# Anything I need to know for 1st visit to nursing home?



## llombardo (Dec 11, 2011)

Midnite and I are going for our first visit on Saturday. The nursing home is one level, so everyone is all together, meaning ill, assisted, and mentally challenged. I'm slightly concerned about the mentally ill part because in past experiences/volunteer work has proven they can be very belligerent. Of course I know they can't help it, but will Midnite know that? He is smart and by the standard he should know the difference and I think he will, but what if I'm approached in a manner that he feels is threatening? I know that remaining calm on my end will be extremely important. What else can I expect? Do I just walk around and whoever wants to see him approaches if do I attempt to approach everyone? I'm excited and I want this to work out.


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## MichaelE (Dec 15, 2012)

I think I would speak to a couple of regular staff members and nurses who deal with the residents on a daily basis for information on any patients that your dog may consider a problem.


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## Baillif (Jun 26, 2013)

Yeah the important thing is to watch your dog for stress signals or for signs hes maybe going into avoidance behaviors. If that happens back him off. Be prepared to diffuse him with treats or toy and let him blow a little stress off if you notice any.


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## Springbrz (Aug 13, 2013)

Be aware that most elderly patients are incontinent to some extent often wearing adult diapers and that the smell of urine/feces on patients may make him curious to sniff in those places. That may startle or frighten the patient. Old people fall easily trying to take a step back. It might be wise to having greetings with sitting patients until you get a good sense of how Midnite is going to react in this new environment.
It's a good thing you will be doing. My Grandmother-in-law and the residents at the nursing home she is at love it when my MIL brings in her lap dog to visit. He's small so it's easy with him to be put in someone's lap for visits.
Good luck to you and let us know how it goes.


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## Shade (Feb 20, 2012)

I agree, be in tune with your dog and recognize their signals and be ready to step in. Alex was one of the most quiet, easygoing dogs you'd ever meet so I really had to watch him because his signals were so subtle. Don't be afraid to tell the resident you need to go, there's always another visit next time  Nurses/other volunteers can be a wealth of information and help 

I had a small backpack with lots of small treats, it's much safer for people to feed food that you know where it came from  Also baby wipes to clean hands/messes up, a bottle of water both for you and Midnite, gum (keeps the throat lubricated and I found it helped with nausea from certain smells), and kleenex (always useful)

Hope that helps  It's extremely rewarding!


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## ken k (Apr 3, 2006)

you should limit your visits to an hour, if your dog shows any signs of stress, then take him out of there, ears forward, tail out, get him out of there, never mind the treats, if you have to brib your dog with treats, then you shouldnt be doing therapy work with him, also when you go up to a wheel chair have the dog sit at the side for petting, never in front, if the person reaches out front to pet, could fall out of the chair, also watch out for pills on the floor, keep an eye on your dog at all times, being a Therapy dog team is very rewarding, your first responsibility is to your dog, let us know how it goes, forgot to mention, you should be calm, if you start getting stressed so will the dog


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## Quinnsmom (Dec 27, 2008)

What Ken K said is very comprehensive advice. Even a half hour is enough for a first visit. Take your dog out before he gets tired to keep it a positive experience. I would discourage any feeding of treats by residents to your dog. The skin on elderly people is very delicate and should Midnight bump someone's hand with a tooth or, heaven forbid, raise a paw up and scratch someone, an injury can occur. Someone might also mistakenly think the dog had bitten them and that is a world of trouble. Ask the recreation staff or whoever is arranging your visit for a list of residents who would like a visit, as not all will be receptive to dogs. As time goes along and the residents expect you, watch for any of them offering treats to Midnight. It could be a chocolate or a sandwich they kept from lunch four days ago - seen it happen!


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## llombardo (Dec 11, 2011)

All very good advice and all stuff I wondered about. I'm teaching Midnite head down so that he places his head in their lap gently. I have also been blowing in his face, making noises at him and around him. I even dropped medication on the floor as a test...he has to be thinking I finally lost it.


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## Kat Tastic (Nov 26, 2013)

I would give his nails a trim too, everyone is very correct about the skin issue. With the elderly, it becomes paper thin and bleeds/bruises easily. Add the blood thinners...oh my. 

It may be a good idea, if this is his first visit, to give him (and you!) a little break outside to play and relax every 30 minutes or so? Just a thought.

Ask the staff about signs on the doors too. Usually people who are at risk for falling have pictures of waterfalls (not kidding) by their names. Little things like that can help you know what to expect/watch for.  
*Find out what sign/color they use for patients with dementia...some can become violent and prone to outbursts, which may frighten your pup. Usually they have a seperate wing, but I would ask.

I hope you have a fun time, and your pup too! That's wonderful work, and the residents talk about it all week! They even tell us on their ambulance trips about "the sweet man/woman who brings in the beautiful dog..." Touches my heart!


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## llombardo (Dec 11, 2011)

Nails were trimmed last week. I thought last night when I seen another GSD with super long nails...wow that could hurt someone. He also just had a bath.


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## ken k (Apr 3, 2006)

just a short story on how important it is to always watch your dog, T.D.inc had a claim come in, a handler and her dog were at a facility, the dog was a husky mix, the handler was not paying attention, in come`s an elderly women 80 plus years, the dog jumped up to her, and the elderly women received 90+ stitches, the claim was denied


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## llombardo (Dec 11, 2011)

The great thing about Midnite is that he is not and never has been a jumper. I know to never say never and my first priority is protecting him him and I will do everything necessary to do so.


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## Blitzkrieg1 (Jul 31, 2012)

I have a certified therapy dog that I take to a nursing home...its a Chihuahua/pug mix.

My current GSD is very friendly, yet I will never take her to a nursing home. Some of the people in there are dealing with dementia and other mental health challenges, this can sometimes lead to aggressive / confrontational behaviors. The kind of thing I expect a well bred GSD to key in on. I will never expose myself to that sort of risk its just not worth it. Plenty of breeds suited to that environment, to my mind the GSD is not one of them.


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## llombardo (Dec 11, 2011)

I think that GSD's are perfect for this kind of work if they are stable. I'm the opposite, I don't think I would ever consider bringing a smaller dog, because I think they in general tend to be more defensive.


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## ken k (Apr 3, 2006)

llombardo said:


> I think that GSD's are perfect for this kind of work if they are stable. I'm the opposite, I don't think I would ever consider bringing a smaller dog, because I think they in general tend to be more defensive.



some GSD`s are good at this some are not, outside of the family, not a touch me feel me dog, Max tells me when its time to go, he`ll just turn his back on a patient, then I know hes done for the day, he does do his best work in the mental ward through


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## Msmaria (Mar 2, 2013)

This is very good information. Dexter is (was) in therapy training . Hes 10 months and the first visit with our group, a dementia patient grabbed him around his neck really hard and he cried out. After that he started drooling, and showing avoidance by sleeping so I took him home. We havent gone back and Im thinking of taking him out of the program or wait until hes older.


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## Castlemaid (Jun 29, 2006)

I used to visit nursing homes, geriatric/psychiatric hospital wards with my therapy dog (Spaniel/Retriever mix). Nothing anyone did bothered him (shouldn't - that is part of the screening for a therapy dog), but what I found working in those environments is that people were pretty withdrawn and confused, so it was rare that they approached you - I found that I needed to take the initiative to go up to people and start talking to them - I always brought some dog treats with me, and gave them to people to give to my dog (I don't know if you would be allowed to do this where you are visiting - ask first) - and that worked well to get people involved in interacting with him. 

I also taught my old guy some tricks (well, he was seven when we started), and performing them was always a big hit, people calling out 'requests', which was also a great way to get people out of their shell. 

Hands-down his best trick was playing the piano - most places had a commons room with a piano available, and I would set it up as if William (the dog) was a brillant but misunderstood modern artist. I'd give this indroduction and carefully place his sheet music and he would stand up on his hind legs and start "walking" the keys up and down with his front legs, hammering out intersting sounds. It was so funny - had most people just laughing their heads off - we were quite the hit, many people eagerly looking forward to our weekly recitals, LOL!

Just use your judgement - some people were not comfortable with dogs, I watched for those signs and kept our distance, but for the most part, due to the nature of some of the places we visited, I certainly had to make initial contact and take the initiative to interact with people - it was more tiring for me than for William!


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## Msmaria (Mar 2, 2013)

Just wanted to note: if your like me and never been around dementia patients before, its worth going by yourself before you go with your dog. I had no idea that they could be aggressive and scream at you, throw things. I have visited a few senior homes and most were just lonely older people. The nursing facility was very different. If your dog can make it in a nursing facility , they would do great anywhere.


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## Blanketback (Apr 27, 2012)

One thing I'll add: there could be other families visiting with their own dogs, so be on the lookout. These other dogs don't have to screened, so they could nasty with yours - that's from my own experience. 

It's your call with the treats, but I personally don't like the idea. As mentioned already, the residents will stash all sorts of things to feed your dog, so it's better IMO to set the precedent right off the bat that your dog isn't to be fed anything, ever. 

Watch out for walkers! My TD was run over a few times so give a wider berth than you think is necessary.

My TD was a GSD. I guess we all have our own opinions on what breed would make a better TD, but IMO when you're visiting the elderly then you don't want a wiggle butt, you want sedate. As long as the particular dog enjoys physical contact and conversation then you're good to go.


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## Castlemaid (Jun 29, 2006)

I think the disagreement about which breeds makes for a good or bad therapy dog is moot, because it really depends on the dog! I'm sure there are tons of Golden's out there that would not cut it as a Therapy Dog, while the "Therapy Dog of the Year" award for the organization I was involved with was a GSD (despite what some people here are saying about GSDs). 

So look at the dog - not the breed!


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## Blitzkrieg1 (Jul 31, 2012)

llombardo said:


> I think that GSD's are perfect for this kind of work if they are stable. I'm the opposite, I don't think I would ever consider bringing a smaller dog, because I think they in general tend to be more defensive.


 
I bring a small dog because he is enormously confident and social. He also ignores people when they act abnormally or will even try to placate them by being social. Also, if someone does try to hurt him or me and he responds, its likely not going to end too badly..

I expect a well bred GSD to key in on anyone thats a threat. It has nothing to do with stability or training and everything to do with genetics. When someone behaves like they are a threat, smells like they are a threat and sounds like they are a threat then a well bred GSD should and will acknowledge the "threat". 

Hence why I wont personally risk even the most social GSD in that sort of environment, things can be great for years until one time they arent and then you and your dog are in for a world of hurt. The genetics are there and can be expressed even in the most social seeming dog under the right circumstances.

That being said Im sure there are some shepherds that will do fine there.


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## llombardo (Dec 11, 2011)

Msmaria said:


> Just wanted to note: if your like me and never been around dementia patients before, its worth going by yourself before you go with your dog. I had no idea that they could be aggressive and scream at you, throw things. I have visited a few senior homes and most were just lonely older people. The nursing facility was very different. If your dog can make it in a nursing facility , they would do great anywhere.


I'm familiar with all of the stuff mentioned above, it is going to be a true test for both of us. If I feel my dog is in any kind of danger we will not go back. I don't want the residents to feed him either, but if they try I will have treats on me to distract.


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## llombardo (Dec 11, 2011)

Blitzkrieg1 said:


> I expect a well bred GSD to key in on anyone thats a threat. It has nothing to do with stability or training and everything to do with genetics. When someone behaves like they are a threat, smells like they are a threat and sounds like they are a threat then a well bred GSD should and will acknowledge the "threat".


I'm on the fence on this one. Because I think there is more then them sensing a threat in general. I think that its a matter of them sensing something more like evil. A kid running with a baseball could be a threat, but do they consider it that way or do they realize its a kid? There are lots of scenarios that can play out and we really can't say what they will consider a threat. A mentally ill person isn't going to have an evil kind of presence, off but not evil, does that play a part in the perception?


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## Blitzkrieg1 (Jul 31, 2012)

I think your ascribing more mystique to something that can be explained by science. When someone is angry or has negative intentions they excrete scent, sweat, hormones etc. Their body language is off, they usually produce vocalizations etc. 
A dog picks up on all these things and uses their senses to determine who is friendly, nuetral or a threat. 
Someone with mental health issues can produce all the wrong stimuli and generate an unexpected response.

A dog that reacts negatively to a child running with a bat is more likely nervy then anything else. Also, yes I do think dogs know the difference between adults and children. A child running around and screaming is just not the same thing and is also unlikely to excrete the scent, body language and sound an aggressive adult does.


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## llombardo (Dec 11, 2011)

Blitzkrieg1 said:


> I bring a small dog because he is enormously confident and social. He also ignores people when they act abnormally or will even try to placate them by being social. Also, if someone does try to hurt him or me and he responds, its likely not going to end too badly..
> 
> I expect a well bred GSD to key in on anyone thats a threat. It has nothing to do with stability or training and everything to do with genetics. When someone behaves like they are a threat, smells like they are a threat and sounds like they are a threat then a well bred GSD should and will acknowledge the "threat".
> 
> ...





Blitzkrieg1 said:


> I think your ascribing more mystique to something that can be explained by science. When someone is angry or has negative intentions they excrete scent, sweat, hormones etc. Their body language is off, they usually produce vocalizations etc.
> A dog picks up on all these things and uses their senses to determine who is friendly, nuetral or a threat.
> Someone with mental health issues can produce all the wrong stimuli and generate an unexpected response.
> 
> A dog that reacts negatively to a child running with a bat is more likely nervy then anything else. Also, yes I do think dogs know the difference between adults and children. A child running around and screaming is just not the same thing and is also unlikely to excrete the scent, body language and sound an aggressive adult does.



Fair enough. I went today to drop off the paperwork. I was surprised at how clean the place was. It didn't smell like a hospital and had a warm feel to it. I'll keep my ears and eyes wide open. I won't push anything on him and I'll make sure he is comfortable.


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## ILGHAUS (Nov 25, 2002)

Don't write off GSDs as Therapy Dogs. It is the individual dog that is evaluated as with any breed. One of my GSDs was a wonderful choice for therapy work and he and I enjoyed working as a team for years in this and other activities out in the community. 

I recommend that anyone who wishes to get involved with this activity to go with a well-known Therapy Dog group. There the handler will be instructed on the proper manner to go about their visits and have basic questions like those in this thread answered. 

Through a group, the individual team will also have a large liability insurance coverage if needed.


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## Chicagocanine (Aug 7, 2008)

I know someone who has had 9 actively working therapy dogs and Most of them are/were Dobermans.


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## erfunhouse (Jun 8, 2013)

Blitzkrieg1 said:


> I think your ascribing more mystique to something that can be explained by science. When someone is angry or has negative intentions they excrete scent, sweat, hormones etc. Their body language is off, they usually produce vocalizations etc.
> A dog picks up on all these things and uses their senses to determine who is friendly, nuetral or a threat.
> Someone with mental health issues can produce all the wrong stimuli and generate an unexpected response.
> 
> A dog that reacts negatively to a child running with a bat is more likely nervy then anything else. Also, yes I do think dogs know the difference between adults and children. A child running around and screaming is just not the same thing and is also unlikely to excrete the scent, body language and sound an aggressive adult does.



As a nurse who regularly gets dementia patients in my ER (and who has had to restrain the violent and "dangerous" ones) and as a former MP I can emphatically state that that episodes of a dementia patient and those of an angry threatening person are two drastically different presentations. I'd hope any shepherd working in a therapy situation and any therapy dog for that matter could tell them apart. The dementia patient is more akin to a temper tantrum throwing cursing child than they are a true threat. 


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