Episode Transcript
[00:00:02] Speaker A: The ability for an Alzheimer's or dementia patient to be able to pour their love back into a pet gives the caregiver great comfort because it's a departure from them thinking about other things that may be destructive or problematic or anxiety laced that can be self consuming.
[00:00:35] Speaker B: Welcome to the Age of Aging, a show about living well with an aging brain, recorded in the Michael Nadoff Communications Hub at the Penn Memory Center. I'm Terence Casey. And I'm Jake Johnson.
Jake, who do we have here?
[00:00:49] Speaker C: This is Birdie.
She is my year and a half old, still kind of a puppy that we adopted a few years ago. And she wanted to say hi for the intro of the podcast because I'm gonna let her down.
Today's episode of the podcast is about dogs and dementia. So we got Birdie as a kind of support dog for our move to Philly. But I wanted to start the show that way just to show how close this topic is to my heart. I grew up with dogs. My parents got their first dog when I had not been born yet. And I kind of haven't been without a dog since growing up. You know, they've just been kind of the center of my life. What about you? What's your relationship with dogs?
[00:01:39] Speaker B: I love dogs, but I was one of five kids growing up, and my father famously would tell us regularly that there were enough animals in the house, so we were not a dog household growing up. And, and I think because of that, we. We all secretly wanted dogs even more once we became adults. My older sister has two dogs. My younger sister has two dogs. And my parents, who got rid of the five animals that they had raised, now they, they. They have a dog. But similar to my own upbringing, I think my kids are now even more aggressive about wanting a dog. And, and so the cracks are starting to show. My youngest son will yell out of car windows at people walking their dogs just to say, I love your dog, while we're driving 45 miles per hour. And if he is at a social event and there's a dog there, he would. He's much more likely to be found just snuggling a dog in a corner than talking to another person.
[00:02:42] Speaker C: You know, we cover a lot of heavier topics on this podcast, all centered around longevity. But we wanted to talk about something that was a little bit more heartfelt, a little bit more joyful.
And we came up with dogs as a support system for older adults. And this idea really came from Dr. Jason Karlewish, who's the executive producer on the show. He talks a lot about how patients often have a dog in their life that is a support for them in some way. So we wanted to reach out to a lot of people who are both impacted by dementia in some way and have, you know, a dog that supports them through it and talk to them a bit about what it is about having a dog that is so beneficial to aging and dementia care.
[00:03:34] Speaker B: And Dr. Karlowish would know not just as a physician who sees patients, but as a proud dog owner. For as long as we've worked together, I've known him to have a series of whippets. We've even had a couple of visits by the Carlo ish animals to our office in old days. But our Pen Memory center team in general loves dogs. We have had a Slack channel and now a teams channel focused on pets of pmc. And it seems to be when one of us gets a dog, the whole team gets a dog and we're very excited about it. So it seems like a podcast episode. That may have been Dr. Karla Wish's idea, but everyone's pretty excited about.
But first, let's hear a word from our sponsor, the TIAA Institute.
[00:04:25] Speaker D: Understanding longevity can better prepare individuals to make thoughtful decisions not only about their finances, but about their health and lifestyle, too.
Matching lifespan with healthspan and pairing both with financial readiness has become a defining challenge.
The TIAA Institute wants to help build longevity literacy to better support outcomes for all.
[00:04:53] Speaker E: Just the sheer love. You know, she could be a real pain because if I lay down for a minute, she's on my lap. If I sit down for a minute, she's on my lap. When I come home, she's all over my heels for about a minute. So it's nice to be adored even by a dog.
[00:05:11] Speaker C: I Miguel Centeno is a professor at Princeton University, but today we're not hearing from him for his expertise on public policy.
[00:05:20] Speaker E: Her name is Simone. Her nickname is Moni. She is what is crudely called a Saturday Night special.
Her front is Beagle, her middle is Wiener Dog, and her back end is Pug.
[00:05:34] Speaker C: Centeno is one of the 45% of Americans that own a dog, and he is one of the nearly 12 million unpaid people in the US caring for a person with dementia.
[00:05:46] Speaker E: My wife began to show signs of dementia about five years ago. It was diagnosed a couple of years ago, and at this point I don't like to leave my wife alone for more than an hour or so. So she always has Simone with her and that's a big help and gives her something to talk about sometimes if she needs that, it's just a constant presence, which is what my wife needs.
[00:06:12] Speaker F: My mother owned a dog years ago.
[00:06:15] Speaker C: Kathy Oldfield's mother was diagnosed with Alzheimer's disease seven years ago.
[00:06:20] Speaker F: So after the passing of her dog years forward, my sister acquired two dogs, a chocolate lab by the name of Charlie and a black lab by the name of Finn. And my mother became really one of their primary caretakers as my sister and her husband both work. So every day my mother would go over at lunchtime, let the dogs out, walk them, take them to the dog park, and they were always a point of comfort for her enjoyment and also an area of concern. I mean, she was just as concerned about the dogs as she was about her children and her grandchildren.
[00:06:57] Speaker C: For this episode, we reached out to a number of people with these two things in common.
They were or are caregivers from for someone with dementia and they have a dog in their life who they believe helped them do that caregiving. Here's Tom Casey, whose wife was diagnosed with Alzheimer's in 2022.
[00:07:15] Speaker A: Gracie is always at my wife's side and what I observe with Gracie is a fair amount of communication between them and comfort in their company. And for me as the caregiver, she provides wonderful support and backdrop to some of the things that we do day to day. It is a great symbiotic relationship between our dog and my wife of 41 years.
[00:07:46] Speaker G: We have been co evolving with dogs for longer than with any other animal species.
[00:07:54] Speaker C: Philip Tedeschi is a professor at the School of Social Work at the University of Denver.
[00:07:59] Speaker G: I would say it's pretty certain that we've been co evolving with dogs for literally tens of thousands of years, arguably maybe as much as 50,000 or 60,000 years.
[00:08:10] Speaker C: Tedeschi's research and expertise focuses on the concept of bioaffiliation, which is the relationship between humans and the living world. In particular, Tedeschi looks at humans bond with non human animals and how that relationship is tied to things like mental health, conservation, social and interspecies justice, to name a few.
Tedeschi is also the founder of the Institute for Human Animal Connection at the University of Denver.
[00:08:38] Speaker G: It was the first human animal bond academic center in the United States that was not directly affiliated with veterinary medicine. Ours is really looking at these through the social sciences and the interconnection between people and animals from that social scientific kind of perspective.
[00:08:56] Speaker C: Tedeschi said that nowhere is the bond between human and non human animals more apparent than and more intimate than with dogs.
[00:09:04] Speaker G: They Are maybe not the smartest animal on the planet, but they're probably the smartest animal on the planet relative to understanding human beings. So they recognize small changes in our voice, tone, affect and facial expression. We have them in our lives in ways that a lot of people would describe them as some of their most reliable and important relationships.
[00:09:29] Speaker C: For many Americans and those in Western cultures, dogs are present throughout the lifespan.
[00:09:34] Speaker G: Tedeschi said many children see them as siblings, not just a pet, and really interact or sometimes even grow up with their first reciprocal playmate. Being a dog, but going all the way to the other end of the lifespan.
Where dogs are often the relationship that somebody chooses to have, for example, when they're in hospice or at the end of their life, you know, the last hours that they might be alive, often choose to have these very reliable relationships with them.
[00:10:05] Speaker C: It's also important to note that humans relationships with dogs are culture dependent and that not every culture sees dogs as potential companions.
Still, in many Western countries, interaction with dogs is seen as being beneficial, particularly for older adults. Tedeschi said one major benefit dogs offer is social support.
[00:10:27] Speaker G: You know, as a social work professor and researcher in this area, one of the things that when we're working with people, we almost always do to begin with is we would evaluate the social support system of our client to determine whether or not somebody is experiencing this lack of support.
It turns out that it can be a non human animal that can provide that support and in many cases might even provide it better.
One of the things that dogs do that we're not as good at is that they lack judgment on as an individual. So some of the challenges that might impact a human relationship, even a conversation where somebody's either forgetting details or facts, wouldn't matter probably to many dogs as long as the basic framework of being treated well and treated respectfully and humanely are there. And one of the things that has been interesting is that there is some research that would suggest for those persons who lose memory and are lacking some of these capacities for continuity within a human relationship, are able to do that with their dogs.
[00:11:38] Speaker C: Tedeschi said that having a dog can also have benefits for an older adult's physical and mental health.
[00:11:44] Speaker G: There's been some research that shows that owning a companion animal, particularly one that gets you up and out, not only reduces that sense of isolation, but also has things like cardiovascular health dimensions, improved aspects of things like reduction in likelihood of diabetes, reduction in hypertension. We know that when somebody's walking in a community or neighborhood with their companion dog, often they're having about twice as much social interaction as somebody who's walking by themselves.
So these become conduits for human to human connection. I think the other aspect then that comes alongside that is physical movement tends to reduce depression and anxiety, which are very highly diagnosed in older adults. And that depression comes often with kind of some of the dimensions I mentioned earlier, which is these loss of traditional support systems, maybe a passing of a spouse, or the loss of your career. And often animals step into these places in ways that are just remarked and can really reduce these mood disorders.
[00:12:49] Speaker C: Lynn Cronomiz, who is a part of the Aging Brain Cohort study at the University of Pennsylvania and actually previously spoke with us on season one, episode four, Diagnosing Dementia, said an experience she had with a therapy dog changed her life.
[00:13:04] Speaker D: My mother passed from Alzheimer's, and I had been struggling because I was with her at end of life, and it was very hard to watch. And she actually lost ability to swallow, and she actually turned blue in front of my eyes and passed that way. I had trouble sleeping after that, and I went to a counselor and she started asking me, what. What was your mom's life? There were certainly happening moments. And I told her about an incident where I was on her nursing home floor and the therapy dogs came in. And at this point, my mother was just, like, sitting like this in a chair, and she wasn't really responsive. And even when I'd ask her or say, mom, Lynn's here, she wouldn't wake up. And then this dog came up, and all of a sudden she woke up and petted him. And she couldn't speak at that point, but she was just babbling away to the dog, you know, trying to talk to it. So when I'm telling my counselor about this, she said, you know, you like pets. Maybe that's something you could do, train a therapy dog and help people like that. And so that's how it all started, and that's how I. I got into doing this. And it was very cathartic for me. I started sleeping better when I was helping other people.
[00:14:16] Speaker C: Now Chronomiz and her dog Chester, travel daily all over the greater Philadelphia area to elder care facilities, as well as a variety of other groups that benefit from interaction with a therapy dog.
[00:14:29] Speaker D: Not only did I go to nursing homes, I ended up learning so much about it that I have several places I go. So we have two different mental health hospitals that we visit. We also visit a brain injury place where Chester wears saddlebags, and we play, like, cornhole games and they have to bend down and reach the sandbags. And that helps them learn to regain their muscle control.
Another area, which was surprising was a daycare at the local homeless shelter called Opportunity House.
And the kids are so rambunctious, and they said, we're going to, what we're going to do is tell them Chester's ears hurt and we're going to have them sit in a circle and we're trying to teach them control over their emotions and their behavior.
So we have them in a circle and Chester comes in and he lays down and everybody has to be very quiet. And it's amazing to get preschoolers who are running all around the room and you come in and they're perfectly quiet. And one at a time they come over and they get to pet Chester.
And then one time we went to the farm show because they were giving Covid shots and he sat there and when the kids would get their shot, he would stand next to them and they could pet him. And that's how they got through their shot. So it's very much for anxiety relief.
[00:15:45] Speaker C: Anxiety support from their dogs was something many of the caregivers we spoke to brought up. Here's Tom Casey and Miguel Centeno.
[00:15:53] Speaker A: Again, the ability for an Alzheimer's or dementia patient to be able to pour their love back into a pet gives the caregiver great comfort because it's a departure from them thinking about other things that may be destructive or problematic or anxiety laced that can be self consuming.
[00:16:16] Speaker E: Whenever my wife is upset or I'm upset or whatever, she, she acts like a big comforter. She just starts hanging around even more and, and pressing herself onto you and trying to cheer you up.
[00:16:28] Speaker C: While dogs can make great companions for older adults, there are some cautions.
First, having a dog does increase a person's risk of falling. This is where older dogs, who are often more mellow, can make good companions for older adults.
However, as Associate professor of Clinical Animal Behavior and Welfare at the University of Pennsylvania, Dr. Carlos Siracusa explained, older adults may struggle to care for senior dogs.
[00:16:56] Speaker H: There are cognitive changes and physical changes that happen to older animals that are parallel to the changes that you will actually see in humans. So it's even more relevant at this point that the dog is someone that can take care of the animal needs because they are really dependent. Another aspect that I actually been in contact with because I, when I did my PhD, I was working in a shelter and there were really heartbreaking cases of older individuals that lost their independence and the family owned the dog to a shelter. And this was heartbreaking for the older person, but I have to say also for the dog. There was this older dog that really, once he entered the shelter, it just refused to leave. So we were really trying to convince the family to take the dog back and see if there was some way to make it work.
But many, many facilities of assisted living, they will not take the dog. So it is complicated.
[00:18:06] Speaker G: I've known a lot of older adults who have had concerns about, for example, as their ability to care for the animal declines, is that fair to the animal? And you know, that's a really a fair conversation and also one that needs to be really overtly talked through.
So I think that's where either the care facilities that sometimes are the homes of older adults can provide unique supportive services. For example, having a veterinary care setting, help set up transportation for those appointments, but also a safety plan or a backup plan if that person is hospitalized or passes away, even what is the plan for that animal. And so if we're asking them to be part of our lives, we can also plan for these kinds of transitions just like we would in any other relationship.
[00:18:58] Speaker C: Both Saracusa and Tedeschi said that like human relationships, human dog relationships are complex and ultimately individual to each person and their dog. These situations should be evaluated case to case with the inclusion of another perspective to make sure the dog is having its needs met. Therapy dogs like Chester are incredibly beneficial for this reason because there is no expectation of care from the older adult. Some companies have even begun to make robotic animals that allow for some of the comfort of touching a real animal without having to actually care for it.
And I'm sure all the cat lovers have already turned off this episode at this point.
But Tedeschi said they are also great companions for older adults. Cats are less likely to knock an older person over, are more independent than dogs, and are similarly in tune with human behavior.
Tedeschi said that if we look even more broadly, human's well being is intensely intertwined with other living creatures.
This is called the biophilia hypothesis.
[00:20:00] Speaker G: Originally credited or coined by Edward Wilson, who was a Harvard professor and identified the fact that optimum human health requires that we have interactions with other healthy living aspects of our world.
So somebody who even has a room with a window that looks out on a set of flourishing trees or forests, or be able to even watch the squirrel doing its antics in the tree outside the window are all elements of very interesting bio affiliative interactions. And the more we have of that suggests that the better, the better off we are.
[00:20:40] Speaker C: I'm sure what Tedeschi said rings true for many of us. Animals, plants, and just nature generally can have an incredibly grounding effect on us that is almost impossible to describe.
I'm sure it's the same way many of us feel about our dogs and pet companions.
Here's Miguel Centeno again.
[00:20:59] Speaker E: We love her. I mean, it's one of those irrational things, why human beings spend so much time and energy on their animals, but she helps us. She helps us go through the whole thing.
[00:21:18] Speaker B: Jake, that was a lot of fun. I really appreciated hearing from both the experts and the caregivers on their different experiences with raising dogs or helping train therapy dogs and so on. And I couldn't help but think about how this story really brings into focus something that we often overlook when we're talking about dementia care, and that is the emotional needs that persist even as cognitive abilities change. We talk about it all the time, that people living with dementia may experience isolation, boredom, and loneliness, and not just occasionally, but daily.
And while medical care is essential, emotional connection is just as critical. And I think this story really highlighted that dogs can help offer that emotional connection even without words. And that's really helpful for people living with cognitive impairment because they may struggle to organize thoughts or find language, but you don't need to have that conversation with a dog. You can just show up and take it for a walk or play or sit comfortably beside them. And that presence can be really grounding, even healing, for older adults. And I think people living with cognitive impairment also benefit from the structure of dogs having consistent walks, consistent feeding, consistent attention.
By meeting those needs, someone living with cognitive impairment gets movement, routine, and socialization, whether they intend to or not. And it's a nice way to stay engaged with the world. But that was my perspective on this as approaching someone who did not grow up with a dog and doesn't have a dog now. Jake, you were producing this episode with your own dog by your side. Tell me, what was that like?
[00:23:01] Speaker C: Yeah, it was really fun to talk to people about their dogs and think about myself, of what I love so much about my dog. I found myself, as I was asking people about their relationship with their dogs, kind of realizing how indescribable the. The connection that people feel with their dogs is and how hard that is to articulate on a podcast, and really that it's just. That's what it is. It's a connection. It also is really nice to talk to an expert like Philip Tedeschi as he's going through the evolutionary history of dogs and humans, just how connected we are as species. One of the most interesting things that I thought that he said was that, you know, dogs might not be the smartest animal on the planet, but relative to understanding humans, they are probably the smartest, you know, non human animal. And in turn, we're also very engaged with them. When we, you know, are around them, I think we really just kind of get each other.
And I think that that's, like, very sweet, beautiful thing. I loved. I loved hearing all of those, you know, stories of people with varying levels of dementia finding some kind of comfort or calm or, you know, solace in taking care of dogs. And it's like, really beautiful.
[00:24:19] Speaker B: And what I liked about Tedeschi's comments is that we're talking about these two animals and their. Their relationship to one another evolving over time, but at the end of the day, the basis of that relationship is largely unchanged. It's socialization and companionship and codependency and all these things that, you know, we're talking about it in the context of dementia. Dementia care, of course, but this, it really gets to healthy aging as well. We talk about socialization and getting in some physical activity, making sure there's some sort of cognitively challenging stimuli throughout your day. And all of those things seem to be addressed both now and, you know, thousands of years ago by one's relationship with their dog.
[00:25:12] Speaker C: One thing that didn't make it into the episode that Professor Tedeschi said to me was that when you have a dog, you'll know the names of your neighbor's dogs, but you might not know the names of your neighbors, which is very true for me, and that we do so much connecting through our dogs. And actually, as a teaser for the next episode of the podcast, Dr. Karlewish sat down with Dr. Daniel Gibbs and his wife and caregiver, Lois.
Dr. Gibbs is a retired neurologist living with Alzheimer's currently, and he brought up independently during that conversation that the majority of his daily social interactions come from walking his dog and having conversations with his neighbors. And he even brought up that same concept of, you know, knowing your neighbor's dog's name and not knowing your neighbor's name, which was pretty funny. So people should definitely look forward to that episode. It was a super interesting conversation. But I definitely have to agree with Tedeschi and Dr. Gibbs. I get so much social interaction and exercise and physical activity from walking my dog. I have to throw the ball for her for 45 minutes every day.
And, you know, it's A great motivator for doing things that seem kind of trivial. But when you have a dog or something that you have to take care of and you want to make sure it's happy.
[00:26:33] Speaker B: Can you hear now?
I hear it, but it's great. Great audio for this episode.
[00:26:38] Speaker C: My dog is whining at the back door as we speak.
Speaking about taking care of an animal and making sure that it's happy. There are some annoying parts about having a dog too, but it's very rewarding at the same time.
[00:26:54] Speaker B: And so you talked about some of the responsibilities of having a dog and taking care of it all day, every day. But I think we saw a second pathway with this, with Lynn talking about the therapy dogs versus companion dogs. I think the stories about dealing with therapy dogs went in nicely with Dr. Siracuso's concerns about having older adults who are caring for dogs. And this is not to say that of a certain age or cognitive ability or something that you shouldn't have a dog, but there is a time that it may be an inappropriate or otherwise unsafe environment for an animal. And I know at the annual Alzheimer's Association International conference that there seems to always be at least one vendor who talks about robotic pets. And one of the things that I found fascinating about it is that they have transitioned away from your traditional dogs and cats and getting into pets that may not be typical to have in the home, but are much easier to hold for those with, say, advanced dementia. And I think the one that captured our attention, the most, robotic seals that had a little bit of warmth to them, a little bit of movement, and they were soft touch. And so that way we could provide some of the benefits of holding an animal without providing any, any risk to it.
[00:28:19] Speaker C: I do want to apologize to all of the cat owners and cat lovers in our audience. We also love cats. I also grew up with cats, but, you know, we wanted to focus on dogs for this one. But cats are also great companions that have been with humans for thousands of years as well. And, you know, Dr. Tedeschi was telling me all about these different kinds of animal interventions that are popping up. People will go to, you know, farms and meet the cows and pigs. And I think Lynn Chronomiz was telling me about how she knows a woman that brings geese to the local library and has the children read to them. So there's all types of animals that can be incorporated into healthcare and general well being. And I think that kind of touched on one of the things that I found really fascinating from the episode, which was this idea of bio affiliation and the biophilic hypothesis that Dr. Dadeski brought up. As we're recording this podcast, I have my desk set up looking out my back window at this tiny little garden that we have and it definitely does a lot for my well being to be working back here during the day than in my my dark kitchen that faces the street.
And if you've been inspired by this episode to get a dog for your cognitive health, we'll definitely put a few resources in the show notes all right.
[00:29:53] Speaker B: Well thanks for all your reporting on this. We had some some great interviews. I hope that everybody, including the cat lovers, enjoyed it.
Thanks for listening to this episode of the Age of Aging. This show is made possible by generous support from the Michael Nadoth Communications Hub Fund and our sponsor, the TIAA Institute. The Age of Aging is produced by the Penn Memory center in partnership with the Institute on Aging and the Penn FTD Center. Our team includes Dalia Al Said, Jake Johnson, Jason Karlewish, and myself, Terrence Casey. Contributors include Nicolette Calcimecchia, Emily Largent, Allison Lynn, and Megan Sharp.
[00:30:34] Speaker C: Special thanks this episode to Tom Casey, Miguel Centeno, Kathy Oldfield, Philip Tedeschi, Lynn Chronomiz, and Carlos Syracusa.
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