Improved quality is among the potential returns on investment for pet therapy programs. But hospices need to vet and train human and animal volunteers to sustain these services.

Hospices offer a variety of volunteer-based programs such as art, aroma, massage and music therapy, with some providers increasingly integrating animals into their mix of services.

Pet therapy programs can help boost satisfaction among hospice patients and staff alike, according to Lori Asmus, volunteer and integrative services manager at Hospice of Cincinnati (HOC), part of HOC Navigators. Having these programs can help foster a strong and supportive organizational culture, Asmus indicated.

“Our team members really benefit from our [therapy] dogs almost as much as the patients and families do,” Asmus told Hospice News. “It’s so important for staff to have a break with the dogs, that opportunity to disconnect from the heaviness of the work. I [also] cannot underscore the impact on team culture and on team resilience with the dogs – to observe patients’ moments of joy, [to] feel like they’re part of that success [and] making a difference.”

Improving patient, staff satisfaction

HOC has about 23 dogs in its pet therapy program, in addition to a Flemish Giant rabbit and miniature ponies. Important operational considerations involve volunteer onboarding and training, as well as developing strong partnerships with pet certification organizations, according to Asmus.

Therapy animals offer nonjudgmental support and a comforting environment while also fostering opportunities for greater patient and family engagement. Families often share memories of pets with the volunteer therapy dog handlers, which can provide greater connection, comfort, psychosocial support and improved quality at the end of life, Asmus indicated.

“It frequently gets mentioned in the [caregiver survey] comments in their overall experience of care,” Asmus said. “We’ve gotten some shoutouts for pet therapy at a time when we’re really looking at person-centered care. The time we take to just sit, listen and connect really changes their feelings and impressions of their hospice experience.”

Photo courtesy of Hospice of Cincinnati

Pet therapy services can be a driver of volunteer recruitment and retention among some hospices, according to Renee Wisby, director of volunteer services at Alive Hospice. Word-of-mouth is perhaps the most powerful tool in garnering volunteer interest in a hospice’s animal therapy program, Wisby said.

Tennessee-based Alive Hospice has roughly 16 volunteers who have a certified therapy animal. In addition to visiting patients and families, the pet therapy program is also featured in the hospice’s summer bereavement program for children, Camp Forget-Me-Not. Alive Hospice also uses therapy dogs in its monthly support program for bereaved families, PAWS for Grief.

“Volunteers themselves get a lot of feedback when they take a dog or pet into a room — it’s all been positive,” Wisby told Hospice News. “But it’s important for them to know how to manage certain emotional and psychosocial situations that they may encounter in hospice. What I hear a lot from volunteers is that family members appreciate the diversion of an animal in what can be a sad or stressful situation. The way to build a program is connecting with leaders in animal therapy certification who can connect you with interested volunteers and pet owners.”

Key components of hospice pet therapy

A common thread of hospice pet therapy programs is that they are largely offered in facilities rather than patients’ residences, mainly due to the variety of unknown factors in the home, according to Annie Peters, president and CEO of Pet Partners and the Association of Animal Assisted Intervention Professionals (AAAIP). Established in 1977, the Washington-based organization operates a national therapy animal visitation program.

Another commonality is that, nationwide, 90% of hospices with pet therapy programs use canines, according to Peters.

Hospices predominantly take two approaches to pet therapy, she stated. One model is to have trained volunteers provide these services, while another approach involves integrating animals into interdisciplinary services. Hospice chaplains are among the professionals increasingly seeking to include their own pets into their professional work, Peters said.

A large consideration is understanding how to maintain volunteer capacity in terms of both the humans and animals, according to Peters. Also important is understanding the type of patient who could benefit from a pet therapy visit, she added. Having a standardized operational process for pet therapy services is key.

“There is that managing of expectations,” Peters said. “First you have to have the time and interest of the volunteer, but it’s as important that the animal has the interest and is comfortable being in new environments. Not all pets are — they’re not tools, they’re sentient beings. So what are those standards? Is there good communication with the handler, with the staff and the patients they’re visiting? What is the procedure for checking to make sure that as an animal ages, they’re still interested and healthy enough to do this kind of work?”

Staff engagement is a significant component of establishing policies and protocols for pet therapy programs, Asmus indicated. Engaging interdisciplinary teams can offer important insight around risk management of infection prevention, questions related to potential liabilities and the keys to ensure compliance, she stated. Volunteers need to understand the regulatory requirements around hospice services in addition to undergoing pet therapy certification protocols, Asmus said.

Researching pet organizations that specialize in animal service and therapy certification is the most important first step a hospice can take, according to Asmus. Also significant is dedicating resources to develop and expand collaborative referral relationships with various community and nonprofit organizations to help fuel a sufficient volunteer base/volume of volunteers, she added.

“The important thing from a nuts-and-bolts standpoint is to understand that our role is to provide hospice care, so leaning on partnerships with those organizations that have specialties in pet therapy certification is really critical,” Asmus said. “Developing a strong policy as to what type of certifications and from which organizations you will accept is a big hurdle to overcome. The humans and dogs are onboarded on all the pieces that go into a hospice volunteer program to ensure that you’re remaining compliant. We have to put them through a pretty strong vetting process.”

Hospices should have a foundational understanding of the logistical aspects to determine whether a pet therapy program is a fitting option for their volunteer service repertoire, according to Peters. Hospice providers can point to a few guidelines when building and growing a pet therapy program, she said, including:

• Starting a small pilot pet therapy program of one or two teams
• Being mindful of allergies that patients and families may have
• Understanding differences of patients’ cultural viewpoints and beliefs around animals
• Ensuring both hospice education and therapy training for animal handlers
• Standardizing animal therapy certification processes
• Establishing a balanced schedule for animal volunteers
• Clear communication systems that connect volunteers, staff and patients
• Collaborating with an organization that provides insurance for pet-related incidents
• Setting standards for animal health, including physical screenings and temperament evaluations
• Establishing infection prevention protocols 

“Pets are so much a part of our life, and therapy animal teams make a difference, especially with vulnerable populations,” Peters told Hospice News. “If you’re someone who has had dogs or cats your whole life, or animals have been incredibly meaningful to you and now you’re at the end of life and cut off from them … That opportunity to interact with a therapy animal again can be incredibly meaningful and appreciated, and also for the family members during a sad and stressful time.”