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JJ the Hospice Therapy Dog Lends a Helping Paw

Photo courtesy of Tracy Calhoun

Dogs can provide comfort to hospice patients and their families, or even to people who are grieving at funerals.

Anyone who's ever loved a dog knows that they're more than furry goofballs – a dog can be one of the best sources of comfort there is. If you've ever cried into a dog's fur or stroked a dog's head during a stressful moment, you probably won't be surprised to learn that some dogs are therapists.

A therapy dog isn't going to sit you down on a couch and ask about your childhood. Instead, he will wag his tail, smile, and lean into your hug. Therapy dogs work in a variety of life's most stressful situations and places, from scenes of disaster (therapy dogs visited survivors of the recent Pulse nightclub shooting in Orlando, Florida) to homeless shelters to hospitals. And when a life is coming to its end, a hospice therapy dog may be there to offer comfort.

We talked to Tracy Calhoun, a hospice nurse who also trains and works with therapy dogs. Her golden retriever, JJ, has become something of a superstar ever since a deeply touching video of her went viral in 2015. In the video, JJ pushes her nose under the hand of a dying woman, licking and comforting her.

Tracy remembers that day, recalling that the patient was a blind woman who was actively dying when JJ visited her. "She had no family; she was never married. She had caregivers who took care of her. So we had Yeats playing in the background. The caregivers had brought in her tapes from the library for the blind. And towards the end of the shift I had plenty of time and I knew that she liked dogs, so I put JJ up on the bed. (The patient) had shown no purposeful response all day. Get JJ up on the bed and she does start doing that kind of nudgy stuff, and pretty soon… she starts actually moving her fingers petting JJ. She died later that day."

For a woman in her last hours of life, alone and unresponsive, it was the attention of a dog that sparked a final purposeful action. That action, petting a dog, is something that has comforted humans from our earliest days. Our connection to dogs is primal, and even when there's very little life left in us, something deep within can still respond to soft fur and a cold nose.

But in a hospice setting, it's not only the patients who need comforting. When families are visiting their dying loved ones, a therapy dog like JJ may spend time with adults and children alike, offering friendship, affection, or a distraction from time spent waiting.

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A dog can be a nonjudgmental listener when we need to talk, or a quiet friend when talking is the last thing we want. Tracy notes, "Sometimes people just get tired of talking... and spending some time petting a dog really just gives them a moment away from everything."

Hospice staff, too, can have their day brightened by a visit from a therapy dog. And a therapy dog like JJ is absolutely there for the benefit of staff, as much as she's there for the patients and their families. Hospice work can be emotionally draining, and the comfort of a dog is just as appreciated on a difficult day of caregiving as it is when visiting a loved one. "I am told by staff often, '(JJ) usually doesn't pay any attention to me, but she spent time with me today and today was the day I really needed it," Tracy said.

Interacting with a therapy dog can take on all the forms that interacting with a family pet would. Petting and scratching the dog is a favorite activity, and many patients and family members seek out warm dog hugs. JJ is a champ when it comes to hugging – Tracy tells us that JJ doesn't just accept hugs; she also gives them, sitting on her haunches and hugging with her front legs. It's amazingly cheering to those who experience it, Tracy says. She often hears, "She's hugging me. I can't believe she's hugging me."

Some patients and families can engage in more active play with a dog, throwing a ball and encouraging tricks. Giving the dog treats is a favorite activity, and many therapy dog handlers carry small treats for patients to offer. If JJ is in a room at mealtime, Tracy says, she is well-versed in bringing a smile by cadging a bite of people food: "We've also had many people and family members telling me they get quite a giggle when the people are in here that do eat, they might order a little bacon or a little egg [for JJ]. Luckily, she's got a steel stomach, and they just get a kick out of her because she's very cute when she's begging."

The comfort, joy, and smiles brought to us by dogs may seem like a no-brainer, but there's more to pet therapy than that. Spending time with an animal can help hospice patients in concrete physical, emotional, and social ways as well. Studies have shown that hospice patients who receive pet therapy experience reduced pain and lowered blood pressure, leading to better physical well-being overall. Pet therapy visits can promote range of motion as the patient physically interacts with the animal. Loneliness, anxiety, and depression are reduced in hospice patients receiving pet therapy, raising the patient's overall positivity.

Some studies have specifically looked at the positive effects of pet therapy on people with dementia. The presence of a dog makes a dementia patient more likely to be calm and responsive, and the patient is apt to eat more heartily than usual after a visit with a pet. Caregivers at facilities for those with Alzheimer's disease have discovered that the presence of a dog in the evening can help reduce the time-specific "Sundowner's Syndrome" that makes their residents likely to be particularly agitated and confused during those evening hours.

Tracy has noticed another clear benefit to the calm that a therapy dog can bring. She told us, "A lot of times when I've got people who are agitated, waiting for meds to kick in, if they tend to respond to her, I'll put her up on the bed and it'll kind of keep things quiet long enough until medication can really take effect. I've done that many times. Sometimes she's a great distraction for trying to get meds into somebody."

And when a patient's final minutes of life are approaching, JJ has a tendency to show up to offer comfort to the patient and family. "From what families have told us," Tracy says, "a lot of times when somebody's getting close, she's checking in. She'll come in and kind of just nudge a hand without getting up on the bed. There are a lot of times where somebody doesn't have anyone, or are waiting for families, and it's getting close. If it's a slow enough day or if I've got a period where it's a little slow, we'll sit in there. If I know it's a patient who liked dogs, I'll put her up on the bed. And she'll often just lay with them. Sometimes she will nudge under their hand and get their hand up on her head."

JJ has also chosen one special task to perform that not all therapy dogs do–the "walkout." When a patient has died and their body is being transported out of the building to the funeral vehicle, hospice staff offers a brief, formal procession to accompany the body. The very first time JJ saw this happening, Tracy says, she instinctively joined in and made herself a part of the ceremony. "She walked right next to the gurney, walked right out." Now, she does it every time, offering her companionship during a solemn ritual.

It's one manifestation of the intuitiveness that has made JJ such a great therapy dog, able to recognize just how she's needed and jump in to help. That intuitiveness makes her very special, but JJ is a special kind of therapy dog in more ways than one. Hospice therapy is her full-time job, as she accompanies Tracy to the hospice facility whenever she's working. In fact, Tracy says JJ will typically be "more stressed if I leave her at home," knowing she's missing out on interacting with some of her favorite people. There are other full-time therapy animals out there, working alongside owners at their jobs like JJ does, but many animal therapy handlers do it on a part-time, voluntary basis.

There's no one breed that makes the best therapy dog. Golden retrievers like JJ are common, but therapy dogs come in all shapes and sizes. It's more about the specific dog's temperament than his breed, size, or appearance. A potential therapy dog needs to be comfortable and calm around all kinds of people, from little children to the elderly. The dog should have good basic obedience skills, as well as being comfortable when touched and petted. In a hospice setting, there may be medical equipment that makes sounds that are unfamiliar to a dog, so the dog should be able to handle surprising sounds.

Tracy notes that the handler has to work closely with the dog and have a solid understanding of how that dog signals she's feeling stressed out, whether that be yawning, tucking her tail, licking her lips, or something else. If these signs appear, it's time for a break for the dog. A handler might take the dog outside for a quick walk, let her snooze in a quiet room, or even call it a day if they've been there long enough. JJ takes her own breaks whenever she wants, stepping away from the action to nap in her crate for a while if she needs it. But a volunteer therapy dog may need to rely on her handler to understand her stress signals and give her a break.

For JJ and any other therapy dog, self-care is as important as it is for a human caregiver. After a therapy dog has been working, she needs a chance to shift gears and engage in a favorite stress-busting activity. That might be swimming, going for a run, playing tug, or wrestling with a canine best friend. JJ loves to take part in a dog sport called barn hunting, using her nose and running joyfully as she searches through hay bales and tunnels for a coveted target. Just like a session at the gym or a meal with close friends will help rejuvenate a human caregiver, these moments of pure fun are essential to therapy dogs' well-being.

Not every dog that is friendly with people will be a great therapy dog, but if you think your dog might be a good fit, it's worth looking into. Therapy dog associations like Project Canine, the Seattle-based group with which Tracy works, offer the training and certification that are crucial steps before a dog can enter a hospice setting to provide therapy. A web search can help you find therapy dog associations in your own area. Other animals can provide pet therapy as well, so if you are the owner of a cat, horse, pig, or other social animal, you may be able to train him in pet therapy.

If your pet does prove to be a good fit for therapy work, you both may find it one of the most rewarding things you've ever done. Tracy loves it and is an enthusiastic advocate for therapy dogs in hospice. "I don't think there's a downside to it," she says. "It's an extra layer of comfort and support for everybody. And it's not just visitors, because the staff, any of the hospitals, anywhere the therapy dogs go, the staff love it and they get just as much TLC." Asked to sum up why hospice pet therapy is so useful and important, Tracy says, "Animals can provide compassionate support without asking anything from you during a time of ultimate crisis and stress."

You can follow JJ's life as a hospice therapy dog on her Facebook page


Read More Stories from This is Terminal:

In Hospice, Aromatherapy Brings Comfort and Memories

What It's Like to Comfort the Dying

Massage Therapy at the End of Life