According to the literature, animal therapy has the potential to reduce social isolation, stress, anxiety, and depression in older adults living in nursing homes or retirement communities. The document proposes implementing weekly animal therapy sessions for residents of a Naturally Occurring Retirement Community to increase social engagement and combat feelings of loneliness. Upon providing an initial therapy session with dogs, residents expressed enjoyment and hoped the dogs would return soon. The literature and positive initial response from residents supports that animal therapy can improve psychosocial health and quality of life for older adults.

1. According to current literature, animal therapy has the potential to:
• Provide companionship and camaraderie and decrease feelings of
loneliness, social disconnection, and depression, while promoting social
interaction, attachment, and engagement, especially in older women
(Krause-Parello, 2012).
• Reduce stress hormone (cortisol) levels and decrease anxiety, which
can improve vital signs, physical functioning, and immunity (Beetz et
al., 2012).
• Stimulate human to human interaction by enhancing trust, empathy,
and a positive mood (Beetz, Uvnas-Moberg, Julius & Kotrschal, 2012).
• Elicit “feel good” hormones, such as oxytocin and dopamine, as a
result of 5-24 minutes of stroking a dog or any trusted animal (Beetz et
al., 2012).
• Facilitate physical exercise, mobility and opportunities for further
socialization during long walks. The amount of care required for a pet
also creates a sense of purpose, accomplishment, self-value and self-
efficacy (Brownie & Horstmanshof, 2011).
Based on clinical recommendations:
• Health care personnel should encourage the elderly to remain engaged
with friends, family and community, and participate in activities
provided by voluntary organizations (NIHCE, 2015).
• Social isolation is highly prevalent in the elderly population as a result
of more time spent addressing health concerns, the development of
financial constraints, difficulties with mobility, and the death of peers
(Steptoe, Shankar, Demakakos, & Wardle, 2013).
• In 2015, about 29% of all non-institutionalized older persons 65+, lived
alone (9.2 million women, 4.1 million men). The proportion living alone
increased with advanced age. Among women aged 75 and over, for
example, almost half (46%) lived alone (U.S. Census Bureau, American
Community Survey, 2015).
• Social isolation can have a negative impact on physical and mental
health, as it has been found to increase one’s risk for cardiovascular
disease, infection, hypertension, inflammation, cognitive decline, and
mortality itself (Steptoe, Shankar, Demakakos, & Wardle, 2013).
• The physical debilitation associated with social isolation further leads to
a decreased quality of life and increases healthcare expenditures.
• Residents of a naturally occurring retirement community (NORC)
lamented shrinking peer groups, time-consuming health concerns, and
mobility issues, highlighting their social isolation.
• As social isolation affects the elderly population at large, it is a
significant public health concern that must be addressed.
• Implement weekly animal therapy group sessions, in addition to the group
activities already provided in a naturally occurring retirement community
in an urban setting.
• Collaborate with an animal-therapy organization in the community.
Establish rapport and maintain weekly visitation.
• Determine the logistics of the pet-therapy events, in terms of accessible
location and appropriate time of day for the target population.
• Create a colorful, aesthetically pleasing, easy-to-read flyer, encouraging
participation. Language must be at 5th grade reading level. Utilize large
font to promote ease of visibility.
• Provide transportation assistance to those who have decreased mobility.
Implement interactive, community-wide, social engagement opportunities to
stimulate social behaviors which may decrease stress, loneliness, and increase
quality of life.
• Include animal therapy in the community setting to combat social isolation
in the elderly.
• Provide population-specific community programs geared towards elderly
interaction.
• Use an interdisciplinary approach including nurses, social workers, and
home health aides to increase community engagement, thereby combatting
social isolation.
Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-
animal interactions: the possible role of oxytocin. Frontiers in psychology, 3,
Brownie, S., & Horstmanshof, L. (2011). Management of Loneliness in Aged Care Residents: An Important Therapeutic
Target for Gerontological Nursing. Geriatric Nursing, 32(5), 318–325. http://doi.org/10.1016/j.gerinurse.2011.05.003
Halm, M. A. (2008). The Healing Power of the Human-Animal Connection. American Journal of Critical Care, 17(4), 373–
376.
Krause-Parello, C. A. (2012). Pet Ownership and Older Women: The Relationships Among Loneliness, Pet Attachment
Support, Human Social Support, and Depressed Mood. Geriatric Nursing, 33(3), 194–203.
http://doi.org/10.1016/j.gerinurse.2011.12.005
National Institute for Health and Care Excellence (2015). Older people with social care needs and multiple long-term
conditions. NICE guideline, 22, 24-25 (Level I)
Reed, R., Ferrer, L., & Villegas, N. (2012). Natural healers: a review of animal assisted therapy and activities as
complementary treatment for chronic conditions. Curadores Naturales: Una Revisión de La Terapia Y Actividades Asistidas
Por Animales Como Tratamiento Complementar de Enfermedades Crónicas., 20(3), 612–618.
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men
and women. Proceedings of the National Academy of Sciences of the United States of America, 110(15): 5797–580. doi:
10.1073/pnas.1219686110
Evidence published in 2011 or later was compiled,
including 2 clinical guidelines, 2 randomized
controlled studies, and 1 cohort study. The evidence was
searched through CINAHL, PubMed, and Cochrane
Library databases. Keywords searched included:
social isolation, elderly, depression, geriatrics, pet
therapy, animal therapy, and animal-assisted
interventions.
• Track and analyze the attendance of animal therapy sessions over
time, accounting for new and returning participants.
• Conduct a verbal survey to engage effectiveness and likeliness to
return to future events.
• Use EORTC QLQ-C30 questionnaire pre and post intervention to
ascertain effectiveness of animal therapy in improving
social isolation and over all quality of life over the span of three
months.
Effects of Animal Therapy on Social Isolation amongst the Elderly Living in the
Naturally Occuring Retirement Community (NORC)
AUTHORS:
Bianca Diaz
Steven Jacques
Cynthia Marini
Judith Rollhaus
Sean Ryan
Estefania Saldana
BACKGROUND
SEARCH STRATEGY
For patients aged 65 and older living in a long-term community health
setting, does the use of animal therapy provided for 45 minutes weekly
reduce social isolation compared to those of the same population who do not
participate in the session?
REVIEW OF LITERATURE
REFERENCES
EVALUATION
PROPOSED PRACTICE CHANGE
The totality of the literature supports that animal therapy can reduce stress,
anxiety, social isolation, and feelings of loneliness. Older adults with various
medical conditions have reported social, emotional, and psychological benefits
from working with therapy animals, improving their overall well-being (Reed,
Ferrer, & Villegas, 2012).
Upon implementing this intervention at a NORC, we witnessed the benefits of
dog therapy firsthand. The 15 residents that participated were all smiles as two
friendly dogs sat on their laps, licked their hands, and showed off
tricks. Multiple seniors expressed hopes that the dogs would return soon,
stating that they would be eager to attend future pet therapy events. The event
was successful in creating a social and engaging environment for NORC
residents, demonstrating its ability to improve participants’ quality of life over
time.
CONCLUSIONEBP RECOMMENDATIONS
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