The impact of animal assisted therapy on quality of life and participation in activities of daily living of persons with dementia in Pretoria.

Abstract

Introduction: There is an increase in the elderly population in South Africa with an estimation that one fifth of the elderly population will be aged 80 years and older within the 21st century. With this, comes an increase in dementia diagnoses and people living in assisted care facilities. Problems with disruptive and social behaviour are difficult for the care facility staff to address with limited availability of therapy services available, animal assisted therapy can be used to improve quality of life and participation in activities of daily. Aim: The aim of the research is to investigate the effect of animal assisted therapy on quality of life and participation in activities of daily living of patients with dementia in a private retirement assisted care facility. Methodology: A single-subject design tested the effects of AAT on QoL and participation in activities of daily living of four participants. The study consisted of three 10-week phases. Data collection took place at fortnightly intervals. A blinded rater collected data using the Dementia-Specific Quality of Life Instrument (QUALIDEM) and the Disability Assessment for Dementia (DAD). Analysis of the data used graphs and tables. Excel was used for data analysis and trends were established using visual analysis. Statistical methods specific to single subject research were used to demonstrate the impact of the intervention. Results: The study yielded mixed results and each participant showed varied responses. For two of the four participants AAT was beneficial with significant improvement in QoL during the intervention period, while for the other two participants QoL decreased. Results displayed no significant outcomes in the overall score. None of the participants showed improvement over the three phases with participants 1, 2, and 4 showing varying scores for DAD over the study period. The participants v scores varied greatly in the baseline phase indicating that their function changed from week to week even before the intervention started. Discussion: The QUALIDEM scores for the participants ranged from 5.5-10.5. There was a greater difference in the DAD scores with an average score of 8 and the lowest score at 1. Two participants had significant positive changes in QoL during AAT intervention, the change was only positive at withdrawal for one participant with the other having a significant decrease in QUALIDEM scores. Both these participants had a significant decrease in DAD scores during intervention and withdrawal phases. The other two participants had negative changes during AAT intervention for QoL on the QUALIDEM. The change in QoL was positive for both participants at withdrawal with Participant 3 found to have significant increase in QUALIDEM scores. Both these participants had a very small decrease in DAD scores indicating they maintained their level of initiation, planning and effective performance in basic and instrumental activities in daily activities during the intervention phase. There was a significant decrease and no change for DAD scores during the withdrawal phase for Participant 2 and 3 respectively. The null hypothesis was accepted for QoL but not participation in ADL for Participants 2 and 3. Conclusion: The study indicated the effects of AAT on participants differed in terms of components which constitute their quality of life and the need to consider the duration and intensity of AAT intervention. The study provided detailed information about changes in QoL and ADL in patients with moderate and severe dementia that indicated both improvement and deterioration that has not been reported in other studies. Further research is required with a larger sample size and a mixed-method study design is recommended.