Medscape Medical News
March 8, 2013 -- A small but growing number of U.S. hospitals are expanding their visitation policies to allow supervised visits from furry family members.
Rush University Medical Center in Chicago, one of the latest hospitals to adopt a visiting policy for pets, had its first patient-owned pet visit in February. Sadie the dachshund climbed onto the lap of her owner, Bernadette Slesinski-Evans, who from her hospital bed happily let her dog lick her face.
The visit took less than two days for staff to arrange, but the policy took almost three years to develop, says Diane Gallagher, RN, associate vice president of nursing operations at Rush. The challenge, she says, "was how to make the policy safe for patients, employees, and visitors without making it burdensome to implement."
"When you say 'hospital and dog,' it doesn't sound like it fits," Gallagher says. "The hospital is not a resort, but this is a therapeutic intervention. It's one more tool we have to help patients get through what must be some of their worst days."
Or in some cases, the patient's final days. Slesinski-Evans died weeks after her visit with Sadie. "I feel so lucky we were able to do this for her," Gallagher says.
She believes pet visiting programs, although becoming more common, are still controversial because not everyone likes animals or thinks they should be in a hospital. When she surveyed hospitals nationwide in 2010, Rush says she heard from only 12 hospitals that have similar programs.
Citing extensive research showing that patients feel hope and joy from being near their pets, Gallagher says the benefit to the patient is worth the risks of a pet visit in the hospital. "It takes their mind off their stress and anxiety," she says.
Many studies have shown both physical and psychological good effects of animal-assisted therapy. Reported benefits include lowered blood pressure, less pain, more happiness, and motivation to get better, a review in the American Journal of Critical Care shows. Supporters of pet visitation programs, however, say hospitals need to go beyond long-standing policies of having therapy dogs, because patients prefer to see their own pets.
A visit from one's pet is especially meaningful for patients who are depressed, says Deborah Stein, MD, MPH, chief of the section of trauma critical care at the University of Maryland's R Adams Cowley Shock Trauma Center in Baltimore.
Before the University of Maryland Medical Center began its pet visitation program in 2008, Stein, a dog lover, helped get approval to reunite two of her spinal-cord-injured patients with their dogs at the Shock Trauma Center. Although both patients were paralyzed from the neck down, they were mentally aware and were able to be close to their dogs during the short visits, she says.
"It did wonders for these patients to be able to gain a little bit of normalcy. The expression on the patient's face was wonderful," Stein says. These good feelings tend to linger after the pet leave, she says.
A pet visit may also have social effects that can improve care. There is anecdotal evidence that after a pet visits, the patient may open up and communicate better with care providers, says Jane Rosenman, MD, a pediatrician at the Mayo Clinic Children's Center in Rochester, Minn.
The Mayo Clinic's pet visitation policy has been in place for at least 20 years at its Minnesota campus and is part of its complementary and integrative medicine program, says program coordinator Barb Thomley.
As is typical of hospital pet-visiting programs, the Mayo Clinic requires family and staff to get approval from the patient's doctor, schedule the visit ahead of time, and limit the in-room visit to two hours so the patient does not become overly fatigued. The Mayo Clinic does not allow pets to visit if the patient has open wounds that cannot be covered or if the patient's immunity is low.
Hospitals that allow pet visits, most often limited to a single dog or cat, have a long list of requirements for the visiting animal. Typically the pet must:
Some hospitals have additional requirements. For instance, the University of Maryland Medical Center asks that pets wear a coat or T-shirt to lessen shedding and dander. State laws on animal visits vary, with Minnesota not allowing animals younger than 1, according to the Mayo Clinic's policy.
Proper pet selection also is important for a safe visit. To ensure that a dog has a nonaggressive temperament, Rush University Medical Center has a staff member call the pet handler to ask whether the dog has ever growled at or bitten anyone, Gallagher says. A unit volunteer meets the pet handler and dog when they arrive at the hospital to make sure the animal is friendly. The hospital staff members inform the patient and pet handler that if the pet misbehaves or causes problems, the visit will end.
At Rush, as at other hospitals, a designated staff person must stay with the pet throughout the visit. In addition, pets cannot be in Rush's obstetrics or psychiatric units or the neonatal intensive care unit, Gallagher says.
The Cincinnati Children's Hospital Medical Center in Ohio plans a different kind of pet-visiting program. The 500-bed hospital announced plans to break ground this spring for an attached pet-visiting center, which it calls "the first hospital-based, pet visitation center in the nation."
John Perentesis, MD, director of oncology at the children's hospital, suggested the addition after seeing a similar center at Alberta Children's Hospital in Canada. Pets will not need to be groomed or recently checked by a veterinarian -- policies required at some hospitals that he says are difficult for both the family and the pet.
Because the proposed center will have an exterior door and pets will not need to move through the hospital, there will also be less risk of aggravating allergies of other patients and visitors, he says.
"Our goal is to allow pets to visit patients with a minimum of inconvenience and cost to patients, families, and pets," Perentesis says. "It will be easier for the family, who is already under a lot of stress."
Expected to be completed this summer, the pet-visiting center will have both indoor and outdoor space and will allow two pet visits at a time, he says. Grant funding from CancerFree KIDS, a Loveland, Ohio, nonprofit organization, will help pay for construction of the center.
Pet visitation programs are in place not only at large academic medical centers such as Cincinnati Children's, but also at rural hospitals such as Grinnell Regional Medical Center in Iowa. As part of an initiative to create a healing environment that includes nature, the pet-visiting program initially focused on hospice patients and expanded from there, says Todd Linden, president and chief executive officer.
To see a version of this story for physicians, visit Medscape, the leading site for physicians and health care professionals.
SOURCES: Diane Gallagher, RN, associate vice president of nursing operations, Rush University Medical Center, Chicago.Margo, A. American Journal of Critical Care, July 2008. Deborah Stein, MD, MPH, chief, Section of Trauma Critical Care, University of Maryland R Adams Cowley Shock Trauma Center, Baltimore. Jane Rosenman, MD, pediatrician, Mayo Clinic Children's Center, Rochester, Minn. John Perentesis, MD, director of oncology, Cincinnati Children's Hospital Medical Center,Ohio. Todd Linden, president and chief executive officer, Grinnell Regional Medical Center, Iowa.
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