Abstract
To comprehensively review studies on dog-assisted interventions(DAIs) among older people in residential long-term care facilities (RLTCFs) and to provide an overview of their interventions, outcomes and methodological quality. We searched 18 electronic databases to identify English articles (published January 2000-December 2019) reporting on well-defined DAIs targeting older adults (≥65years) in RLTCF. Data were extracted by two independent reviewers. Descriptive statistics were produced for quantitative studies, with key themes identified among qualitative studies. Where possible, estimates were pooled from randomised controlled trials using random effects meta-analyses. Forty-three relevant studies (39 quantitative; 4 qualitative) were identified. The majority of quantitative studies were assessed as low-quality according to the MMAT criteria (n = 26, 67%). Almost half of the quantitative studies (n = 18, 46%) found no significant changes over time or between groups across outcomes measured. The most salient intervention effects included improved social functioning (n=10), reduced depressive symptoms (n=6) and loneliness (n=5). A random-effects meta-analysis revealed a medium effect in favour of DAT on reducing depressive or loneliness symptoms (pooled SMD: 0.66, 95%CI 0.21-1.11; I2 =50.5; five trials), relative to treatment as usual. However, compared to treatment as usual, no overall effect of DAI on activities of daily living was detected (p=.737). Key themes from qualitative studies included (a) animals as effective transitional objects, (b) the therapeutic value of pets and (c) the significance of the care environment and stakeholders in facilitating DAI. The findings of this review indicate that while DAI has value for older people in RLTCF, challenges remain in accurately measuring its impact to provide a stronger evidence-base. Standardisation of DAI service design, delivery and evaluation is required for future research and practice in providing holistic care for older adults.
Highlights
Older adults living in residential long-term care facilities (RLTCFs) (Siegel et al, 2019), including nursing homes (Sanford et al, 2015), represent one of the largest high dependency care populations worldwide (Chatterji, Byles, Cutler, Seeman, & Verdes, 2015)
Based on data from four randomised controlled trial (RCT), we found no overall effect of dog-assisted interventions (DAIs) on increasing activities of daily living or physical functioning three to eight months postintervention (SMD: −0.11, 95% CI: −0.74, 0.52; p = .737), compared to treatment as usual (TAU) (Figure 3)
Reminiscence was frequently reported as an outcome of DAI (Coleman, 2016a; Gundersen & Johannessen, 2018; McCullough, 2014; Swall et al, 2015), and the presence of a dog was reported to act as memory triggers and evoked feelings from ‘time and places retold’
Summary
Older adults living in residential long-term care facilities (RLTCFs) (Siegel et al, 2019), including nursing homes (Sanford et al, 2015), represent one of the largest high dependency care populations worldwide (Chatterji, Byles, Cutler, Seeman, & Verdes, 2015). The impact of long-term conditions, multimorbidities and reduced opportunities for social contact in a closed environment often creates a complex range of needs and requires a comprehensive holistic approach (World Health Organization, 2015). Meeting these care needs is the responsibility of a great number of professionals, including RLTC staff and a range of visiting healthcare professionals. Some research has started to explore the pivotal role of creating a culture in RLTCF that genuinely thinks about different and diverse ways of maximising resources and finding ways to support care so that it meets the needs of the care community (Killett et al, 2013)
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