There are countless programs in the United States that help older adults with loneliness, social isolation, dementia and Alzheimer’s. And then there are those born out of a grand passion or combination of passions, and these programs tend to not only stick with us as observers, but also demonstrate favorable outcomes for the populace to which they are aimed. One of those programs is Connected Horse.
Connected Horse is run by two lifelong horsewomen, gerontologist Nancy Schier-Anzelmo and Paula Hertel, both of whom have worked for decades in long-term care and senior housing. People with dementia and their care partners come to a barn (there are multiple locations in Northern California and Nevada, one in Canada and one in Mexico) and work with the horses, on the ground—grooming, walking, interacting in a safe way. This is not a riding program.
But as Hertel says, “It isn’t so much the activity that’s important to people, it’s the connection people have on a very sensory level with the horse that is therapeutic.”
According to one caregiver, “the interaction becomes more than just an activity, it becomes healing.” Seeing the people who have dementia calming down during such a positive interaction tends to have a cathartic effect on the caregivers and they, too, relax a bit.
Basis in Equine-Assisted Therapy Programs
Modeled after similar equine-assisted therapy programs that have been successful for children with disabilities, people with PTSD or in the formerly incarcerated population, the idea is that if horses can help these populations, why wouldn’t they be equally effective for people with dementia and their care partners?
“What drew both of us to start this was our desire to look at society as a whole, and how it views older adults, especially those with a diagnosis of dementia,” said Hertel. “We wanted to change up the dependency thinking and shift the focus away from being so paternalistic and protective.”
They also wanted to figure out a way to “help those two people [the care partner and the person with dementia] start to look at how they move forward once there is a diagnosis in a way that is healthy and helpful, versus despairing,” added Anzelmo.
Another way in which this program differs from many is that Schier-Anzelmo and Hertel are equally concerned with the mental and physical state of the horses. They purposefully use older horses, some of whom may have been abandoned or viewed as having lost their worth. Both women are convinced that just as humans want to continue to find purpose in life no matter their age or physical and mental abilities, so, too, do horses want to give back and have purpose in their lives, as they have been working with humans often for decades. These two ideas clicked to form an ideal pairing.
Although they knew from experience with horses and kids with disabilities that such a program would work, they wanted research to back up the idea, so they approached the Red Barn Equestrian Center at Stanford University. It already housed an equine leadership program in its School of Business.
‘We wanted to change up the dependency thinking and shift the focus away from being so paternalistic and protective.’
Schier-Anzelmo and Hertel asked for sponsorship to put together a program with Dolores Gallagher Thomson, a professor emeritus of psychiatry and behavioral science, who is a geropsychology specialist in people who have late-life depression and dementia. Gallagher Thompson said yes, as she had wanted to look at caregiving and caregiving support in a new way. And Jacqueline Hartman of the Stanford Red Barn Leadership program signed on to help design the program. Soon funding was secured, mostly from senior living companies and some from individuals. The research continued for another year at UC Davis through its Alzheimer’s Disease Research Center and the Center for Equine Health.
The study of 66 dyads of care partners and people with dementia showed great promise for the program—improving sleep, decreasing depression, decreasing anxiety and feelings of being a burden, and having an equally positive impact for care partners. Six months following the first study, they conducted a study booster session inviting back original study participants and had an unheard-of 100% participation rate. The Stanford researchers said the study showed that more research was warranted, and when results were presented at the Gerontological Society of America and Alzheimer’s Association International conferences, other researchers were intrigued.
No Need for More Formal Studies
Schier-Anzelmo and Hertel, however, are women of action, or as Schier-Anzelmo said, “we’re practitioners, we knew they could study it until the cows come home, but we wanted to just do it right now.”
So, they launched Connected Horse. Both women are careful not to say the program slows disease progression but to emphasize that the real goal is to strengthen the relationship between care partners and those living with dementia, allowing them to continue to work together in a positive way. They may not have detailed numbers on exactly how it works, but they have plenty of word-of-mouth testimonials.
“People want to come back, we have lots of repeat participants,” said Hertel. “Even if a person is hard to get out of bed, they’ll be excited to come to the barn, and they both benefit from doing something new together, being in nature, experiencing what it feels like to be in the moment, and to be present. Because if you’re not, if you’re thinking about your shopping list, the horses simply will not engage.”
She finds care partners often have a rougher time relating immediately to the horses as they’re often distracted, thinking of checking tasks off their long lists, whereas people living with dementia excel at being present in the moment.
Care partners, once they have a few sessions under their belt, figure out that if things are not going their way, they need to learn to let it go. Such an emotional connection to the training helps make the lessons stick. Hertel and Schier-Anzelmo draw a bright line between their program and pet therapy, because this is a learning process in which the participants build a relationship with the horse, and as a result can start doing more in their own lives as they take these lessons home. The equine-assisted activities also can help overcome the stigma that comes with a dementia diagnosis. The horses certainly aren’t judgmental and both parts of the caregiving dyad can have a meaningful experience.
“One man [who had dementia] hadn’t been out of his house for months, and after some sessions with the horses he went back to the gym and was able to travel again,” said Hertel.
‘The program activates them back to life, where they are no longer waiting for the “dreaded disease” to take over.’
“Activation is the ultimate goal. The program activates them back to life, where they are no longer waiting for the ‘dreaded disease’ to take over,” she added.
“We are out in the field working with families and trying to normalize the disease and focus on what you can do versus what you can’t do. Why not focus on what you can do—on healthy eating and sleep and building programs for individuals that are active, where the family can see the person as a whole person and not one labeled by the disease?” asked Schier-Anzelmo.
“We’re showing there is joy and a reason to live and even happiness, which is so important.”
Looking to the future, Hertel and Schier-Anzelmo know the program is scalable and would welcome its spread across the country and continent. To that end they have put together a training academy to teach and coach facilitators, which is priced at a reasonable rate. And because they secure funding through fundraising, they offer the program to participants for free. Their hope is anyone receiving a diagnosis has the program as an option.
“I can only imagine there are other people in this profession who are looking for a purpose and to be creative, and this is a great way to do that—it can take people out of the ‘I’m the expert’ mode into practicing being in the moment,” Schier-Anzelmo said. “There’s value in it for everyone who participates.”
Watch a video of the horses and participants in action below:
Alison Biggar is ASA’s Editorial Director.
Photo credit: Isabel Soloaga
Photo caption: Participant Barbara connects with Covergirl at the 5 Star Equestrian Center.