The opinions stated below are my personal feelings and observations. My observations may, or may not be supported by scientific fact or research. Additionally, this information may not reflect the opinions or beliefs of individuals or companies that Jackson and I are affiliated with.
My introduction to the Hospice Therapy Dog
I have watched Jackson connect with patients in their last days or hours of life and communicate with them silently in an intensity that I could only initially describe as overwhelming…until I came to understand that it this intense primal exchange was only overwhelming to a species who had long since favored high order analysis and verbal communication over the primordial senses and non-verbal mediums; and much had been lost in translation. Jackson found a way to communicate to them that another creature they could touch and feel, that breathed the same air and occupied the same space understood the path they must walk. Then in a very intimate physical and what could only be described as spiritual interaction, he seemed to give them his permission to go. The reaction was usually similar regardless of the patient’s cognitive function; it was often simply a moan, a slight change in expression, or a sigh. However, the simplicity of the response did not diminish clear message being sent. Even at the lowest level of consciousness, the patient had found some comfort. At the same time, the family and staff too found additional comfort through Jackson. This was my first glimpse into the world of the Hospice Therapy Dog and even after a very short time, it was clear that Jackson had found his calling and my life would never be quite the same.
How we came to depend on the assistance of an animal that cannot talk to speak to the actively dying:
It is my opinion that the act of death, just as with birth is an intensely biological and spiritual, as well as physiological experience. It is beyond the realm of comprehension of advanced cognitive function; it is simply too intensely primitive. Almost from the moment of birth, as a society we are conditioned to strongly favor data that can be quantified, qualified and explained utilizing our higher brain function. As a result, we spend the entire journey of life working to transcend the bounds of primordial cognitive sensitivity. Just as every action has a reaction, the choice to train ourselves to favor advanced cognitive function above all else is also a choice to partially abandon a primitive biological connection. While tens (if not hundreds) of thousands of years of conditioning has degraded what must have once been a powerful connection to the environment around us, this connection is one that all other creatures feel and accept, without the disadvantages that come from the need to question the intangible.
Hospice Care and the final phase of the actively dying
Death is an accepted reality for the Hospice patient and can even be a welcome relief for some, but we are still bound to the same biochemical process as all creatures. This failsafe has evolved as a method to ensure that all options for survival are exhausted. In other words, dying is not simply a just phase of life; it is a process containing several phases. One of the many truly wonderful benefits that Hospice provides is the capability to help ensure that the patient is as comfortable as possible during this process. Aside from the intensely and spiritual and emotional aspects, the final phase in the process of dying is a progressive and systematic return of priority to the most robust control systems. The ancient but most robust primitive brain functions begin to prevail, while the more highly developed sections begin to shut down. As one watches an actively dying patient, there is a distance that evolves, a bridge that cannot be walked by the two legged among us in any other stage of life. This is not to say that the human connection is broken, but at some point we may need the assistance of an expert and this is one of the most important jobs for a Hospice Therapy Dog.
While modern medicine greatly helps the Hospice patient in a physical and emotional sense, often a feeling of helplessness is experienced by family, friends, and even staff. I also believe that at times the patient feels a barrier of separation as well. A Hospice Therapy Dog not only has the ability of being able to emotionally and cognitively communicate with the dying through the last steps in the journey, but also possesses a keen ability to determine those in the family or staff that need comfort as well. It would make sense that this ability of dogs (and some other species) has evolved out of the necessity to remain highly sensitive to the natural environment, while also having to develop sensitivity to human emotion and non-verbal queues. However, all over the world it has become clear that some individual dogs are simply more in tune with the special needs of people than others, both in general and with regard to specific circumstances. For instance, some dogs naturally seem to connect with highly autistic children. Another example is a Therapy Dog outside of Philadelphia that is able to identify a child who is a victim of abuse with extremely high accuracy. In the case of the Hospice Therapy Dog, they seem to be highly sensitive to a person who is dying and extremely compelled to comfort them and their family.
Religion, clergy, Family and the Hospice Therapy Dog:
At first, I was unsure of how Jackson would fit into the religious beliefs and practices of the families of patients. I was extremely uncertain about how the Chaplain or a priest would react to his presence. As it turns out, for the actively dying, Jackson and the clergy seem to work hand in hand to comfort the patient and family. Often Jackson will enter the room by request of the family as soon as the chaplain is completed. It became clear that there was a sense of acceptance, respect and awe towards him by the clergy. My uncertainty was replaced by complete clarity the first time I experienced Jackson's impact on the family of an actively dying patient. The chaplain's role was helping the family and the patient find some peace and guidance. Jackson's role was helping the family find comfort and peace through an emotional outlet that did not require speech, thought, or concentration. Emotional barriers were broken and stress relieved that some did not realize they had. Unlike friends or family members, Jackson had no fear of rejection, or sociocultural programming that prevented him from approaching anyone who he thought needed him. Jackson's attentive stare, soulful brown eyes, and overall expression conveyed a simple message "I feel your emotional grief and pain. There is no need to speak or try to convert a feeling into a word. You are not alone." Jackson was not telling someone he "knew how they felt". He was not offering sympathy, or trying to fix a situation that could not be fixed. He was not asking a person to share their feelings; instead he was providing a safe outlet through a clear non-verbal medium people did not even know they needed. Additionally, his large size and fluffy fur invited hugs from women and men alike, without fear they were squeezing to hard, or would hurt him. Additionally and possibly most importantly, there seems to be a universal sense of oneness and faith in something bigger than ourselves when we intimately connect with an animal. Clearly, Jackson and members of the clergy had the same message; ultimately, it was just a different delivery system.
Unsurprisingly, when I say that my dog works with Hospice patients, peoples' eyes light up in a mixture of interest and guarded curiosity. The most frequent question I receive (and ultimately the reason I wrote this commentary) is “but what does a Hospice Therapy Dog actually DO??”
I suppose that is an intensely individual answer, as all creatures are different and the viewpoint of all involved is unique. While Jackson and I are still relatively new to Hospice, so far he has demonstrated a very consistent pattern of interaction with patients in various stages.
For the terminally ill who are not actively dying, he is a 165 pound ball of tail wagging love and affection. For some, he simply provides the warmth of a dog when they are unable to have one of their own. For others, who shy away from the awkwardness of a time when there may be nothing left to say, he provides friendship and compassion without the need to speak. Some patients enjoy his warm attentive stare and gentle nuzzling when they share the details of their day. Still, other patients who don’t have the benefit of visitors or family get to experience the simple joy of knowing that this majestic creature has come there for them.
With the actively dying who are in their final days or hours, Jackson acts entirely different. Upon entering the room his amusing and at times downright goofy demeanor is immediately replaced by a solemn intensity that at first I was not prepared for. Jackson will approach the patient slowly and cautiously or lean next to the bed until a path is cleared for him to walk without disturbing staff or family. This is not something Jackson wants to do, it is something he NEEDS to do and when animal with immense physical strength and great mental fortitude (read stubbornness) breaks from his normal submissive behavior telling you he needs to do something, even those who don’t speak dog are compelled to listen. Once Jackson is able to reach the patient, he will stick his nose into the palm of their hand regardless of whether they are able to move their hand to him, or he must position his snout in a certain way; this seems to be the first part of his required routine. Jackson will then proceed up to the patient’s head and insist that any bed rails on that side be temporarily lowered. He will then lay his head next to their chest and remain there for what seems like a minute, but is probably only several seconds. Jackson will position his monstrously large and heavy head until he is touching the patient so softly that a gentle breeze could pass between his fur and their skin. This seems to be what I can only describe as Jackson trying to comfort them and offer his permission for them to go. I can also say without doubt, that everyone in the room including the patient seems to get the message loud and clear.
In addition to the comfort Jackson provides the family as mentioned above, witnessing this interaction has proven to be powerful for everyone who has been present. The beauty and kindness of the act, as well as the compassionate determination displayed by an animal so in tune with the natural order of life, is one that re-affirms with an almost deafening absence of words what everyone in the room, including the patient needs most -- The knowledge that there is an unquantifiable and yet very real connection to something bigger than ourselves. While we may not understand what the patient is feeling or how to help them complete the last leg of their life's journey, it is clear that there is a very large, very white, and very talented creature in the room that knows exactly what the patient is feeling and how to comfort them. After witnessing Jackson carry out his self proclaimed duties, the expressions and commentary of everyone in the room reflect their unexpected and yet unquestioning acceptance of that which cannot be explained. A feeling of helplessness is momentarily replaced by a sense of solidarity provided by a glimpse of the primordial connection and communication medium Jackson and the patient share; one long forgotten by our ancestors.
At first, volunteering with Hospice was something I felt compelled to do and the thought of bringing my dog along to share the joy he brings me with others was a wonderful benefit. I soon realized that I had it backwards. My dog was bringing me to Hospice and allowing me to share in the intimate relationship that he built with patients and family. I hope that Jackson continues to enjoy his job and reach patients on many levels. Even if his enthusiasm and dedication does not last, I will forever feel honored and humbled to have been able to witness such an honest and pure interaction between dog and man. Watching the impact Jackson has on others leaves no doubt in my mind of the need and benefit of a Hospice Therapy Dog and Therapy Dogs in general. Children and adults alike have stated that they believe he is an angel in a dog’s body and I can hardly argue with that opinion.
Another question we get is “how did you train Jackson to be a Hospice Therapy Dog?”
The most honest answer I can provide is this one: you don't. A Hospice Therapy Dog, just like Therapy Dogs in general, as well as many types of working dogs is something they are born with the ability and desire to do. We can train dogs to do many things and there is intense training involved prior to having a dog certified as a Therapy Dog, but disposition and natural talent are out of our control. Luckily, we were fortunate enough to have the support and guidance of our therapy group in closely assisting our entrance to Hospice and helping me recognize Jackson’s true calling in life.
Published to site on 19-Apr-2011