The wisdom of horses

Can horses teach people with early-stage dementia useful lessons about how to cope with their disease?

That's the question behind a pilot project at Stanford University's Red Barn, which recently hosted five early-onset dementia patients along with their caregivers for a series of workshops with horses.

Foreseeing a tidal wave of dementia cases with the aging of the baby boomers, organizers hope to test whether equine therapy can counteract the feelings of isolation and hopelessness often experienced by newly diagnosed patients. If successful, the approach could be replicated in stables and barns across rural America, where there can be a shortage of organized services for families coping with dementia.

The Connected Horse Project is the brainchild of Paula Hertel and Nancy Schier Anzelmo, both equestrians who have worked for decades in the senior services industry.

The two have enlisted Stanford researchers to assess whether a three-week series of intensive interactions with horses could improve measures of depression, stress, quality of sleep and perceived social support among patients and caregivers alike. Results are still being analyzed but Hertel and Schier Anzelmo have tentatively planned a second round of workshops with new participants in 2016.

"As equestrians, we know there's a very real healing presence about horses," Schier Anzelmo said. "We hope our project is a way the person with dementia and their care partner can learn coping skills, have an outlet for engagement and overcome stress, which can help them deal with the road that's ahead."

The women approached Stanford psychologist Dolores Gallagher Thompson, who studies the efficacy of different psychosocial efforts to reduce stress and improve the psychological status of people with dementia and those caring for them.

"This project interested me a great deal because in this field there's very little we can offer to early-stage patients and their caregivers," said Gallagher Thompson, a research professor of psychiatry and behavioral science at Stanford University School of Medicine.

"We're looking for a program that would really offer something to people in these early stages. They're often very demoralized, and so are their care partners. They don't think they have much to look forward to.

"What we're trying to show here is, 'No, you can have a good quality of life.' That's the focus of dementia care — improving the quality of life — because we don't have a cure."

According to 2015 data from the Alzheimer's Association, more than 5.3 million Americans have a diagnosis of dementia, and that number is projected to grow by 40 percent during the next decade.

For Jacqueline Hartman, a co-founder and lead instructor at the Stanford Red Barn Leadership Program, "equine-guided education" for the dementia population seemed like a natural extension of similar work she has done with high-level executives and stressed high school students.

"A lot of these (early-onset dementia patients) are hiding — they're embarrassed and they don't want their friends to know," Hartman said. "But when you come here you don't feel like your diagnosis. All of sudden we're all the same, all working on our own skills."

Engaging with a 1,200-pound horse, she said, helps people gain confidence and relational skills — being able to share observations, and recognizing and showing empathy.

"It can help give people the confidence that they can continue to try to do some of those things they did before this diagnosis," Hertel said.

"Howard," who was diagnosed with Alzheimer's two years ago at age 50, participated with his wife in the fall round of equine workshops. (The names have been changed to protect the privacy of the couple and the research study.)

"I'm not a really big horse guy and I carry a little bit of baggage from my youth with a horse stepping on my foot ... so I was a little bit scared from that experience," he said. "But people including me, who aren't horse people, were able to get out there and were able to be guide to a level where we could feel comfortable being right next to the horse and touching the horse.

"For me it was getting over some fear and lack of confidence dealing with horses," Howard said. "I felt better and I could see it in other people, too. Maybe not everybody, but at least a few people, I thought I could see a change. They seemed to be more confident and seemed to have more joy in their life."

Howard's wife and main caregiver, "Karen," said the Stanford Barn sessions gave her a new perspective on her life situation. The couple has two sons, 11 and 13, one of whom has autism and is nonverbal.

"We have two boys who are very active and require a lot of energy," Karen said. "These sessions were an opportunity to really slow down and be present with my husband and share this experience together. My biggest message from the horses was that there's nothing I need to do, nobody I need to take care of — they're all fine. My job is to be with them, to love them, to love myself and to be present."

Hertel and Schier Anzelmo said the timing of the next cohort of the Connected Horse Project depends on funding. The two have begun an online fundraising campaign at GoFundMe (gofundme.com/connectedhorse).

"We're looking for sponsorships," Schier Anzelmo said. "We're volunteers, doing this because we believe in it so much. If the pilot data shows what we're hoping in the hypothesis, we'll be able to do another study. But it's brand new, and we're not sure where it's going."