Sit, Stay and Heal

A new breed of dogs has arrived in the world of health care.

Once limited only to guiding the blind, trained canines are finding places in a variety of assistive settings. Hospitals and nursing homes are using animals called therapy dogs to comfort, entertain and de-stress--and thereby help heal--patients battling a variety of conditions. For the mobility-impaired, highly trained canines called service dogs can pick up dropped keys, open and close drawers, retrieve prepared meals, help a person in and out of a bathtub, dial 911, push and pull wheelchairs, help operate a car or van, and pull off gloves, shoes, socks and jackets. Other dogs provide specific assistance to those who suffer seizures and require special medication. And, of course, the helping dogs provide companionship, play and unconditional love for the people they assist.

This year marks the 25th anniversary of the placement of the first assistance dog (seeing-eye dogs have been around longer than that). But only in recent years, with the rising independence movement among disabled people, has the idea begun to spread widely.

Although most service dogs are trained to work with people who rely on wheelchairs, other categories of helping dogs include hearing dogs (they alert their owners to sounds: doorbells, phones, cooking timers, alarm clocks, smoke alarms) and seizure dogs (they carry medications in their packs and are trained to dial 911 on large-keyed phones).

For Jay Liesener, 28, who has been paralyzed since he snapped his neck while playing on a friend’s backyard trampoline 11 years ago, his black Labrador was a step up from human predecessors.

Teddy gives him round-the-clock assistance.

“The big thing for me is having someone around at all times,” says Liesener. “I used to feel like I was bugging people like [his fiancee] Melanie or my attendant, asking for help, picking things up for me. Having Ted there, I feel better about myself. He minimizes my disability.”

It was not always this simple. Two years after his accident, equipped with an automated wheelchair, Liesener enrolled as a freshman at the University of Maryland, got an apartment, and hired a live-in attendant to provide bathing, dressing and medical assistance during certain hours at his apartment. The setup looks good in theory, but with human helpers, there are problems. Like the fact that they can’t always be there to anticipate every problem.

Despite all the high-tech gadgets now available, the most minor mishap can ruin a day for a disabled person who lacks 24-hour assistance.

The benefits of service dogs, who are always available uncomplainingly, are simple but profound.

Teddy has been Liesener’s full-time companion for two years, going to the grocery store with him, sleeping on his bed at night, attending classes with Liesener while he finished his bachelor’s and master’s degrees, and as he works toward a doctoral degree in counselor education. A human attendant now comes to the house only in the morning and evening to help with bedtime and morning routines.

“At home, Ted is half pet, half service dog,” says Liesener. “He gets up on the couch with us and plays, and I brush him, but if I drop something, he gets it.”

Ted is fully specialized, meaning he performs tasks to fulfill Liesener’s specific needs. But training is a continuing process. Most recently, Liesener has been trying to teach Ted to bark on command.

A Lifeline to the Outside World

Twenty five years ago, while traveling and teaching in Turkey, Nepal and Iran, Bonnie Bergin noticed self-sufficient disabled people going about their unremarkable daily business, often using burros and donkeys to hold pots, pans and other wares to be sold. She later returned to the United States to begin work on a master’s degree in special education.

“I thought hard about what can be done to get people out of institutions and onto the streets, getting jobs, and it came to me: dogs,” says Bergin, who today has a doctorate in education and is founder of the Assistance Dog Institute and originator of the service-dog concept.

She ran into fierce resistance from academics and professionals at first: Dogs spread disease. Dogs are stupid. The disabled can’t take care of dogs, how could dogs take care of them? But the long list of negative reactions didn’t stop her. Her first trainee was Abdul, a golden retriever puppy someone had given her.

“I knew absolutely nothing and had no preconceived notions,” she says from her office in Rohnert Park, Calif.

Her first dog-assistance client was Kerry Knaus, a soft-spoken 19-year-old woman who had a neuromuscular disorder that had left her unable to move her legs and much of her arms. If Knaus accidentally fell forward in her wheelchair, she could not get up. She clearly lacked the physical force to train and maintain a dog. But Bergin was undeterred.

Bergin and Knaus concentrated not on physical gestures, but on verbal cues such as “sit” or “stay,” using variations in tone of voice and facial expression to get Abdul to help Knaus.

By the end of his training, the dog could push Knaus up from her in-chair falls, open doors, turn on lights, retrieve food and push levers to help her operate the chair lift to her van. Most important, Knaus developed a trusting emotional bond with Abdul simply by spending time with him, much in the way humans get to know one another and develop subtle, complex relationships based on mutual understanding.

Today, more than 150 programs provide similar services, and an estimated 3,500 service dogs are in place worldwide. Waiting lists for the dogs, who are worth around $10,000 by the end of training, can be long--sometimes five years--because of the extensive breeding, training and bonding required.

People in this mostly nonprofit business foresee significant growth to meet the needs of aging baby boomers, who will likely live longer than the elderly in previous generations and therefore have higher risk of disabilities--and more need of assistance.

“No one wants to be institutionalized,” says Debbie Gavelek of Fidos for Freedom, a nonprofit group that offers seeing, service and therapy dogs. “But at some point, there are going to be a lot of us disabled.”

Lydia Wade of Manassas, Va., graduated from Bergin’s eight-week program for trainers in 1994. Wade operates her program, Blue Ridge Assistance Dogs Inc., in a remodeled barn.

Like many people in the business, Wade compares her dogs to children. Emotionally and intellectually, they are very similar to human toddlers, she says. They can’t use language, but they have emotions on which they act without understanding them completely. They follow directions when kept on track. They want to please. They need and return loads of affection.

Repetition, patience, display of respect for the animal, verbal and sometimes culinary rewards--methods that mirror today’s toddler toilet training--help Wade teach a dog about 20 commands in six weeks. Wade carefully matches a trained animal with a client, and the three work together for two weeks, often spending eight-hour days in the barn. “The dog should be looking to the client, not to me, for what he or she needs,” says Wade. She often hides behind the client’s wheelchair on the first day and gives commands in her own voice until the dog makes a visual connection between the command and the client.

“The client really has to want the dog,” Wade says, “because training is frustrating.”

Offering a Dose of Playful Joy

Therapy dogs, which deliver some of the emotional benefits of canine contact but not the lasting relationships, visit people in hospitals, nursing homes and other locations. There, people with physical or mental illnesses can share, at least briefly, the joy, comfort and liberating moments the animals can provide.

Medical studies have shown that petting an animal can lower blood pressure, heart rate and skin temperature, and that pet owners tend to live longer than non-pet owners. Although much of the literature devoted to the benefits of human-animal bonding is anecdotal, a number of Washington-area health-care providers--including two high-profile research centers--offer such visits for some patients.

Anyone can volunteer themselves and their dogs to participate in a therapy program. The dogs must pass a test that demonstrates obedience and a docile nature.

The Delta Society, a national organization that oversees animal-assisted therapy and provides certification protocols for animals and their handlers, estimates that more than 2,000 animals nationwide participate in assisted-therapy programs, visiting more than 350,000 people each year.

National Capital Therapy Dogs Inc., a Washington-area nonprofit group, organizes regular visits to several local hospitals, including the National Institutes of Health in Bethesda, Md., and the Children’s House at Johns Hopkins in Baltimore, which provides housing and emotional support for families of Hopkins’ pediatric patients. In all the years of pet-assisted therapy throughout the country, not one case of infection has been shown to be caused by the animal, the group reports.

One recent Tuesday night at the Children’s House, volunteers Linda Solano and her whippet, Jessie, Marlene Truesdell and her chocolate Labrador, Claire, and Michelle and Mark Cohen and their beagles, Daisy and Annie, gathered in the downstairs rec center. Solano and the volunteers, members of National Capital Therapy Dogs, covered the newly upholstered couches with pink sheets.

Gradually the kids, who suffer from serious illnesses--cancer and neurological and spinal disorders--were wheeled in. One blond, paper-pale wisp of a boy, in a wheelchair with his legs propped straight out and a pillow clutched protectively across his stomach, was so weak he could barely speak. Solano gently picked up Jessie and carried her over to the boy.

Encouraged by his mother, the boy attempted to raise his hand to pet the animal. Solano got closer. The boy smiled. By the end of the hourlong session, he was giggling at the circus-like performance of Daisy and Annie, especially Annie as she flew from the couch and landed on the Cohens’ backs. The boy’s legs were bent and swaying contentedly. The pillow was tossed aside. “Do that again,” he said to the Cohens and laughed.

At the evening’s peak, the place was packed with more than 23 highly animated, smiling people and four dogs. Claire visited with a girl with severe palsied movements. Claire never flinched. The dogs, wearing official therapy-dog packs and tags, maintained their composure through it all.

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Curative Canines

Service- and therapy-dog programs vary widely in cost and operations. Applicants seeking a hearing or service dog from Fidos for Freedom in Laurel, Md., pay $160 and must complete at least 120 hours of training with the dog. At the Assistance Dog Institute in California, applicants pay $2,500 but train for two weeks.

Also, organizations vary dramatically in their relationships with the disabled person after the dog has been placed. Clients frequently need ongoing assistance.

So applicants might want to weigh the benefits of a local versus a national company.

Lydia Wade of Blue Ridge Assistance Dogs Inc. frequently visits with clients and dogs she has matched. National organizations, such as Canine Companions for Independence, don’t always have local contacts.

Among the groups offering assistance dogs are:

* Canines Companions for Independence, P.O. Box 446; Santa Rosa, CA 95402-0446; (707) 528-0830 or e-mail info@caninecompanions.org.

* Pet Assisted Therapy Services, P.O. Box 90550, San Jose, CA 95109; (408) 280-6171.

* Assistance Dog Institute, P.O. Box 2334, Rohnert Park, CA 94927; (707) 585-0300; https://www.assistancedog.org.

* Blue Ridge Assistance Dogs, 11215 Dumfries Road, Manassas, VA 20112; (703) 369-5878; e-mail, BLRDGHOPE@aol.com.

* Fidos for Freedom Inc., P.O. Box 5508, Laurel, MD 20726; (410) 880-4178; TTY, (301) 570-7770; https://www.fidosforfreedom.org.

* Dog Ears & Paws, P.O. Box 688, Owings Mills, MD 21117; (410) 655-2858, TDD, (410) 655-2858; e-mail, Debbie@YOURCOMPANIONS.COM.