From Take One Dog and Call Me in the Morning: Amazing Therapy Dogs, Prescription for Healing.
Chapter One: “Go Say Hello”
Lying in the corner, on a sheep-skin pad, Holly Go Lightly waits.Her mouth is curved in that Golden Retriever smile, her tail thumps the floor in anticipation, while she holds the ‘down-stay’ position waiting to go to work.
Nearby, elderly patients sit in chairs placed in a circle. They also wait, some without purpose, others may be simply waiting to die. There is no conversation.Some of the patients look confused, as if they don’t know where they are; others mumble to themselves. One man is slumped over, half asleep, perhaps medicated. The atmosphere in the room is heavy with the depression that comes with Alzheimer’s, Dementia, and other psychiatric disorders.
Vigilant, Holly watches me.She sits sphinx-like on all fours, head up, ears forward and alert, listening for her release-command. I point to the patients, and give her the release words, “Go say hello.”In a flash, she’s up, her tail swaying gracefully as she trots to the circle of chairs, moving through the one space we have left open for her. She is off lead, but I am close behind. She stands quietly, scanning the room. Someone is in distress.
Arms thrashing, his body writhes in the hospital chair, while his moans and groans are heard over the mumblings of the other Alzheimer’s patients. The Golden Retriever moves quickly to his side. She stands in front of him staring for a moment, and then lays her head in his lap. From deep in the animal’s throat we hear a low vibrating note, “ummmmm.” The patient‘s groans change to sounds that match hers, and together they hum, “Mmmm Mmmmm.” His body becomes still. His arms relax. Now, one hand reaches slowly to touch her head as they continue to vocalize together. The dog doesn’t move but looks up into his eyes.The man returns her gaze, regarding her calmly. We just witnessed Animal-Assisted Therapy at UCLA’s Neuro-Psychiatric Hospital.
Without any cues from me, my canine partner sensed agitation in the group of patients.She could smell it. I didn’t interfere with her process by talking to her or giving her instructions while she was assessing the room. I let her nose do the work. The extraordinary power of the canine nose enables dogs to diagnose depression, anxiety, disorientation, and psychiatric disorders through smelling chemical changes in the body.They sense crisis the way medical-alert dogs predict seizure and heart attack, detect breast and bladder cancer and warn diabetics of low blood sugar.
Holly moves in a clockwise direction, stopping in front of a woman who is clutching her leather bag in her lap. The patient’s name tag reads ‘Lila.’ Her mouth is down-turned and her lips pursed tightly. Frown lines run deep between her eyes. Holly sits in front of her, then lifts a paw and offers it as she makes eye contact with the woman.Lila hesitates as Holly continues to wave her paw in the air. Finally she takes hold of it, shakes it, and says, “Hello.” I notice the frown lines soften on her face and her mouth starts to smile as she releases the handshake.
Holly doesn’t skip anyone in the circle. She stops to greet each person, waiting long enough to get a response from them, before moving on. She is here to communicate with those who are disconnected from themselves and from life. She will not leave them until she makes that connection.
The next patient is asleep. The dog stands alongside his chair staring at him with anticipation, just as she stares at closed doors waiting for them to open magically for her. Maybe he hears her breathing, or feels her presence in the same instinctive way that we know when someone is watching us. He opens his eyes to see a dog looking at him. He appears confused as to what to do about it, until she lifts her paw and puts it into his lap. From somewhere in his memory, he recognizes the gesture, and takes the extended paw in his hand. With his free hand, he touches the top of her head, and whispers, “Good dog.”
Holly will approach the person in need; the suicidal kid, the withdrawn adult, or the wildly agitated Alzheimer patient. She will look into his eyes, offer her paw, or lean into his body. She will stay with each patient until her presence is acknowledged. She will wait, not moving from the spot until a hand reaches out to touch her.
My tail twitches from side to side. My eyes see feet all around me. I lift my head and sniff the room. Something is wrong. I smell something I can’t read. The smells in the room are not the usual human smells. My nose picks up the scent of illness, or weakness, something is out of balance. She is talking too long. It is hard to wait. I stare at her. When is it my turn? She gives me the signal, “Go say hello.” I know those words. I jump up and go to one whose smell is different. I look at him but he is not looking at me. I sit at his feet and stare at his down-cast eyes. I put my head in his lap and wait for his hand to touch my head. I lean on his legs. I push my side into him and now he looks up and now his eyes see me. He touches my head. His face smiles. The funny smell is gone. Then I move to the next one who doesn’t smell right and do it all again.
~ Keppel
Sarah, the Occupational Therapist asked if I would visit a private patient after we finished our regular group session.She wanted Holly to interact with a woman who had been “unreachable” saying the family pleaded for a dog visit when they spotted Holly coming down the hallway with me.I said okay, even though we were both tired.She warned me that it might not work as this woman was ‘catatonic,’ and appeared to be in a stupor, not moving, not speaking, and not responding to her name.Individuals with this mental disorder typically show extreme immobility and rigidity. They may stay in the same position for hours, days, weeks, or longer. (DSM-IV-TR)
We followed Sarah down the hallway and stopped outside of a private room. The door was open and four family members were gathered inside speaking what sounded like Yiddish.The patient sat in a wheel-chair, and appeared to be sleeping.The family insisted, “It’s okay to wake her.”The nurse in the room tried to rouse her.“Anna, you have a special visitor.” I stood in the doorway with Holly so she could see us if she opened her eyes. But there was no movement. She didn’t seem to know the dog was standing there. I walked Holly in to meet this woman, not knowing how I would encourage my dog to make a connection with a non-responsive, immobilized patient.
The small room was crowded with the family members, standing around the woman who sat propped up in her chair. Anna was young, probably in her thirties. Someone had dressed her and combed her hair. She used to be pretty, I thought. Her face showed no expression, and she looked as if she had died. How could we do anything? I thought. I introduced Holly to the family and told them that she was a “zeis kindt”(sweet child). My mother called me ‘zeis kindt’ when I was little. I knew about three Yiddish words, and these were two of them.
The other word was ‘Keppel’ an affectionate form of Kop, meaning head. My mother always said I had a keppala (nice little head). I had once taught Holly “keppel” as an invitation to put her head in my lap. Out of desperation, and not knowing how else to make this happen, I said “Holly, keppel” while I lightly tapped the woman’s knees with my hand. My dog approached the lifeless woman and put her golden head on the still lap. The family was impressed that the dog understood Yiddish. There was no response from the woman in the chair. But Holly stayed with her, not moving. She seemed to know someone was in that shell of a body. She would simply wait, as she had learned to do with the Alzheimer patients, wait… as she had learned to do when she wanted me to open doors for her. She knew how to wait.
We all saw it. Anna slowly moved her hands to touch what she felt in her lap. She knew. With her eyes closed, she reached out to explore Holly’s head, as her astonished family looked on. With both of her hands she ran her fingertips over the dog’s face. She felt the eyelids, and eyelashes, then the high forehead and the smooth top of the oval head. Holly sat still, not moving or flinching; just allowing herself to be felt and known.
Everyone in the room seemed to stop breathing and stood in silence. The inquisitive hands slid down to caress the velvety ears and the thick furry neck. The movements were those of a blind person seeing with her hands. The family of three took a needed breath and gasped aloud, almost in unison. I looked at the O.T. who was starting to tear up. Holly moved away when the petting stopped. I brought her back, so she could do it again. I repeated “keppel,” and she knew what to do. The quiet hand reached down once again and stroked the head lying on her legs. The family members sighed, and spoke Yiddish to each other. I heard the word “keppel.”
The catatonic patient never spoke or opened her eyes. But she clearly felt the dog’s presence. The therapist explained that this was the first time this woman had responded to anyone since she’d been there. She was moving, touching, and interacting with the dog. There was life! When we left the room, each member of the family thanked me with tears in their eyes, and caressed Holly’s face, calling her “seis hindt” (sweet dog). The older woman, probably the mother, kissed my hands. I was crying too. These are the moments. Animals can be the source of our connection to each other.
After this visit, we returned to the dining room and I wrote my comments in the PAC log. Sarah and I reviewed what had just happened. She was still in shock. I guess I used the right word.