Four-Legged Therapists

Eliciting smiles from hospitalized children, specially trained dogs work miracles, sometimes just by cuddling.

A visit from therapy dog Lille was a welcome distraction for patient Brianna Incorvaia, who had been undergoing testing for five days at Hackensack University Medical Center.
Photo by Jared Castaldi.

It’s hard to imagine any teenage girl ignoring a phone call, but 13-year-old Brianna Incorvaia has just told her mother to silence the ringing iPhone lying on a table next to her hospital bed. “Oh, turn that off. Don’t answer that,” she insists, quickly returning her attention to the small Shetland sheepdog named Lille curled up in her lap.

“That’s typically not her,” the girl’s mother, Helen Hicks, later admits. “She probably sends 3,000 texts a month. But at that moment, there was a bond between her and Lille. The only time I’ve ever seen her react that way is with her sports.”

Incorvaia, who plays softball and is a member of Garfield’s competition cheerleading squad, had been admitted to Hackensack University Medical Center five days earlier experiencing immobility in her neck and back. After almost a week of testing and confinement to bed, the teen was becoming depressed and worried. But that was before Barbara Babikian showed up with Lille, her trained therapy dog.

“It felt good to finally see my daughter smiling again,” Hicks says. “Brianna is very athletic and outgoing, so it was torture to see her like that. But Lille lit up the room.”

Therapy dogs have a strong track record. “Studies have shown that the introduction of a pet into the environment with both physically and mentally ill patients improves socialization, empathy and nurturing behavior,” explains Catherine Dipasquale, manager of Hackensack UMC’s volunteer services. “I’ve seen children more inclined to cooperate with physical therapy when there is a pet in the room. It provides them with a happy distraction from their pain and discomfort.” 

Dr. Stephen Percy Jr., vice chairman of the pediatrics department, attests to the phenomenon. “You can see the children visibly brighten up when the pets come into the room and get in bed with them,” he says. “A positive mental attitude helps the children be more cooperative with their care plan and helps increase activity that the child might otherwise avoid.”

Hackensack UMC has been offering animal-assisted therapy to many of its patients—young and old—since 1992. In 2007, the center partnered with the Westminster Kennel Club’s respected Angel On A Leash program, now an independent charity, offering comprehensive training for dogs and handlers as well as administrative and research support for its partner organizations. Hackensack UMC is the only Angel On A Leash partner in New Jersey.

“Being partnered with Angel On A Leash gives us a national presence and a feeling of unity with other hospitals and health-care facilities,” Dipasquale explains. Angel On A Leash, Dipasquale adds, has a “vision that we support: to create the best therapy-dog programs in health-care facilities and other settings across the country.”

On top of Angel’s requirements, Hackensack UMC has its own rules—32 policies and procedures as well as numerous medical requirements. For example, handlers are not permitted to discuss the subject of illness in any way with the patient and family. Babikian admits this is sometimes challenging, especially when she visits a sick child and observes the parent “trying to hold it together…. Sometimes it’s very hard to hold back the tears, but you do it long enough until you leave,” she says. “I remember one time I cried uncontrollably the entire hour-and-a-half ride home. The child ended up being in my life for the next two and a half years until she lost her battle with cancer at the young age of nine.”

At Hackensack UMC, the animal-assisted therapy teams are primarily used in a meet-and-greet capacity, in which the dogs are brought into a room for a comforting snuggle or to play with the patient. Smaller dogs like Lille are placed on a blanket—crocheted by hospital volunteers—on the patient’s bed.

“Lille is a cuddler,” Babikian says. “She just wants to move up next to your body and cuddle. And sometimes that is all someone really needs.” A larger dog like Harvey, a 150-pound Newfoundland, may rest his head on a patient’s bed to be petted, but more commonly larger dogs frolic with children who aren’t confined to a bed. “Harvey will lay on the floor and the kids will just fall all over him,” Dipasquale chuckles. “He just doesn’t care. He’s so mellow.”

Susanne Schulz, a Little Ferry resident who volunteers with her Italian greyhounds, Bella and Dancer, says she sometimes is asked to sit in on recreation sessions or to work with a patient who is afraid of dogs. Those requests often come from Solange Griffith-Ruff, the therapeutic-recreation specialist, who works in the department of psychiatry and behavioral medicine. “Sometimes my patients won’t get out of bed for recreation sessions,” says Griffith-Ruff, “but if I tell them we’re going to have pet therapy, they look forward to it.” She says otherwise-uncooperative patients will sit in a circle with other patients and share stories about the therapy dogs or their knowledge of a particular breed.

“I’ve seen patients aggressive around each other, but when the dogs come around, the meanness changes,” Griffith-Ruff says. She encourages patients who are fearful of dogs to attend the sessions. “My one patient was afraid of dogs because he was bit when he was young,” she recalls. “By the end of the first session, he went over and touched his head. The next week, he was on the floor, rolling around, hugging and kissing the dog.”

Both Babikian and Schulz say they volunteer because of the joy it brings the patients, but they also do it because they believe their dogs were intended for this work. “I have no idea how Dancer can sense what people need, but he does,” Schulz says. “Once we were visiting a paraplegic, and he went up and cuddled his face—the only thing [the patient] could feel. How could the dog know? It astounds me.” Babikian claims Lille won’t allow her friends to hold her, that she will only go to people “if she feels they need her.”

“When I visit with her, I place her into the bed of a patient, and she will keep repositioning herself until her body is touching the patient, and then she will relax and fall asleep,” says Babikian, wiping tears from her eyes. “This one, she just chooses.”

Incorvaia’s session with Lille lasted about 25 minutes. Babikian admits it was difficult to take her from Incorvaia’s arms. “Her smile appeared the moment we walked into her room and remained on her face the entire time,” she recalls. “Visits like that, I wish I could just sit in the room and let Lille lay with the child the rest of the day.”

Hicks, who was practically living at the hospital during her daughter’s stay, was grateful for the distraction. “Barbara and Lille definitely brought happiness to my daughter that day,” she says, stifling tears. “That will be one thing I take with me for the rest of my life.”


SIDEBAR: Canine Comforters: How to Get Started
Do you and your pup have what it takes to be a therapy team? To find out, first contact the Delta Society, a national nonprofit that trains handlers along with their pets to visit patients in hospitals, nursing homes, hospices, physical therapy centers, schools, libraries and many other facilities. Before you can volunteer with Angel On A Leash or any other facility, you and your dog need to pass muster with Delta and become a “registered” team.

“We evaluate both ends of the leash,” explains Bill Kueser, Delta’s vice president of marketing. First the handler must complete a home-study course or a local workshop. The human has to learn to identify and alleviate stress in the animal and gain familiarity with rules of patient confidentiality and health and safety codes.

Then it’s fido’s turn. The dog must pass a comprehensive physical exam conducted by its veterinarian. Among other requirements, it must have up-to-date rabies and other immunizations and be free of internal and external parasites.

The final step evaluates how well the handler manages the animal’s behavior and how well the animal responds. “This is more than a K-9 good citizen test,” Kueser says. “We actually have the human and animal encounter things they might when visiting a health-care environment—like loud noises, medical equipment like wheelchairs and walkers and people who might handle them clumsily.”

If the team passes, “We provide them with liability insurance, if something goes wrong,” Kueser says. “We also provide support if they are looking for places to visit, as well as ongoing information.” Teams are re-evaluated every two years. For more information on becoming a Delta-registered therapy team, call 425-679-5500.

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