A patient in Minneapolis VA’s Polytrauma Rehabilitation Unit has a therapy session with Jäger and his handler, Dee Dee Grant.
Jäger is given the “watch me” hand signal.
A patient waits for Jäger’s attention before he tosses the ball down the hallway.
Jäger cuts an imposing figure walking down the halls of Minneapolis VA Medical Center: dark coat, intelligent eyes and a stern demeanor. German Shepherds like Jäger are the favorite working dog of the military or police force, but Jäger has found his calling helping those who have returned from the front lines.
Jäger is unusually social for a German shepherd, explained his owner and handler, Dee Dee Grant. While he likes everybody and welcomes being petted, Jäger bonds and snuggles more with those patients who demand a lot from him.
“Jäger’s very active, he’s highly distractible,” said Grant. “I think the VA patients like that, because he’s always watching the door. I tell them, ‘He’s got your back.’”
When it is time to get to work and focus on the therapy session, all Grant has to do is hand Jäger’s ball to the patient.
“They become the center of his world and I think the patients really like that, because he’s not focused on them because of their injuries,” said Grant. “They are someone who can provide play and work for him.”
Animal assisted therapy may appear to be a series of games, but each activity is developed with a rehabilitative goal in mind.
“That’s what my job is all about: working on specific therapy goals, but in a fun way so you’re not thinking about the therapy behind it,” said Shannan Anderson, certified therapeutic recreation specialist (CTRS) at the Minneapolis VA.
Walking with prosthesis is more challenging with a dog on a leash and giving verbal commands can serve as speech therapy. Even the simple action of brushing a dog can improve hand dexterity in a traumatic brain injury patient recovering from partial paralysis.
In the Minneapolis VA polytrauma center there are four dogs in the animal assisted therapy (AAT) program and close to ten more dogs take part in animal assisted activities (AAA) throughout the hospital. AAA has been incorporated in recreation therapy services for several years and only recently has AAT been incorporated on the Polytrauma Rehabilitation Unit as a unique way to motivate patients, as well as complement traditional therapy services.
AAA is a relaxed meet-and-greet with the therapy dog and its handler. This allows patients to temporarily distract themselves from everyday worries and life events. Although AAT provides the same distraction, it’s more goal oriented, longer in duration, and emotionally and physically more involved for the patient.
Grant brings Jäger to the hospital once a week to visit with patients. In the two hours they spend at the VA, the pair sees up to four patients with the VA recreational therapist.
For a patient who had lost both of his legs, a few months spent playing ball with Jäger became more than an exercise in balance.
“Jäger is a dog that has a really high work ethic,” explained Grant. “Some of the patients that Jäger works with are very severely injured and the more that you demand of him, the more he will respond and respect you.”
There are rules for playing ball and the ability to command and enforce these rules serves as a part of the patient’s rehabilitation exercises. By the time the Veteran was ready to move out of the polytrauma rehab unit, he was giving his mother lessons on handling Jäger during play time.
The student had become the teacher, Grant marveled.
“All of a sudden, the mother-son relationship changed. He wasn’t just the disabled son, dependent on his mother as a caretaker.”
The animal-assisted therapy program has been in place for about a year at the Minneapolis VA. Patients entering the polytrauma unit are asked whether they are comfortable with dogs before they are scheduled for an appointment with Jäger or one of his colleagues. Anderson and the rest of the medical team have already witnessed how helpful the therapy can be.
“[The patients] kind of open up more,” said Anderson “It’s like the focus is on the dog, not them.
“Once they get to know Jäger, he’s a big teddy bear. They tend to open up even more from week to week.”
A Veteran who had lost her leg was convinced that her horseback riding days were over, but she set the goal of taking Jäger for a walk when her new prosthesis arrived. Grant admitted that she was worried they wouldn’t reach that milestone.
“When the leg came, the first day we went to see her, Jäger didn’t even react to it,” Grant said. The patient was just as surprised by Jäger’s indifferent attitude. “She said, ‘Oh, look, he doesn’t think my leg is weird!’
“They went out and walked around the unit. She sat down and realized that she can go back to working with her horses. She learned to just take baby steps in her recovery.”
Jäger’s patience is a tribute to his sweet nature and the intense training program for both himself and Grant.
Operated by the Delta Society, therapy animals and their handlers prepare for work as a team in many types of environments. The Delta Society defines different levels of environments based on complexity, and most teams are restricted as to the settings where they can work.
In a health care facility, the teams learn how to appropriately interact with the staff, as well as the patients. They have to respond appropriately or safely — or not at all — if somebody pulls their tail or ear a little too hard.
“They have to prove that they are safe for all types of patients and they have to manage unpredictable behavior situations as well,” said Anderson. “It’s a fairly intensive program for therapy animals to go through and they have to renew their registration every two years with the Delta Society. The VA Medical Center requires an annual Health Certificate for every animal.”
Grant is tested by the Delta Society, too, and every visit to the VA brings the challenge of a new patient or therapy goal. Though they can always fall back on a game of ball, Grant and Anderson trade many ideas for new games and props.
“And sometimes it’s the patient and Jäger who figure out something that works,” Grant said. “Dogs are so much more sensitive than we are to emotion and energy. So maybe, in a way, Jäger is able to give something to patients without them having to ask for it.”