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When Best Friends Can Visit

By Judith Graham, April 10, 2013 6:00 am April 10, 2013 6:00 am

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Harry Grandis received a visit from his pet Yorkie, Minnie, while he was a patient at Virginia Commonwealth University Medical Center, which has a pet visitation policy. Credit Courtesy of Ann Grandis


A year and a half ago, Ruth London lay in intensive care in a hospital in Boca Raton, Fla., with severe pneumonia, delirious and hallucinating that she was in jail.

With the permission of a doctor on the unit, Ernest London, 81, cooked up a plan. He would bring the family dog, Delilah, a fluffy white Maltese, to see if the pet could calm his wife down.

At the entrance of the hospital, Mr. London was met by volunteers who stopped him cold. No dogs from home are allowed, they told him. But a call to the doctor was made, and eventually Mr. London and Delilah were allowed to go upstairs.

In the hospital room, the dog ran to Mrs. London’s side and nuzzled her hand. She stirred from her delirium “just a little bit,” Mr. London recalled, and began to remember where she was. “It was a turning point,” he said. “From that point on, she seemed to take a turn for the better.”

“I love that dog. I love her so much,” said Mrs. London, now 74.

It was a one-time deal: after a hurried meeting, hospital staff members decided they wouldn’t allow Delilah to come again, nor would they let other family members bring family pets to see other patients, Mr. London said.

That’s the policy at most hospitals across the country.

But a few medical institutions have taken a different approach and thrown open their doors to patients’ own dogs and cats, letting them visit along with spouses, children and friends. (Lots of hospitals have pet therapy programs using trained dogs, but that’s a different matter.)

The University of Maryland Medical Center in Baltimore lets family pets visit their owners, so long as certain requirements are met, as does the University of Iowa Hospital and Clinics in Iowa City; Virginia Commonwealth University Medical Center in Richmond; Rush University Medical Center in Chicago; two hospitals associated with the Mayo Clinic in Rochester, Minn.; and more than a dozen other medical centers.

On Long Island, North Shore University Hospital allows personal pets to stay with patients around the clock in its 10-bed palliative care unit, as does Hospice Inn, a freestanding 18-bed hospice facility that’s part of North Shore-LIJ Health System.

Policies vary at the institutions that allow visits by patients’ pets, but many share some of the same requirements. A doctor’s order allowing the family pet to visit is typically necessary, as is an attestation from a veterinarian that the animal is healthy and up to date on all its shots. Most institutions require that dogs — the most common visitors, by far — be groomed within a day or so of a visit and on a leash when they walk through hospital corridors. Cats must be taken in and out of the institution in a carrier.

If a dog or cat wants to get up on a patient’s bed, a covering is laid down first. If an animal seems agitated or distressed when it comes into the hospital, staff members who meet the family and escort them to the patient’s room have the right to turn it away. If the patient shares a room with someone, that person must agree before a pet may visit.

“We have not had any problems,” said the Rev. Susan Roy, director of pastoral care services at the University of Maryland Medical Center, whose “your pet can visit” policy has been in place since 2008. If anything, she said, the visits can be hard on dogs, who often respond viscerally to an owner’s illness and may take a day or two to recover from a visit.

Rush University Medical Center spent three years studying the issue before its new pet visitation policy went into effect in February. Diane Gallagher, the hospital’s associate vice president of nursing operations, described some of the questions: Would animals transmit infections to patients, or vice versa? What were the liability issues? Could allowing pets to visit interfere with patient care — if, for instance, a family dog became alarmed and protective of the sick person when a doctor, a nurse or a technician came into the room?

In the end, officials decided that the benefits — comfort and reduced stress for patients — were more substantial than the risks.

Although research has shown that hospital therapy dogs can pick up germs and potentially transmit bacteria that can cause dangerous infections, those animals typically wander from room to room, while people’s own pets are expected to stay with the patient they are visiting. If someone has an open wound or an active infection, a visit from a family pet is discouraged, according to most hospital policies.

Research on the value of personal pets visiting patients in the hospital hasn’t been done. One small 2010 study of 10 healthy dog owners by researchers at Virginia Commonwealth’s Center for Human-Animal Interaction found that both unfamiliar and familiar dogs provoked similar reactions: a relaxation response and reduction in blood pressure and levels of cortisol, a stress-related hormone, according to Dr. Sandra Barker, director of the center and a professor of psychiatry.

But personal anecdotes abound. Anne Mahler, 57, a clinical nurse specialist at Hebrew SeniorLife, the largest provider of elder care services in the Boston area, remembers how depressed her elderly father was after breaking a hip and trying to recover in a rehabilitation facility. That institution wouldn’t allow his beloved dog Molly, a springer spaniel, to come to his room, but a visit was arranged in a back room off the lobby.

“My dad sat there sobbing,” Ms. Mahler said. Afterwards, the older man began eating more regularly, his attitude lightened, and he seemed determined to do everything possible to return home to join Molly.

More than 400 seniors live on the long-term care unit at Hebrew SeniorLife’s Roslindale campus, and staff members strongly encourage pet visits, Ms. Mahler said.

Harry Grandis fought off bladder cancer for seven years before finally succumbing to the illness last October at the age of 91. The final year of his life he was hospitalized five times at Virginia Commonwealth University Medical Center, and during two of those stays had regular visits from Minnie, his beloved Yorkshire Terrier.

“Minnie would come into Harry’s room and his eyes would light up,” said Ann Grandis, his widow. “It was like bringing home to him. It just made such a difference.”

Harry returned home to die, and on the last day of his life Minnie lay in bed at his side until close to the end. Now it’s Ann who relies on Minnie and would want her there if anything untoward were to happen. “I would be lost without her,” Ms. Grandi, 70, said. “She’s family.”

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1   [USMedEdu 于 2014-12-23 13:37:08 提到] [FROM: 209.]
A Singular Life, an All Too Common End
By Paula Span
April 9, 2013 12:06 pm April 9, 2013 12:06 pm

http://newoldage.blogs.nytimes.com/2013 ... ommon-end/


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President Ronald Reagan was Margaret Thatcher’s closest foreign ally. Their relationship was called “the most enduring personal alliance in the Western world throughout the 1980s.”

President Ronald Reagan was Margaret Thatcher’s closest foreign ally. Their relationship was called “the most enduring personal alliance in the Western world throughout the 1980s.” Credit Gerald Penny/Associated Press


The long list of roles Margaret Thatcher played during her 87 years — potent politician, free-market evangelist, labor antagonist, dominant global leader — includes the one she never publicly discussed: person with dementia.

The stroke that killed her on Monday was not her first. Mrs. Thatcher suffered several small strokes more than a decade earlier, canceled all her speaking engagements in 2003 and largely withdrew from public life. Even before the strokes, her daughter, Carol, wrote in a 2008 memoir, she was losing cognitive ground, repeating questions and showing other signs of confusion.

Heartbreakingly, she often forgot that her beloved husband, Denis, had died of cancer in 2003. “I had to keep giving her the bad news over and over again,” her daughter wrote. “Every time it finally sank in that she had lost her husband of more than 50 years, she’d look at me sadly and say, ‘Oh’, as I struggled to compose myself. ‘Were we all there?’ she’d ask softly.”

At the time, members of her mother’s political circle and other British commentators denounced Carol Thatcher for invading her mother’s privacy and, supposedly, diminishing her dignity. The criticism arose again in some quarters last year, when Meryl Streep won an Oscar for her portrayal of Mrs. Thatcher’s dementia in “The Iron Lady.”

The contrast with her fellow conservative and staunch supporter Ronald Reagan perhaps says something about American openness versus British reserve. Or maybe his movie-star past made him more at ease in the public eye.

Mr. Reagan chose to disclose his Alzheimer’s disease in a handwritten open letter in 1994, accompanied by an explanatory letter from his doctors. He, too, had experienced memory loss for a couple of years, and once he got the Alzheimer’s diagnosis, he and Nancy Reagan considered how much to say.

“In opening our hearts, we hope this might promote greater awareness of this condition,” his letter said. “Perhaps it will encourage a clearer understanding of the individuals and families affected by it.”

Alzheimer’s and other forms of dementia, to this day, carry a stigma that most other diseases — heart failure, for example — do not. To my mind, Mr. Reagan’s public disclosure showed courage, as Betty Ford’s candor about her breast cancer and her substance abuse did 20 years before.

Mrs. Thatcher’s family, on the other hand, has never discussed her diagnosis — whether she had vascular dementia from the earlier strokes or some other form of the disease. Perhaps she forbade her children to offer details about her illness, or perhaps by the time her condition was clear she was no longer able to make such decisions. We may never know.

But we do know that dementia will become an increasingly common condition in coming years, that it’s a terminal disease which doesn’t respect the public stature or intellectual accomplishments of its victims, that it can cause families to grieve for the people they’ve lost long before they die.

Grocer’s daughter. Chemist and barrister. Member of Parliament. First and to date only female prime minister of Britain. Major figure on the world stage. Dementia patient.

It is not why Margaret Thatcher will be remembered, or why Ronald Reagan will be remembered, but it is not something we should turn away from or something we can ignore. Dementia is part of their stories, and of so many others’.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

 
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