Animals in Health Care Facilities? Consider These Six Points

Animals were largely banned from health care facilities once microorganisms were identified as the cause of infectious disease. That is reversing. Animal Assisted Therapy (AAT) and pet visitation are moving back into hospitals, and long-term care facilities are keeping companion pets. Here is what the evidence says, and what you need to manage if animals come onto your unit.

1. For many people, a pet is their most significant relationship

A child confides in the dog when they are upset. A person who lives alone bonds more with their cat or bird than with family. For an older adult living alone, caring for an animal can be the main reason to get up in the morning, and walking a dog helps maintain fitness. One study found that older people living alone with a companion animal had 19% fewer encounters with the health care system.

2. Interaction with animals calms patients

This is not new. In the 18th century, William Tuke ran an asylum where patients gained health benefits from being around animals. Florence Nightingale, in Notes on Nursing (1859), wrote that patients confined to one room took pleasure in the presence of a bird.

"A small pet animal is often an excellent companion for the sick, for long chronic cases especially. A pet bird in a cage is sometimes the only pleasure of an invalid confined for years to the same room." -Florence Nightingale

Animals are returning to care settings mainly because they reduce stress. Studies show that stroking and talking to an animal lowers blood pressure and heart rate. Newer research shows cortisol (the stress hormone) drops and oxytocin (the attachment hormone) rises during positive interaction with a companion animal. The same work found that children reported less fear and more optimism after a therapy-animal visit, and looked forward to the next one.

3. Interaction with animals can reduce pain

Studies back this up. A 2009 study reported that children visited by a therapy dog had four times less pain than children who simply rested for 15 minutes. A 2014 study found that adults who had at least one AAT visit after total joint replacement used less pain medication afterward, and patients who had a 15-minute AAT visit before physical therapy reported substantially less pain than the standard-care control group.

4. Know the three types of animal interaction

Animal Assisted Therapy (AAT). Trained, certified handlers and animals (usually dogs) run planned, goal-directed sessions to improve patient outcomes. Ask the patient first, since not everyone wants to interact with a dog.

Pet visitation. The patient's own pet visits. This helps wellbeing but is not structured and has no specific therapeutic goal. Set clear procedures: permissions, a designated area, a veterinary check and vaccination certificate, grooming before the visit, leash or carrier control inside the facility, and staff authority to end the visit if the animal becomes anxious or aggressive.

Pets in long-term facilities. Care homes, psychiatric units, and rehab facilities keep dogs, cats, and other animals in the same role they fill at home. These animals need suitable temperaments and standard pet care: correct feeding, regular grooming, vaccinations, deworming, flea treatment, and vet care when ill. Hold living and feeding areas to a higher hygiene standard, and keep animals out of treatment rooms, food storage and prep areas, and dining rooms.

5. Infection risk from animals is very low

Infection fear is the main objection, and it does not hold up. Hospitals are not sterile. They harbor as many microorganisms as any other setting and are a leading source of resistant organisms. A number of investigations, some long-term, found no increased infection risk from AAT. A literature review concluded that immunocompromised people face no greater infection risk from animals than from other people.

Cut the residual risk with basics: wash hands before and after contact, and use a disposable cover if the animal is allowed on the bed. Keep animals away from invasive-device sites, wounds, surgical incisions, and equipment. Some areas stay off-limits entirely: ICUs, neonatal units, isolation areas, treatment rooms, kitchens, and pharmacies.

6. Published guidelines exist

The Society for Healthcare Epidemiology of America published "Animals in Healthcare Facilities" in 2015. SHEA stresses these are recommendations based on expert opinion, since there are no recognized standards, laws, or robust scientific evidence yet.

The bottom line: there is little reason not to use AAT or pet visitation as added therapy when it benefits the patient physically or psychologically.