By Amanda Zoccolo, MS, OTR/L
Occupational Therapist, South Carolina

Dogs are not our whole life, but they make our lives whole.

| Roger Caras

It’s hard for many of us to imagine our lives without our beloved pets. However, many older adults have to relinquish their dogs and cats when some of the tasks of pet care become more demanding and contribute to potential fall risks. 

But as OTs, we have the unique ability to assess a patient’s performance with pet care and analyze what aspects we can improve or alter to promote increased independence if functionally appropriate and skilled.  

Using PEOP to Help Older Adult Patients Keep Their Pets

I like to use the Person-Environment-Occupation Performance (PEOP) model during my initial evaluation. This includes assessing intrinsic factors such as cognitive, physiological, neurobiological, psychological, and spiritual, along with extrinsic factors such as social support, culture/values, social and economic systems, natural environment, and available equipment/technology. 

Let’s take a look at what the application of the three components of this model can look like for an Instrumental Activity of Daily Living (IADL) like pet care in the following case study.

“Shirley is an 87 YO female who resides in an apartment complex on the first floor and has a small dog to care for. She was referred to OT for B hand arthritis and impaired balance impacting her ability to grasp objects and perform ADLs. Shirley reports dropping objects often and unsteadiness bending to pick up dog poop on walks. She uses a rollator while walking her dog. During the interview, OT stages the patient in level 3 on the Global Deterioration Scale (GDS).”

1. Social and Economics Systems

Shirley has a fixed income and is able to make small purchases, but nothing out of her ordinary purchases. High-technology equipment may not be the best option for her. She has a daughter that lives nearby and comes by weekly. The rest of her family lives out of town. She has 1-2 neighbors she is friendly with. 

2. Physiological Intrinsic Factors

With Shirley’s significant hand arthritis, using joint protection techniques is essential. In addition to education strategies with task-specific training implementing techniques, she may benefit from using a leash with a more oversized gripped handle to disperse pressure and increase control walking her dog. 

Education on body mechanics and functional balance training will increase her safety with walking her dog, along with waste management. She may consider a long-handled pooper scooper as well. There are also options for bowls with long handles to lift from the floor to limit bending and use the rollator seat to transport items. To cut her dog’s nails herself, I would suggest a large handle dremel that decreases the grip/pinch strength required.

3. Cognitive Intrinsic Factors

Shirley is beginning to show signs of worsening dementia. It will be helpful to instill habits in her pet care routine now to increase safety as her disease progresses. This could help lengthen the time the patient will be able to care for her pet without additional assistance from family or caregivers. 

Keeping her economic situation in mind, I might suggest an alarm for a reminder to feed her dog instead of the more expensive automatic water and food dispensers. It can also be helpful to pair the feeding of the pet with an external situational cue, such as directly after retrieving the mail or right before she sits down to eat dinner. Having a calendar in easy view helps remind the patient to write down vet appointments and reminders for oral medications for her dog. Keeping the leash, harness, and dog’s food in consistent places, along with easy-to-read labels, is important for the patient to be able to locate easily.

Pet Care is Good for Our Patients

Many patients or families assume that pet care will be too challenging for them to continue as they age, but there are myriad techniques to enable them to keep pets and age in place. With older adults more at risk for depression and social isolation, pet care can potentially serve as a health protectant, and it is critical for occupational therapists to assess safety with pet care with our patients. Always utilize your clinical judgment to identify if a treatment is appropriate for your specific patient and ensure the creation of corresponding goals.