Sometimes the resources that benefit a patient’s health and the tools that doctors use are separated without reasons that explain that divorce. A clear example of this contradiction is the animal-assisted therapies. Today nobody comes across a pet in a clinic or hospital. And although the first written record of the benefits of contact with dogs and cats in the recovery of a sick person was written in 1860, it was only a century and a half later that this complementary therapy began to be accepted by health institutions. Now two hospitals of excellence, one private and one public, have just become the pioneers of this technique in Argentina.
“Being admitted for a treatment is not a harmless process and, for many people, it is almost like a second disease, a very strong dysfunction that causes “collateral damage”, he told NEWS Dr. Liliana Ortega, head of pediatrics at the Argentine Institute of Diagnosis (IADT), “And so all the time we think about how we can alleviate that circumstance, especially in boys,” he explained. “The idea came to us a few years ago when we had a boy hospitalized with an oncological pathology that did not improve. One day he told us that he missed his puppy a lot and we thought about bringing him, but the Institution did not allow it. However, the idea stayed with us biting and since then we always think how to make it possible for other cases”.
It was Diego Fernandez Sassoone of the IADT pediatric hospitalization coordinators.
“In our specialty one wants the family be the most united possible and more in painful circumstances such as a disease with a long hospital stay. And that’s how we encourage grandparents, uncles and friends to come to the hospitalized patient’s visit. But we also think that today the families They are becoming “multispecies“And that’s why it was natural to think that pets would join the visit.”
This, which currently seems a natural step in medical practice, does not have much history. Fernández Sasso recalled that “today it seems natural to us, but the joint hospitalization of children with their mother is something relatively recent. For example, my father had polio and said that he was left alone after my grandmother’s visit. Only in the decade In the 1950s and 1960s, Dr. Florencio Escardó challenged that concept. What is happening now is, once again, changing the paradigm that prohibits pets from entering a medical center.”
On the other hand, this move is something that is inserted in a generalized social phenomenon: in the daily you see more and more restaurants, hotels and businesses “pet-friendly“Why wouldn’t that also happen in an institution linked to health? And more so in Argentina, a country classified as “very pet friendly”.
Humanization
The project with pets that advances in the IADT is not the only one in the country. At the end of 2021 in the El Cruce Nestor Kirchner Hospital (HEC) were also opened to receive therapeutic animal visits from patients as well as staff. “Our institution is highly complex in terms of technology and care, but it also seeks to be a more humane hospital, with people-centered care and adaptation to the needs of each individual that makes up this community,” he told NEWS Dr. Ariel Sáez de Guinoa, Executive Director of the HEC. “In this context, we seek a comprehensive approach to guarantee comfort to the patient both physically, as well as psychologically, environmentally and spiritually of the patient, his family and also of health workers.” Thus, the El Cruce hospital launched the protocol which allows to do activities assisted by petsfit safe in the hospital premises, both in the “open” areas and in the rooms.
“We know that it is something pioneering at a global level and especially in public health, but the truth is that it is not something so new: in fact, the central idea was described 150 years ago,” said Sáez de Guinoa (See box). And there is a lot of literature on the subject. What there is not so much is concrete experiences and less with the pets of the patients. If the use of trained animals is known, they belong to the health center and “interact” with some patients.
“In the case of the HEC, the visit of the pets of some patients required putting together a complete and complex protocol so that it takes place in a safe environment. And what triggered our progress to achieve it was something that happened to us during the pandemic. We had a patient in his 70s, who was intubated for Covid, on a respirator, for more than two months. When he got better and “woke up” in intensive care, the first thing he asked us was if he could see his pet. That made us think again about how key companion animals are for the full recovery of people,” recalled Sáez de Guinoa.
From there, the HEC team worked to develop a careful protocol that can be used for animals to assist the patient. In which? “Pets can assistant to the patient in different specific pathologies: from neurodegenerative diseases to emotional disorders, cerebral palsy, psychosis or schizophrenia, among others”. And it is especially useful for those who must go through a prolonged hospitalization. In the HEC, although the cases in which it occurred were with adults, they plan to extend this practice for the boys.
Background
All the professionals involved report that before taking the first step they carried out a complete investigation. “We looked for bibliography, we spoke with specialists in infectology and also with veterinarians. It took us almost a year to prepare a complete and detailed protocol. And first we made a pilot test“, detailed Fernández Sasso. “To get it ready we tried with six children and one adult and everything has been very satisfactory. Now the idea is to continue testing and improving these visits”.
For his part, the HEC professional reported that “our priority in these visits was avoid the transmission of zoonotic diseases and also allergies. That is why we first analyze whether the patient is in adequate health conditions to receive this visit. And the animal must be healthy, vaccinated, bathed and combed before arrival, thus minimizing hair loss. On the other hand, since we are still in a pandemic, in principle we prefer that the meeting take place in open areas and with adequate ventilation. However, we think it is possible that the animal goes to the patient’s room.”
A key detail in this process of adding pets to regular visits and which was an important factor for the success of these projects was involve all parties of hospital institutions in the protocols. “Before implementing the visits, we talked extensively and reviewed the issue with everyone: from the medical staff to the nursing team, and security officials and hotel managers were also involved,” recalled Ortega.
This move not only adds to the “psychological” quality of life of the patient. It also specifically contributes to medical improvement. “What we saw is that playing with your pet helps to generate endorphins and other neurotransmitters that are linked to well-being. On the other hand, these molecules help to neutralize the action of some “negative” hormones such as cortisolwhich is usually associated with stress,” said the IADT board.
Sasso added that “for now the evidence we have is indirect, but we professionals notice signs of health benefits because the context of hospitalization and the stress that this generates are “softened”. What is concrete is that we see patients ” visited” with a better countenance and spirit”.
Everything indicates that this move in which Argentine medicine is a pioneer will take hold and grow. In fact, those responsible for the IADT and the HEC have received many emails from colleagues from other health institutions, from CABA and from the interior, interested in knowing the details of the “pet protocol”. “And Ortega concluded: luckily for everyone and for the benefit of our health, I think it will be more and more common to come across a dog or a cat in the arms of a patient walking through the corridors and rooms of our hospitals.”
Well-being and concrete improvements
“On 1860 Florence Nightingale, considered the founder of modern nursing, wrote that the presence of small pets help reduce anxiety in children and adults living in psychiatric institutions,” said Ariel Saez de Guinoa, executive director of the HEC. He added that there are other references published in specialized journals that show the health benefits of pet-assisted therapy in a rehabilitation center. “What we saw and what confirms previous data, is that the interaction between the patient and their pets is wonderful. Reduces anxiety, stress and pain of the sick person. And that affects concrete things: for example, it is noted that they need lower doses of pain relievers“. For now, visits and therapeutic assistance have been limited to dogs, in part because they are easier to handle. But cats could also be admitted if the patient requires it. According to Saez de Guinoa, “normalizing and extending this type of activities is a great milestone on the road to having humanized hospitals”.
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