructive ways to expend enough energy, so we wanted to encourage wandering in a safe way."
The right trainer
Sherman explains that once they made the decision to hire a dog, they looked in vain for a trainer who had some experience with Alzheimer's patients. They had to hire a trainer who first spent many hours in the facility learning about Alzheimer's and what the Saul unit required. The staff then evaluated close to 100 dogs because the chosen canine had to possess specific traits. The ultimate candidate would be one that would not retreat from, or become agitated by, prolonged stares--something the dog was likely to encounter with the residents. Prolonged eye contact makes most dogs uncomfortable. In addition, the Saul unit required a dog that could be trained not to bark or jump up on people, and that would be affectionate and patient with the many residents and visitors streaming in and out of the facility.
Those closest to Magic feel he was well worth the initial $15,000 investment, the $1,500 for additional training, and the incidental costs of feeding and caring for the animal.
And it's impossible to place a monetary value on the other services Magic performs. Nicholson says that sometimes new residents are hesitant to emerge from their rooms, but that Magic serves as an enticement for them to venture out and explore the facility.
Perhaps most remarkable about the Saul unit's experience with Magic are the anecdotal reports that residents with mid-stage Alzheimer's disease are learning. Long-time residents are often heard telling newcomers who are heading for an exit door not to go there "because Magic doesn't like it." The staff members say that learning is also evident by the fact that escape encounters have decreased not only during Magic's on-duty hours, but during off-duty hours as well. Magic works an 8:00 a.m. to 4:00 p.m. workday five days per week with weekends off. When he is off duty, the unit uses alarms but residents seldom attempt elopement--they've learned with Magic's help that it is inappropriate.
Nicholson concludes, "Our goal is to maintain a person's independence, to let her function at her highest possible level for as long as possible. Over time, people with Alzheimer's will deteriorate, but we can maintain them for a little bit longer at a little bit higher level of functioning with a little bit more independence," thanks, in part, to a little Magic.
East Northport, N.Y.-based freelancer Lisa Maher is a regular contributor to CLTC.
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|Publication:||Contemporary Long Term Care|
|Date:||Jul 1, 2001|
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