Prime Time Replay:
Elaine Glass, R.N.
on Animals in Palliative Care
MsgId: *breakthru_medicine(4)
Date: Wed Mar 26 20:38:31 PST 1997
From: moderator At: 206.80.178.100
Welcome. I'm Madeleine Lebwohl, the moderator of Breakthrough Medicine. Tonight I'll be speaking with Elaine Glass, R.N. Elaine is a specialist in palliative care. She also visits hospital patients with her dog as part of the Pet Pals program at Ohio State University.
MsgId: *breakthru_medicine(6)
Date: Wed Mar 26 20:52:20 PST 1997
From: Elaine At: 140.254.114.97
Hello, Elaine here.
MsgId: *breakthru_medicine(8)
Date: Wed Mar 26 21:07:48 PST 1997
From: moderator At: 206.80.178.100
Hello, Elaine. Nice to have you on Breakthrough Medicine. Why don't we start by discussing your participation in Pet Pals with your dog, Ollie. What kind of dog is Ollie?
MsgId: *breakthru_medicine(11)
Date: Wed Mar 26 21:12:14 PST 1997
From: Elaine At: 140.254.114.97
Ollie is a beagle-mix. We are not sure what the other part is. We got him at the local Humane Society. He had been abandoned in an apartment when he was one and a half years old.
MsgId: *breakthru_medicine(12)
Date: Wed Mar 26 21:13:49 PST 1997
From: moderator At: 206.80.178.100
What kind of training did he need to enter pet pals?
MsgId: *breakthru_medicine(13)
Date: Wed Mar 26 21:17:11 PST 1997
From: Elaine At: 140.254.114.97
He did not have formal training. He had to pass various tests,including friendliness, fear of noises, fear of hospital equipment, and tolerance to being pulled on. He had to ride elevators and be comfortable around wheel chairs.
MsgId: *breakthru_medicine(15)
Date: Wed Mar 26 21:19:40 PST 1997
From: moderator At: 206.80.178.100
And the patients reactions to him? Was he pulled on much?
MsgId: *breakthru_medicine(16)
Date: Wed Mar 26 21:21:53 PST 1997
From: Elaine At: 140.254.114.97
Occasionally, children of patients have pulled on his tail and ears. We had one case in five years where the patient was a little rough. The most remarkable reaction to Ollie came when a stroke patient who had never talked in the presence of the nurse on duty, suddenly thanked us for bringing the dog.
MsgId: *breakthru_medicine(19)
Date: Wed Mar 26 21:30:26 PST 1997
From: moderator At: 206.80.178.100
Let's back up a little and talk about the theory behind animal-assisted therapy. Nurses on the floor can see the benefits that patients get from your visits. What are these benefits? Who started bringing animals into hospitals?
MsgId: *breakthru_medicine(20)
Date: Wed Mar 26 21:33:17 PST 1997
From: Elaine At: 140.254.114.97
As early as 900 b.c. Homer wrote about the healing power through dogs. In 1790, in England, dogs were used in treatment instead of drugs. In 1859 Florence Nightengale said "a small pet animal is often an excellent companion for the sick." In 1919, animals were used in a hospital in Washington D C and they are still used today. In 1950 Dr. Levinson began doing research in documenting the effects of animal-assisted therapy. Benefits documented since then are: decreased blood pressure and pulse, decreased stress level, and feeling less pain when the animal is present.
MsgId: *breakthru_medicine(24)
Date: Wed Mar 26 21:40:30 PST 1997
From: moderator At: 206.80.178.100
And how did the dog help the stroke patient to speak?
MsgId: *breakthru_medicine(25)
Date: Wed Mar 26 21:43:03 PST 1997
From: Elaine At: 140.254.114.97
There are times when a patient will respond to a dog when the patient will not respond to another human. This is especially true with autistic children.
MsgId: *breakthru_medicine(26)
Date: Wed Mar 26 21:43:48 PST 1997
From: moderator At: 206.80.178.100
Are there any theories on why this happens?
MsgId: *breakthru_medicine(27)
Date: Wed Mar 26 21:47:47 PST 1997
From: Elaine At: 140.254.114.97
We do not know of any theory. My guess is that it the dog's unconditional love.A good resource for animal-assisted therapy is the book by Mary R. Burch, PhD. titled "Volunteering With Your Pet" 1996 We have used this as a source for part of our prior information.
MsgId: *breakthru_medicine(30)
Date: Wed Mar 26 21:53:17 PST 1997
From: moderator At: 206.80.178.100
Elaine, let's discuss your other work in palliative care. I understand you are involved with a hospice program.
MsgId: *breakthru_medicine(31)
Date: Wed Mar 26 21:55:10 PST 1997
From: Elaine At: 140.254.114.97
Although we're just getting our hospice program started, I'm familiar with a dog in another hospice program in town. The dog always seemed to know when someone was going to die soon, and she would have an intuitive sense to pick out the most grieved person and sit with them. One example was a fourteen year old whose Dad was dying, who would just sit against the wall with her head down and her arms crossed. And the dog went and sat with her and within half an hour the teenager was stretched out and crying with the dog.
MsgId: *breakthru_medicine(33)
Date: Wed Mar 26 21:57:30 PST 1997
From: moderator At: 206.80.178.100
How is palliative care tied to the hospice program?
MsgId: *breakthru_medicine(34)
Date: Wed Mar 26 21:58:46 PST 1997
From: Elaine At: 140.254.114.97
Palliative care is to relieve pain and symptoms which can occur in persons at any time during their illness, not just during the terminal phase. The palliative care is often used to provide comfort to people with prolonged, chronic illnesses. In actuality, hospice has been around longer than palliative care, and palliative medicine is just now starting to use the skills and techniques used in hospice earlier in the disease process. Just within the past few years the academy of Hospice and Palliative Care physicians has developed a certification program for physicians in palliative medicine in the United States. They're just now starting to do research on the ICD-9 code, which is one of the hundreds of codes that doctors use to bill patients, to figure out what kinds of treatments are used and what are the costs of the treatments to provide palliation.
MsgId: *breakthru_medicine(38)
Date: Wed Mar 26 22:04:46 PST 1997
From: moderator At: 206.80.178.100
What exactly comprises palliative care? How is different from a social worker or psychologist visiting a patient in the hospital?
MsgId: *breakthru_medicine(39)
Date: Wed Mar 26 22:06:21 PST 1997
From: Elaine At: 140.254.114.97
It includes those two specialties, plus spiritual care and good medical management. Specialists in palliative care have said that if more physicians were familiar with the skills in palliative care, less people would want to visit Dr. Kevorkian.
MsgId: *breakthru_medicine(40)
Date: Wed Mar 26 22:07:12 PST 1997
From: moderator At: 206.80.178.100
Can we talk a little about palliative care in difficult cancer cases?
MsgId: *breakthru_medicine(41)
Date: Wed Mar 26 22:09:19 PST 1997
From: Elaine At: 140.254.114.97
I've heard several speeches given that 90 to 95 % of cancer pain can be controlled, but if you have a pain specialist 100% can be controlled. And twice in the last three years we have used sedation in addition to opiodes to make the patient comfortable.
MsgId: *breakthru_medicine(42)
Date: Wed Mar 26 22:11:45 PST 1997
From: moderator At: 206.80.178.100
When a patient leaves the hospital, how does palliative care continue?
MsgId: *breakthru_medicine(43)
Date: Wed Mar 26 22:13:37 PST 1997
From: Elaine At: 140.254.114.97
If the patients prognosis is more than six months, the palliative care would continue through home health care. If the prognosis is less than six months, the care would be provided by a hospice. The advantage of a hospice is that it is truly multidisciplinary. All the social work, nursing, spiritual care and medicine work together to provide the care. Hospice also provides bereavement care for the family for 13 months after the patient dies.
MsgId: *breakthru_medicine(45)
Date: Wed Mar 26 22:15:46 PST 1997
From: moderator At: 206.80.178.100
Does palliative care prolong a patients life?
MsgId: *breakthru_medicine(46)
Date: Wed Mar 26 22:17:12 PST 1997
From: Elaine At: 140.254.114.97
Yes, it can. Sometimes when patients pain and symptoms are well controlled they are able to recover from their illness. One lady who was admitted to hospice with a six month prognosis lived for nine years. I had another lady who was doing so well she had to be discharged from hospice. She got additional chemotherapy and lived for another two years.
MsgId: *breakthru_medicine(48)
Date: Wed Mar 26 22:19:07 PST 1997
From: moderator At: 206.80.178.100
What is the difference in the care they're receiving that helps their case turn around?
MsgId: *breakthru_medicine(49)
Date: Wed Mar 26 22:20:20 PST 1997
From: Elaine At: 140.254.114.97
Traditional medicine focuses primarily on the illness and its effect on the body. Where palliative care is holistic and it looks at the illness as it affects the body, the mind and the spirit. I think a lot of people would think this type of work is depressing, but its very rewarding because the patients are very courageous and they really appreciate that you can provide for them. We had a local musician that couldn't play his musical instrument until a pain specialist saw him. In addition to opoids, when nerve pain is the problem, other types of drugs, like anti-depressants are very helpful. And its not because of its anti-depressant effects, its because of their indirect effects on the nerve. And they just kind of serendipitously found that as a result of giving anti-depressant therapy to terminally ill patients.
MsgId: *breakthru_medicine(52)
Date: Wed Mar 26 22:30:03 PST 1997
From: moderator At: 206.80.178.100
Elaine, thank you for your intriguing description of pets effects on patients, and for discussing palliative care.
MsgId: *breakthru_medicine(53)
Date: Wed Mar 26 22:30:53 PST 1997
From: Elaine At: 140.254.114.97
Thank you for the opportunity to dialogue with you on the internet.
MsgId: *breakthru_medicine(54)
Date: Wed Mar 26 22:32:18 PST 1997
From: moderator At: 206.80.178.100
It was great talking to you. Please join me next week for another Breakthrough Medicine. Good Night!
Home || Prime Time || Live Science || Machine Dreams || Project Open Book || SF-Fantasy-Horror
Continuum || Antimatter || Mind-Brain Lab || Interactive IQ || Gallery || OMNI ToonsQuestions, comments and suggestions can be mailed to the webmaster.
Copyright (C) 1997 by Omni Publications International, Ltd. All Rights Reserved.