Listen to the Podcast The Bright Side of Longevity (Hosted by Dr. Roger Landry, MD, MPH) about the impressive bona fides of Connected Horse CoFounders and the science and magic of the Connected Horse program. Listen here.
THE HEALING POWER OF HORSES FOR THOSE LIVING WITH DEMENTIA
Dr. Roger & Friends: The Bright Side of Longevity | August 2020
Speaker 1: Welcome to Dr. Roger & Friends: The Bright Side of Longevity, hosted by Three Peas In A Podcast, Doc. Roger, Teresa, and Danielle. Thanks for joining us for coffee and conversation.
Teresa: Welcome back. Today we are joined by two powerhouse leaders who have dedicated decades to improving the quality of life of older people. Nancy Schier Anzelmo and Paula Hertel share a love for horses and have co-founded Connected Horse, which provides the opportunity for people living with early-stage dementia and their care partners to experience a meaningful and powerful connection with horses. In addition to being co-founder, Nancy is also the educational director of Connected Horse and is a widely known highly regarded gerontologist, and Alzheimer’s dementia care specialist, a consultant, speaker, and a trainer.
She is dedicated to promoting person-centered care that offers those with dementia opportunities to grow socially and spiritually and to enjoy enriched and satisfying lives. Nancy holds a master’s degree in gerontology and has achieved national recognition and awards as a speaker, teacher, and innovator in the field of Alzheimer’s dementia care programming. Paula has spent the last 25 years focused on improving service delivery systems for elders in need of care and services through consulting projects and executive management positions.
She has broad experience in senior housing and assisted living operations, staff training, regulatory compliance, new program development, and family and community needs. Paula holds a master’s of social work from San Jose State University. The research base Connected Horse has shown that the human-horse connection helps participants not only feel relaxed, confident, and happy in the moment, but they also learn about self-compassion, stress reduction strategies, and communication, and awareness practices.
Dr. Roger: Welcome everybody to The Bright Side of Longevity. As always, we are thrilled to be with you, Danielle and Teresa, and I. We’re also thrilled because we have two guests who are professionally very impressive, but personally very impressive and people who have passions that are very aligned with our own. It has to do with animals and it has to do with helping people struggling with some of the challenges of aging, particularly dementia in their case. We’re very happy to have Paula and Nancy here today. In this time of technology, we tend to worship at the altar of technology.
If something isn’t new and bright and shiny, metaphorically speaking, relative to a treatment or any kind of new product, we tend to shy away from it. The three of us, Danielle, Teresa, and I were contra on that, aren’t we? We tend to go with those things that are more aligned with our core as a human species. Connected Horse, which Paula and Nancy are going to talk to us about, I think that goes to the core of social connection of the animal-human bond and of our relationship with nature. I am excited about it. Welcome, ladies. We’re just dying to hear more about this. We appreciate the time you’re giving us.
Teresa: Nancy, let’s start with you. Why did the two of you start the Connected Horse program?
Nancy Schier: Back in 2015, five years ago, Paula and I have been in the field of senior living for almost 30 years, and we try not to date ourselves. We were starting to feel a bit frustrated with the way things were going and the way people living with dementia were being treated. Also, we’ve spent our careers trying to spend time to improve the quality of life when we thought we need to do something really creative and different. We both have horses, we both love horses.
Now that that’s our healing power to get through the week, and we thought, “If horses have helped all these other populations between children with autism and veterans and people with disabilities, why the heck can’t they help people living with dementia and their care partners?” In our ignorance, quite frankly, we said, “Let’s just help both,” and we picked this dyad model. We went to Stanford University and said, “We have this crazy horse project we’d like to do, would you consider doing some research with us with the school of medicine?” The Red Barn Leadership Program that’s there, it’s world-renowned for a leadership program with horses.
We decided that we would test it out. We wanted the science and the research before because we felt the idea would work. One of the things that we did very differently was we wanted it to be in a dyad model. It wasn’t as in usual research where they separate two populations, people living with dementia and diagnosed and their care partners. We felt they’re on this journey together, and we wanted them to be together. With that, we started the program knowing that there was some healing power with the horses in these interactions that would help them at the beginning of this journey when they’re newly diagnosed.
Dr. Roger: Wow. The caregivers, I’m intrigued by that because I think it’s so important. We all talk about how caregivers sometimes don’t outlive those they care for because it is such a stressful thing to do. We’re always talking about the Southwest Airlines, put on your own mask first, and debriefing because caregivers need to do that. Congratulations on identifying that. I’m sure it’s making all the difference. Paula, what are the most impactful things you see within the caregivers as far as a result of your program of what you do?
Paula Hertel: One of the things that you just said about this self-care, what happens magically is when you get to the barn, those roles of I’m a caregiver and I have to take care of somebody. I’m really here to protect this person. The person who has the diagnosis of dementia is the one who’s here for treatment, all of that goes away because the horse just wants to be in relationship.
What we do as facilitators and how we’ve built this program is that we really want to break away those roles of why are you here? What is the outcomes? What just happens when we let all of this planning and programming and outcomes go is that people get in relationship with the horse. People forget that they’re here for a particular purpose. They take a deep breath, and they’re in the moment. I think one of the most incredible stories that sticks in my mind that illustrate what I’m trying to say is we were in a paddock next to a horse. We hadn’t planned for that, we just went in there to have a debrief about an activity.
We were asking people what it felt like to be in this paddock where horses live. Caregivers and people with dementia were saying different things. In one, a care partner said, “I feel like this feels like a prison to me. This must be what my husband who was diagnosed a year ago with dementia feels like.” We asked her husband and he’s like, “No, I feel like I want to play with the horse that’s in the next paddock.” All of a sudden for her, there was this realization is that she was feeling that way. She’s, “I feel like I’ve put myself in a box, in a prison.” The horse next door, I’ll never forget this, stuck his head through the paddock and just laid his head on the horse’s shoulder.
Just that release in that realization that even care partners put themselves into these positions where they feel like they can’t get out of it. What happens at Connected Horse is that, yes, one role, one identity that you are is a caregiver, but you are also a wife, a husband, a friend, and that you have the power to define yourself in ways that are meaningful, purposeful in healing for yourself. Those little magic things happen at the Connected Horse workshops that we don’t plan for, we don’t put curriculum around them. It just if we let it be and we let people be in relationship with the horses, they get what they need, participants get what they need.
Dr. Roger: That’s magical. We just completed a three-part series on spirituality. You can’t talk about spirituality without talking about nature, relationship with other beings including creatures and the whole idea of being present, being able to be in the present moment, so rare today because of our society. To me, that’s what’s going on. It’s a very spiritual thing going on. I’m sure there’s tears everywhere.
Paula: Yes. Tears and laughter, and this idea that even someone living with dementia still is purposeful. I always tell stories because it brings it up. We always say that this is for people with early-stage dementia but Nancy and I have a hard time saying no so sometimes we have people in the program that from a clinical perspective, you may say we’re further along than early stages. A horse came running up from the pasture, and he instinctively moved his wife away. She wasn’t really in harm’s way, but when you see a big 1200 pound animal come running up at you–
There was this realization that his role as a husband, and as a protector of his wife, and the traditional triggers that you have of how my relationship is still there. If you move away and stop looking at all the deficiencies that somebody has in their behaviors and their ability to drive and those kinds of things, that relationship piece that people have is there. We tend to lose it when we get stuck in the day to day activities of what has to get done.
That was, again, another just beautiful moment around if we focus on relationships, if we focus on being in the moment, if we focus on those things that are really around love and connection, those stay with us regardless of what your many mental says or what the clinician says if you can drive anymore and those kinds of things. That’s what we highlight at Connected Horse, what we can do.
Dr. Roger: Bravo.
Teresa: Beautifully said and I haven’t cried yet today so thank you. Now, if she started telling that story, I’m ready to start tearing up because I think that’s beautiful.
Paula: [laughs] Tears are good. It’s a release. [laughs]
Teresa: We’re all animal lovers, but why are horses to us so special? What’s different about horses?
Nancy: Horses, they really have been the foundation of our civilization, have always been parts of what we do. About horses is that they are prey animals. People ask us all the time, why don’t we use other animals, dogs, and cats, and so forth? They’re a predator. A predator wants to be with you. A prey animal is always risking its life. It’s always looking around to see are you going to hurt me? Are you going to do something to me? Horses for centuries have built this instinct that they can read you so clearly, and they can read what’s going on in their environment. A horse will read you immediately. It’s a mirror.
I think of a story as Paula said where a gentleman who was high up in the military, he was now caring for his wife with dementia. He kept saying to me all the time that everyone likes her and not me, that horse isn’t going to come near me, they love her. I took him silently to stand with this horse and be mirrored over, we call this exercise over the fence. The horse came right up to him, and he said, “Oh, my heavens, I had no idea what I’m putting off into the universe.” He said, “If I had known that, I would have been a much better leader for all these years because I’m realizing what I’m putting off. When I put that aside, the horse came straight to me.” He felt just in tears.
He said, “This is amazing. I can do this now. I can take care of my wife. I know this horse has taught me.” The horse is the teacher. We’re the facilitators, but the horses are truly the teachers. We jokingly say next time we’re going to try it with elephants or something much larger because there’s something about the size of the horse that’s inviting that helps the couple or the pair get through this journey ahead of them. There’s a lot of fear involved with a new diagnosis of dementia.
Teresa: You explained it awesome there that they are a mirror to our souls. I thought that was particularly beautiful.
Dr. Roger: Beautiful. I love them but I’ve never heard that expression. Are these horses anything special? Are they trained specially at all?
Nancy: We like to use older horses because they have purpose and it reminds us as older people all have purpose and we needed a job, we need something to do. These horses have been through a lot of training or been a trail horse, or what have you, but they have curiosity that they want to be in relationship with you. They want to be connected with you. We don’t particularly look at any horse, we looked at young thoroughbreds as a partner at one time that we’re looking at other groups.
An older horse seems to be just like an older person, pretty centered, and mellow, and ready for whatever is ahead of them. We like that the older horses have purpose because, in the sport horse world, a horse over 15 is not of use anymore. Yet Paula and I have older horses, and horses live into their 30s and sometimes 40s so they have a whole new lifetime and career ahead of them. We felt it would help horses have a job in our society as well.
Dr. Paula: Elders with purpose, that resonates with us.
Teresa: Paula, tell us about your sensory boxes. It’s connected horse COVID style solution, right?
Paula: Yes. We have been at our own barns but because of COVID, we haven’t been able to do our whole groups and our participants miss being together. We talked a little bit earlier about just the healing power of not only horses but being in nature and being out. For Nancy and I, we said, “How can we keep people connected?” That is really our purpose that we want people to be connected with each other, and we want people to practice being in the moment, and that’s what horses teach us. We did two things. One, we created a virtual barn where we take the barn and the horses to our participants.
Some of them are very funny because horses will do what horses will do, and then the sensory boxes really taking those elements of the barn and sending them to participants. Our first sensory box has brushes. We have artists who donated their time and their talent to create artists’ cards so that people could feel what it feels like to be color with a horse, to see what it feels like to be in nature, and then we have guided imagery.
People will get these boxes, and we lead them through certain exercises that we do with the barn and they’ll have these sensory triggers so they have associated pay.
We’ll have them get in a quiet place and smell the hay, will walk them through what does that trigger emotionally for you because we know that if we get people out of their cognitive minds and the tasks of the day, and into their body, and into their senses, that what they need to do to relax and what they need to do to let go of any stress in the day happens.
These things around smelling hay, about having the tactile experience of having a brush in your hand. We have lemons in there, what it feels like to smell a lemon, to make lemonade. All of those things will allow people to stop, focus on one thing, be in the moment, and let go of those stresses that people hold in their body.
Teresa: It’s such a great solution.
Paula: At the barn, we should mention this. Nancy and I aren’t researchers, but we wish we could get rid of that boring questionnaire and measure some really fun things. It is true that people get to the barn and they’ve had to drive someplace that they don’t really know. Usually, people’s shoulders are up with their ears. We take a few deep breaths, we do our opening circle.
Anecdotally, I swear people’s shoulders go down about three inches. It’s just that idea that I’m at the barn, the smells, the sounds, the realization that nobody is judging me that you’re just here together, your body responds to that. These sensory boxes are helping people to get back to that response that your body does want to be in this relaxed mode if you just let it.
Nancy: In fact, they come in and they say to us, “I feel so accepted here. I don’t feel like I have a diagnosis. I feel normal. I feel part of this team. I’ve never felt so connected to others.” The power of the group is with the horse is what’s so beautiful. We’re trying to recreate that until we can get back to the barn but we are determined to get back to the barn. [laughs]
Dr. Roger: Good on you. My colleagues will tell you I can’t help myself almost every topic we choose, no matter what goes back to our ancestral roots, our hunter-gatherer roots, and who we are as a species. What you’re saying there is that you bring people closer to their inherited environment.
99% of the time we’ve been on earth the nature and the smells and the relationship with the horse maybe not as quite as ancient as the species, but it is long and as you said earlier Nancy, it is is very rich and robust. Even if you haven’t been near a horse this time, I know just about everyone is fascinated by a horse. I think there is some inherited memory we have in our DNA with the horse, I got to believe that.
Paula: We believe it. UC Davis has the one health initiative that if its good for people, it’s good for animals and it’s good for the environment, we should be involved in it. That’s one of the things that really drew Connected Horse collaboration with UC Davis was this idea that we really do fit into this one help. We are interrelated. You can’t say environment only impacts environment and we’re only going to focus on animals because there is that interrelationship that we are on this earth together and so of course we impact each other.
Dr. Roger: We share so much DNA with so many things even a plant, a daffodil is like 20%. A horse must be way up there as a mammal. We are probably sharing 80% or 85% of our DNA with the horse so why wouldn’t we respond to that or they to us?
Paula: One of the things that’s in my mind that I want to say before I forget is that we’ve been telling a lot of stories about what the horses gave to our participants but we do have hundreds of examples where our participants are also helping the horses. It’s this giving and receiving of care which is really important component of our community workshops is that this idea that we as human beings and our horses, it is that reciprocal relationship we give and we receive. Care partners often have a hard time of receiving. We do a lot of exercises where we are asking participants to look at whether they think that the horse needs.
We’ve had horses that have been running back and forth and anxious because we’ve moved a horse somewhere. How can we as participants try to help this horse feel more connected with us and to calm down? That’s really beautiful to watch as well because we want to move that not only are you receiving something from these horses but you still have something to offer. You are still of purpose too and so that relationship piece is really beautiful to watch.
Teresa: I’m certainly not a part of Connected Horse although I would like to be. Can I please sign up after the pandemic?
Paula: Yes. [chuckles]
Teresa: In the meantime what I’ve made a habit of doing, there is a retirement community very close to my home, it’s near and dear to my heart with all the levels of living. I have the residents over. We do a special time for the residents that live in the memory support area. It’s just them and their families. It’s quieter, it’s so meaningful for me. People are at all levels, at all stages of living with dementia. It’s a beautiful thing seeing wheelchair marks in my dirt in the bar afterward. It’s like my little moment. We feed carrots, the horses are spoilt rotten that day and people just light up and they speak.
The people who haven’t lit up in months light up and the people who haven’t spoken in months speak and engage and interact. It is such a beautiful thing the people who are really quite advanced I’ve noticed, they will be the ones to take the tail and braid it. It’s just been such an honor to see how people interact. These days I don’t know the residents personally so I have to wait afterward for the staff to tell me, “Teresa, you have no idea what just happened.” So and so and so and so and they are just so fired up after to have seen the transformation. I can’t appreciate it in the moment but it’s really neat to hear afterwards.
Paula: I think it’s the trust that Nancy and I talk about. It’s amazing how fast that the horses trust the participants, participants trust the horses and they trust each other. I think that’s what allows some of the healing to happen that when you feel like you’re in a non-judgemental place with non-judgemental beings, you are allowed to just feel and to express what you need to share because we are as beings communal.
That piece of it I think is really important and the horses when you allow it to happen, they want to trust you, they are unconditional, they are non-judgemental and they want to love and they want to receive and give love. That’s where I think some of that comes from. Again, we want to figure out how to measure but it’s beautiful. I can see that visual of a resident braiding a horse’s tail that hasn’t participated in some of these more traditional or passive activities. That is just so intimate to be able to do that.
Teresa: So many of them in this area of central California grew up on horses so I think it has something to do with the past too.
Nancy: We work in senior housing as you know and my mentor taught me that a person living with dementia is the true existentialist. I think about that every day when we work with individuals in this population. Thinking how an existentialist makes the moment count. That’s what we are doing with the horse, the making the moment count, and then emotional memory is activated and that stays with them. They can tell us about the story later. The people that you bring out to your community, they’ll always remember that. That part emotional memory doesn’t disappear with dementia and so we are really trying to activate that for both the care partner and the person with the diagnosis.
Dr. Roger: I particularly like hearing that. I saw your video before and you mentioned that. Again, I was key right on it the fact that you talk about activation at least in the video as well as here. Usually, the people are recently diagnosed with dementia. Rather than to go, “It was me in the murder,” and be all negative and think the road is only going downhill, you activate some positivity in them and there is something they can do both the caregiver and the person affected so that’s just fantastic.
Paula: Yes. Positivity and hope.
Dr. Roger: We all need that, don’t we?
Teresa: Pandemic aside, how do you hope Connected Horse will grow?
Paula: For us, Connected Horse grew as fast as it did because it really is a passion project. I think if you believe in something and you believe in the good that it can bring to others, it grows as much as we can make it. For us, we feel like we want Connected Horse to be offered to anybody anywhere. The way to do that is for us to train others to do this work. We are sensitive that we don’t want to create a program that is this traditional pet therapy, that we’ve spent a lot of time putting the curriculum together, putting the research together so we want people to understand the power of the actual program.
We are committed to putting together those facilitator trainings which include the programming, which includes a safety. We’ve talked a lot today about the interactions with people but as you can imagine with group work like this with horses at a barn, there’s all sorts of safety things that you have to think about. We want to offer this to people so that this activation of hope and some control and some healthy living can be spread to anyone throughout this country. We even have people in Europe that are interested in it because certainly, the role of the horse in Europe is very strong.
We are moving towards that. Of course, we need partners with us to help fund that. Nancy talks about this and she’s maybe more patient than I am about this that our big dream is that insurance companies and healthcare will understand the benefits of this beyond giving somebody a pill or a hospitalization that this kind of wellness is important but that’s a long way off. We need partners with us that will take this journey and help us scale it to a place that whether you’re in an urban setting, or in a rural setting that doesn’t have a lot of other options, that Connected Horse is there. We hope that we have people help us grow it and bring it along.
Dr. Roger: In this COVID and post-COVID environment, I hope we are post at some point, I think there will be an increased attention to public health prevention, what keeps someone strong, what keeps someone immune system strong, and how can someone resist that sort of thing. This is definitely in the running for that. If anyone asks me, I’ll tell them to look your way. I think it should be fun.
Nancy: Thank you. We had one lady, was very powerful moment who came straight from getting her MRI test to diagnose dementia straight to Connected Horse. They travel from out of town. At UC Davis, we’ve had people travel hundreds of miles to come to be in our pilot study. She came straight from her MRI. We were with this horse and it was just a magical moment where her husband said, “How are we going to get through this?” Again, as Paula said in the other story, she felt as the person with the diagnosis. We’ll get through this, we’ll get through anything.
This horse brought them both to tears and they had this magical moment to talk about what it was going to be like going forth because she was the strong one. She was the one that held everything together, and he was feeling very lost. This magical moment with this horse was happening and they started talking. The facilitator and I just stepped away and let them have this magic moment. They came out of there and said, “We can do anything. We’re activated. We’re going to do this together.”
I think that’s the most beautiful thing of this short time, in 15 hours with a horse that these pairs go forth feeling like they can weather any storm that comes forth. They’ll remember what they’ve learned, and they will keep that with them on this journey ahead. That is very powerful. No pill can do that. No support group. It’s that power of the horse and being present that’s making that happen.
We think we can help a lot of people. We don’t charge for the program, we look for donations. We really want this to be in every barn, and we’d love to have a doctor, Dr. Landry. Go spend some time at the local barn, the Connected Horse program, because it is that powerful and we have seen it happen over and over again with participants that we weren’t sure we were going to see that outcome, and yet the horse made it happen. We’d like to see it in every corner, and that’s our dream before we kick it.
Dr. Roger: I’m on it. You want something, we’ll talk about that.
Nancy: Dr. Roger, can you write me a prescription to go play with the horses?
Dr. Roger: I can.
Nancy: Maybe Teresa too for the rest of the day.
Dr. Roger: Yes, but she must be accompanied, that’s the thing by an adult.
Paula: Guess we’re a dyad model, we must come together.
Dr. Roger: Nancy, I’m so excited about this program. I wish and hope that soon it won’t be long before anyone can not have to travel very far to take advantage of what you offer in Connected Horse. That’s not the case right now, so what can we tell people? What are the takeaways, the most important things that you’ve learned that perhaps are usable in almost any situation, while they wait for Connected Horse to get nearby?
Nancy: That’s a great question, Roger. Not everyone can get to a barn but people certainly can get in their senses as Paula’s mentioned, and they certainly can be in relationship. Instead of taking those roles of I’m the care partner, I’m going to care for you, and I’m the person living with dementia, we believe that the whole family is affected by a diagnose of dementia. On this journey, we think about ways that people can be present in the relationship. How they can get rid of all those roles and tasks that so dominate our minds every day.
Go out in nature, enjoy the relationship with that person, as well as just being outside and being present and being mindful of where you are. Stop thinking about planning, what you’re going to do every day. This is hard for me because I’m a planner. I’ve learned so much from this program just putting it on that you’re just present and you feel like you just had a day at the beach, where you are completely centered. Being centered with that other person, the horse helps us do that, but you can also do that in nature. You can do that in relationship with others. You can do that taking a walk together.
Really being present for this time that you have together because COVID has taught us things change every day. I think a lot of people are learning that we just need to be present and be grateful for what we have right now. To be in this relationship with someone is really a gift. What can we learn as the care partner as well as the care recipient of how we can build this relationship. What we see in Connected Horse it is we’re not measuring as Paula said, and we wish we had a tool for it, relationships are healing in front of our eyes. We’re giving hope to people on this journey as they go forward. We see couples come in strain and go back out holding hands and being kind to each other.
We had one 94-year-old gentleman say, “I just want you to know what things you’re not measuring is that my libido is up now, after being out here with Connected Horse,” and that is just amazing. We’ve had men who say, “Honey, hold my cane, I’m going to walk this horse.” It’s something about being present and taking the challenges ahead of you. We want that to go forth in Connected Horse. We know that being with the horse is what would really help you get centered and focused on that regardless of your relationship with the person living with dementia. We believe that this can go forth in every area if we can just find the time and quiet your mind to be present.
Dr. Roger: That is beautiful. So well said. I think that solidifies so much of what we’re trying to do with this podcast, and what I think everyone is trying to do as we age in a society that isn’t always so friendly towards aging. You’re my new heroes, Nancy, Paula. You are indeed for many reasons, certainly the quality of the work you do. Horses are very dear to me as they are to my colleagues here. You’re doing noble work. Please keep it up. We wish you the best. I think you exemplify what we hear often, do what you love. It’s clear that you do and thank you for that.
Teresa: Before we wrap up, I want to make sure to ask Nancy, Paula, where can people go to learn more about Connected Horse and the work that you’re doing?
Paula: The easiest way to connect with us through is through the website, so connectedhorse.org. All of our information about our workshops, our virtual barn, to our sensory boxes, and how to donate are all on the website.
Nancy: Or how to become a facilitator. We’re recruiting people that would love to do this work.
Dr. Roger: I think they’ll be coming out of the bushes soon.
Dr. Roger: I’m just anxious to see all the data that will be there. I know you’re aligned with UC Davis, the school of veterinary medicine. We’ve heard some of your stories. If that isn’t enough, I’m sure the data has already and will continue to show the value of this. Keep it up, ladies. You’ll be seeing us.
Nancy: Thank you.
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