**8. Risks of AAT and Their managements**

**Authors Patients or**

316 Understanding Alzheimer's Disease

*Fritz CL, et al. 1995*

*Tribet J, et al. 2008*

*Kanamori M, et al. 2001*

**study group**

64 Alzheimer patients living in a private nursing home.

2 female and one male patients in a nursing home diagnosed with severe dementia.

7 patients with senile dementia and 20 patients enrolled into the control group in an adult day care center.

**Pet therapy model**

Pet-therapy group: 34 patients contact with pets Control group: 34 patients didn't contact with pets.

A dog therapy used 15 times over 9 months. A therapy performed in the same place for 30 min, once a week.

AAT was used for 6 weeks. Before and after AAT was evaluated mini mental state, activities of daily

living, behavioral pathology and salivary CgA.

**Table 5.** Animal Assisted Therapy Studies in patients with Alzheimer´s disease and other dementia

According to the literature, number of studies recommending animal assisted therapies in clinical and social medicine practices in elderly people with dementia, Alzheimer´s disease, ability losses, mental health problems and conduct disorders, cognitive problems, physical and functional health problems have been increased rapidly. [1-3], [63] Targeted acquisitions

**Results Study design**

Methodological

Prospectivequalitative study

Methodological

study

study

It was observed that, verbal aggression and anxiety was reported less in patients exposed to companion animals than patients didn't exposed to pets.

Psychological benefits obtained from the study as follows: *Calming effect* was observed on the patients, which is this effect provided that communication link would be needed during therapy

With the dogs' unconditional acceptance *increased patients' selfesteem* need to pateints felt theirselfs was in more secure

Addition, it was observed that their *social behaviours increased* by touching dog and its non-verbal

The average mini mental state exam score was more higher than baseline, activities of daily living was more higher than baseline, behavioral pathology was more lower than baseline and finally salivary CgA was found to be decreasing tendency.

Several methods can be used in order to show useful effects of AAT in patients with dementia as determined in this study by Kanamori M, et al.

sessions.

environment.

communication.

In USA, 60% of the population has at least one pet at home. Patients and animals participating in AAT require special care for prevention of zoonotic diseases, hypersensitivity reactions and injuries during visits. Therefore, the maximum benefit obtained from this therapy method depends on the multidisciplinary team work of a veterinarian specialist, a veterinarian public health specialist, a medical doctor, and an experienced therapist. [49], [80] Animal assisted therapy performed at treatment centers should always be performed following by a structured program, under the recommended guides, and targeted at the objectives of the program. [49] Hamsworth and Pizer reported after they investigated studies, which evaluated interactions with animals, and risk factors for zoonosis in immunocomprimised children, and guidelines that information obtained from specialists were not adequately evidence-based. Keeping an animal is beneficial for prevention and development of emotional and physical health. However, guidelines are also required to conduct treatments. [81]

Minimization of risks in such applications depends upon a careful planning with multidis‐ ciplinary approaches, written protocols, personnel training, documentation, and investiga‐ tions. Veterinarian public health practices, which will be performed in this field, are important sources to keep risks endangering human and animal health at minimum levels. Especially veterinarians should choose the appropriate animal for therapy of each patient group according to temperament and behaviors of animals, perform the care for each animal, work for prevention of zoonotic diseases, and suggest an appropriate interaction model for the therapy. [32] Infection controlling policies and regulations should be obeyed in treatment and prevention of zoonotic diseases, so that animal assisted therapies will be more widespread. If measures for risk prevention are taken, then AAT applications can be performed safely. [82], [83]

In studies, where risk analyses have been performed, people interacting with pets have been observed to have benefits for their health. It has been reported from regions, where risks were not significantly high, controlled environmental conditions are provided especially in Europe and North America, potential benefits are reported in treatments with animals kept at home or at hospitals. Guidelines have been developed to limit infection risk during applications and to perform safe treatments. [84]- [86]

In addition to guidelines used during treatments, supportive units have also been established. Animal Assisted Crisis Response (AACR) unit is one of these. This unit provides services in how to struggle with the impending crises for assigned healthcare personnel, consultants and other trainers during animal assisted therapies. [87] Efficiency of these studies depends upon conductance of communication between the related units with a mutual language and a multidisciplinary approach. The most commonly encountered crises issues may be animal behavior, infection risk, and patient-trainer dispute.

When AAT is practiced according to guidelines, appropriate ethical principles, then it will be an effective supportive treatment option for improvement of human health, life quality, and especially preservation of health state of individuals. However, as it has been undertaken in this present review, it is believed that studies related to animal assisted therapies are required

1 Canakkale Onsekiz Mart University, School of Medicine, Department of Public Health,

2 Canakkale Onsekiz Mart University, School of Medicine, Department of Neurology, Can‐

3 Canakkale Onsekiz Mart University, School of Medicine, Department of Internal Medicine,

4 Canakkale Onsekiz Mart University, School of Medicine, Department of Psychiatry, Can‐

[1] Laun, L. Benefits of pet therapy in dementia. Home Healthc Nurse (2003). , 21, 49-52.

[2] Sockalingam, S, Li, M, Krishnadev, U, et al. Use of animal-assisted therapy in the re‐ habilitation of an assault victim with a concurrent mood disorder. Issues Ment

[3] Macauley, B. L. Animal-assisted therapy for persons with aphasia: A pilot study. J

[4] Ballarini, G. Pet therapy Animals in Human Therapy. Conference Report. Acta Bio

[5] Cevizci, S, Erginöz, E, & Baltas, Z. A new assisted therapy concept for improving of

[6] Cevizci, S, Erginöz, E, & Baltas, Z. Animal assisted therapy for improving human

mental health- Animal assisted therapy. Nobel Med (2009). , 5(1), 4-9.

and Elif Karaahmet4

Animal Assisted Therapy and Activities in Alzheimer´s Disease

http://dx.doi.org/10.5772/54504

319

also in our country to evaluate its efficacies in different patient groups correctly.

, Fahri Güneş<sup>3</sup>

\*Address all correspondence to: cevizci.sibel@gmail.com

Health Nurs (2008). , 29, 73-84.

Medica (2003). , 74, 97-100.

Rehabil Res Dev (2006). , 43, 357-366.

health. TAF Prev Med Bull (2009). , 8(3), 263-272.

**Author details**

Canakkale, Turkey

Canakkale, Turkey

akkale, Turkey

akkale, Turkey

**References**

Sibel Cevizci1\*, Halil Murat Sen2

Before starting animal assisted therapy and during its' all procedures, it is always remembered that AAT should be performed according to the guidelines in order to prevent risks including adverse reactions of patients, animals, physicians, caregivers, nurses, health personnels, and also relatives of patients, infectious diseases, bitings, etc. it is well clearly explained that AAT should be arranged, managed and performed by a specialist team including patients' physi‐ cian, veterinary surgeon, psychologist, occupational therapist, expert caregivers, specialist nurses. Therefore, especially veterinary students should be trained about animal assisted therapies, activities and first of all human-animal bond during their undergraduate and postgraduate education. [88]- [91] At this point, according to the Timmins, a veterinary family practice conception can be helpful to understand and contribute human-animal bond from the theoretical framework into the practice for providing needs of patients. [92]

During applications, issues like increased work intensity of the personnel, zoonotic diseases, comfort and care of animals are considered. [93] These may be prevented by well-planned programming. [94] Disease risk can be easily prevented by regular animal health controls, and follow up of individuals. In developing countries like Turkey, animal assisted therapy is not practiced as a specialty filed, yet. Only limited services can be provided according to positive outcomes of human-animal interactions. But recently, an international project (Animals in Therapy Education) have been implemented for 2 years among different institutions from Turkey, Italy and France with financial supporting by European Union LLP Grundtvig Program for aged people. This project intends to design a collection of best practices related to implementation of pet therapy on aged people. As a result of this project will also ease the transfer of pet therapy practices through the comparison and the evaluation of different solutions adopted in the countries involved among partners from Italy, France and Turkey. [95]
