タイガープレイス：ペットと年齢を重ねていける素敵な場所
TigerPlace: A Unique Setting for Aging in Place with Companion Animals
ミズーリ大学獣医学部 ヒューマンアニマルインターアクション研究所 (ReCHAI) 所長／ IAHAIO（人と動物の関係に関する国際組織）会長・レベッカ Ａ . ジョンソン

Rebecca A. JOHNSON, PhD, RN, FAAN, Director, Research Center for Human Animal Interaction(ReCHAI), College of Veterinary Medicine, University of Missouri, President, International
Association of Human-Animal Interaction Organizations (IAHAIO)
Thank you very much for the honor and privilege toabout IAHAIO which tells you where we werespeak to you today. I am deeply honored to have been

incorporated and our purposes. The purposes, broadly

invited to present here and to be in the company of

speaking, are to encourage research, education andsuch incredible leaders in veterinary medicine and inpractice in human animal interaction and to advancethe pet product world. It’s a special honor and I am

human animal interaction into new and exciting andvery grateful, thank you.

unprecedented directions. We have a wonderfulconference and our next conference is in 2013 and I

It is my privilege to serve as the Director of thewill tell you about that shortly.

Research Center for Human Animal Interaction at
the University of Missouri. And if you know the USA,

Since I became President 15 months ago we haveyou know that Missouri is right in the middle of thecompletely renovated the IAHAIO website, I encouragecountry. We call it the “Middle of Nowhere” [as a joke].

you to go there and visit. We have done a complete

So we live in the middle of the country, the geographic

strategic planning operation to review our goals

epicenter.

and our mission and look at the projects that we areundertaking to move the organization and human

Also I am a faculty member by appointment in bothanimal interaction forward. We have restructured

veterinary medicine and nursing. My nursing PhD is

our membership categories to make IAHAIO morein Gerontology so my work focus is largely around theinclusive rather than exclusive. And we have createdelderly, care of the elderly and ways to improve that.

a new award called the “William F. McCulloch Award”(Please note that I am running two computers here sothat is going to be given out, for the very first time,that I can see my slides in English but you can see themat our conference in 2013. This award honors Billin Japanese.)

McCulloch who is a veterinarian and who was initiallyworking with Dr. Leo Bustad, Founder of the Human-

It is an honor to serve as President of IAHAIO. IAHAIO

Animal Bond. So we are going to honor Dr. McCulloch

is the International Association of Human Animal-by giving someone an award in his name. It will beInteraction Organizations. We are the global network

someone in the world who is doing wonderful educationof org anizat ions doing work on human animalor practice work.

interaction. So it is a privilege to be here as Presidentof this organization to see some of our member groups

I am also pleased to announce that we have creatednamely HARS and JAHA. We had a lovely dinner last

a wonderful new collaboration with the Americannight with some of our colleagues from JAHA, so it is an

Veterinary Medication Association. So our conference

honor to be here to talk to you from the point of viewin 2013 will be held in Chicago, my hometown, whichof IAHAIO.

is very exciting. And it will be in tandem together with
the American Veterinary Medical Association’s 100th

You can read from your handout some information

convention. So this is the first time that IAHAIO has

2nd Live Love Animals International Conference on Animal Care in Kobe 201285

united with the Medication Association. We are very

Central’ which is going to be an online repository of

excited about that. The new collaborations that will

all literature published and unpublished about human-

result from that will be really great. Because Veterinary

animal interaction. Presently the literature is scattered

Medicine understands human animal-interaction weover different places but this project is going to bringare hoping that, for 2016, we can hold our conference

access to all of that literature in one place on the web,in tandem with a human medical convention so thata place that is new improved and very exciting. I

we begin to bring the fields together to consider ‘one

believe it will be open on March 1st. So, on the far side

health, one medicine’ and human animal interaction. So

we expect to gain more fiscal help for IAHAIO as we

please come to Chicago July 20-22nd 2013.

engage with more corporate partners.

We conducted a membership survey in 2011 and foundAlso, we are going to engage our members. We havethat our members are very happy with our conferences.

already done so by expanding the website and we are

They were very pleased with the credibility associatedalso going to start a database project where people

with being a member of IAHAIO. So I invite you togroups doing animal assisted activity will be working

encourage other organizations doing HAI work to join

together to collect clinical data and outcome data

IAHAIO. There is great strength when we work together

showing the outcomes of visits. Up until now, weand there is credibility in IAHAIO.

can say all we want about “how nice it is to do animal
assisted activity visits” but, until we show actual

So the conferences were viewed as very important foroutcome data, nobody within the scientific disciplines

our members but they also asked us if we could create

is really going to believe us. They just say “that’s justmore ways for them to interact. So our new website

nice, but we want to see scientific data!” So we will

has an area where members can interact together, talkbe creating a research source and a network andto each other, share their projects, share their ideas andeventually we will be down here in the far right handdevelop new projects.

corner where IAHAIO is the source. So for our future
we are growing our membership, we are creatingThis is our logic and in the USA we like logic models.

new partnerships and we are going to move the field

The idea is that you have a strategy on the left side, you

forward in unprecedented and highly exciting ways.

have your focus in the center and you have outcomeson the right side. What we want is down at the very

But now back to Missouri, the middle of the country, ‘thebottom right hand corner, we want IAHAIO to be themiddle of nowhere’. I bring greetings. Our vet school

source for human-animal interaction. In order to do

there has over 400 veterinary medical students andthat, we are going to do several things. We are going to

we have a four year curriculum for them. Our nursing

actively recruit new members and we have been doing

school has close to 500 Baccalaureate Degree nursing

this. I have listed some here for you to see and, when

students, approximately 200 Masters degree students

we recruit new members, what we get over on the far

and approximately 50 PhD nursing students. So we areside is more vitality, new ideas, and more exchange of

fairly large for the State.

information.
The University of Missouri is a land-grant mission

86

We are also going to raise corporate support foruniversity. It was founded on the principles of one of

IAHAIO and we have started to do this. Pfizer is helping

our presidents, namely Thomas Jefferson who was ato fund the William F. McCulloch Award and we arevery strong educator. So we were the first university

working with the Human-Animal Bond Researchcreated in 1839 that was with the new property

Institute (HABRI Foundation) that was formed inpurchased by the United States from Mexico, under the2010 by the American Pet Products Association. We

so-called ‘Louisiana Purchase’. (I wonder if there areare working with them on a project called ‘HABRI

any US history experts among you who know about the

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012‘Louisiana Purchase’?)University). Here is a photo of my husband and my
puppy…I think they are both kind of cute so you have

So we are charged with the responsibility of providing

to look at them. Sorry, but this is my chance to have mya comprehensive education to the citizens of our state.

family with me !

We also have many people who come from outside of
the state to be educated at our university. I will tell you

So why do we have a center at MU? We have thisabout the research at the School of Nursing because it’human animal interaction center because of thes very exciting. We rank number 15 out of more thanconcept of “one health, one medicine”. The health of

300 US schools of nursing in terms of the amount ofanimals and the health of people are not separate, they

NIH research grant funding we receive.

are linked. Indeed, they are dependent on each other so
we cannot study them in isolation of each other. So we

Why the Tiger? (Is anybody here born under the sign

believe in one health, one medicine and in this respectsof the Tiger or the Chinese year of the Tiger? - I myself

we are one of only five universities in the USA thatwas born in the year of the Monkey - Oh good, one

have all of these disciplines. We are one of only five toperson here was born in the Year of the Tiger.) In thehave veterinary medicine, medicine, nursing, physical

United States our culture can be very strange and one

therapy, occupational therapy, law, and journalism.

of the things we like is to have a mascot, for everything.

So it is logical that we would have my center, which

We have a mascot for sports teams and a mascot for

I started in 2005. Our mission is pure and simple -universities. The Tiger is the mascot for the University

we want to study and promote the health benefits ofof Missouri. Of course, there have never been any

humans and animals interacting. That’s what we are

Tigers in Missouri except in the Zoo, so I have no idea

about.

why they chose the Tiger, except that it is a powerful,wonderful, grand animal. The founders probably

So this slide shows our objectives. I won’t read them all

wanted the university to be powerful, wonderful andto you but we conduct research, and provide education

grand which it is. So the Tiger is our mascot and his

opportunities. In fact we have provided an education

name is Truman.

opportunity to a colleague sitting right here, namely
Hamano-sensei who came and worked with us for 6

Do any of you remember President Harry Truman?

months, yes. This slide shows some of the programs

May I say this very sheepishly but he was the one who

but I am not going to go into a lot of detail on these

did something very bad to Nagasaki and Hiroshima. He

but I would like you to read them. We do a wide range

was born in Missouri and is respected for becomingof studies and programs in the community that show

President that for being the only President that everjust how beneficial it can be when you get people andcame from Missouri. So Truman is the name of theanimals doing healthy things together, how it helps the

Tiger, our mascot. And everything at University ofhealth of both ends of the leash. Of course, I am only

Missouri is the Tiger. So TigerPlace is named because

speaking about companion animals. Here you can readof that. You see Truman here? He is at a sports game,the titles of our projects which I will show you briefly

the lower right hand corner is an [American] footballin the interest of time. You can see that we are a busy

game. 60,000 people have come to watch football –moving place with a lot going on. I am sure Dr. Hamano

indeed it is almost a form of insanity in our country. (Asagrees that we are a busy moving place.

you can probably tell, I am not a sports fanatic).
So TigerPlace is what we are really here to talk about.
But why do we have a center on human animal

TigerPlace was an innovation that has grown out ofinteraction at the University of Missouri? The university

needs. In the United States we expect that, by theis a 4 campus system and the four campuses as a wholeyear 2030, over 30% of the U.S. population will be

are called the University of Missouri, or MU (Missouri

over 65 years of age. And I am told that in Japan you

2nd Live Love Animals International Conference on Animal Care in Kobe 201287

also have a rapidly increasing demographic group of

not even to another part of the building to get more

older adults. So we must do something to effectively

care. They move into TigerPlace one time only and stayaddress the needs of that population group. TigerPlacein their apartment until they pass away with additionalarose out of an awareness of that need. Older adults

care added as they come to need it. In my world thissometimes need more help and care and support asalso means having their dog or cat on their bed withthey age. In our culture, we call them “senior citizens”

them.

or “seniors” for short. Seniors want to be active. They
want to try and remain as healthy as possible for as

So the whole foundation of ageing in places is based

long as possible, remaining as independent as theyon careful nurse coordination of the care, prevention

can be for as long as they can and not to be dependent

activities and early assessment of problems before theyon their children. That is our culture. We are a very

become major problems. It is about getting the care

individualistic culture, we don’t have too much in theand support that people need and helping people to

way of filial piety that you have in Japan. Our people

keep their pets. We want to have people healthier for

don’t want to do be a burden to their children.

longer and with their pets. We want to avoid all these
expensive costs of moving into a nursing home where

So the typical way that people age in the States is thatthey soon become depressed and ill, and unable to havethey live in their own house and then they move intoa healthy or dignified life.

some supportive senior housing. After that they go into
what we call ‘assisted living’ where more care is given

So the School of Nursing engaged with a company

to them. From there they go into what we call a ‘nursing

called Americare. Americare had been providing

home’, (I think here you call it a nursery home). Thennursing care to people for 22 years when they joined

they go to the hospital and die in the hospital. Thisus. They built the building at a cost of $30 million.

has been the trajectory of aging in our country for

They not only built is for us but they maintain and run

a long time, but we now have [even greater] culture

the building. This is a picture of TigerPlace seen fromchange. [More] young adults are moving away fromthe front with a tiger tail everywhere as you can see. It’their older adults so we don’t have multigenerationals always a tiger tail - we Americans are just so silly !

families living together any more. Things are now far
more individualistic. Everybody is busy working and

So we started with 31 apartments and these

we have very few people available to take care of their

immediately became full. So they built the second partelderly family members. So we need a different modelof the building called Tiger2 with 23 apartments. Thatfor providing this care.

also was immediately filled so now they have built
Tiger3, which just opened in July. That has many more

Some of my own research on the relocation of older(although I do not recall the exact numbers) but it ispeople has shown that when you start moving people

rapidly expanding. So the idea was to create a building

again and again as they come to need more careso that it can accommodate all the care that anybody

the outcomes are negative on their health. They

might ever need, right in their own apartment.

become depressed, they have falls and they develop
incontinence. They suffer all kinds of problems withThis was the first advertisement for TigerPlace, based

this constant moving. We are better off keeping themon fun. This is a positive model, “move from yourin their home as long as possible.

home to TigerPlace”, “come live at TigerPlace – it’s a
fun place, shake, rattle and roll”. “We want you to be88

So our vision for TigerPlace was to have a place where

happy, healthy, and have your pets”. “If you don’t haveolder adults could age with dignity and have supportivea pet we will help you get one. So come live with us”.

services and nursing care added as they come to need

And people do! There is a long waiting list of people

it. This way they do not have to move to another place,wanting to get into TigerPlace.

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

These are all the schools and colleges at MU that

promotion activities - influenza shots are given and weare joined in the project. You can see that many areteach about how to stay healthy.

involved. We have the School of Architecture involved
in helping to design the building, we have the School

So here’s the point. The standard way that people ageof Horticulture that planned all the gardens and did all

and die is that they have a continuous decline, andthe landscaping. We were all working together. It wasusually the declines are pretty large in function. Thea beautiful thing.

person may fall down and break their hip which causes
a major decline in function. That can often create some

These are the list of general services people

cognitive decline in their ability to think clearly. So

automatically receive when they move into TigerPlace.

people keep having these declines and then they end

There is a ‘Concierge Service’ to drive you where you

up in the hospital and die. We don’t want that. Thatneed to go. They will take you to your appointments,

is not a dignified or healthy way to age. We want the

take you to the doctor or take you shopping. Theymodel that TigerPlace provides. We want people to be

will even go to the casino too, (a lot of TigerPlaceon a long plateau. They may have a slight decline but

residents like to gamble so they go to gamble). All thethen resume with a long plateau again. Then there may

apartments have internet access and computers. Therebe slight decline again, and then they die. Some mightis restaurant style dining with executive chefs. We havejust lie down on their bed with their dog beside them

hired executive chefs so you can choose what you wantand slip off into heaven. This is the goal. It is a moreto eat. So people don’t all have to eat the same thing at

dignified approach - focusing on health, preventing

the same time. Individualized life is what we are about.

illness, preventing problems, maximizing wellness andhelping people to stay active until they die.

We also provide access to the university because
TigerPlace is a university project. TigerPlace residents

This slide shows the front of TigerPlace. Here is a vieware brought to the football games, they come to theof the front door. You will see that there are no steps

concerts and they come to the theatrical performances

at TigerPlace - it’s all on one level. No one needs to fall

and to art exhibitions on campus. They don’t have toup or down steps. Of course the part that is the mosttake care of their home as it is all done for them. These

important to me is the pet friendly construction. I

are the services that are provided. The nurses makewas heavily involved in the design of this building. Allfour in-home visits. If you are healthy you don’t evenof the apartments have screened-in porches. This is aneed an in-home visit so you don’t get one. You just get

little room which is outside of their door with screens

what you need. We provide personal care if someone

to keep the bugs out and the pets in. The cat can beneeds help with bathing or with getting their hair done

outside in the screened-in porch, enjoying and watchingor with light housekeeping. It is all provided. If people

the birds. The dog can be out there or the older personneed help to remember to take their medications, we

can be out there, and can then go outside. The wholeprovide it. And we watch out for problems early.

building is built around a square. In the center is abeautiful courtyard so the dogs can go out into the

So aging in place involves an RN, or ‘Registered Nurse’,courtyard but remaining contained while enjoying lifea Baccalaureate prepared nurse who serves as a care-with their older person.

coordinator, and a veterinarian to identify problemsin TigerPlace pets. We have 17 pets that reside at

The window sills are wide so that cats can watch the

TigerPlace and the pets are also aging in place. Olderbirds out of the windows. There is a tile floor justpeople have older pets, and they too need a little careinside the door so that when dogs come inside withand a little help. So we follow everyone to make suremuddy feet they don’t make a mess. And there arethey can stay in their home, in their apartment andwalk trails all the way around the complex because wehave the services they need. We also conduct healthdo want to encourage people to walk.

2nd Live Love Animals International Conference on Animal Care in Kobe 201289

These are some of the common spaces. You can see

bedroom apartments’ with a separate bedroom, living

views of the dining rooms. These are the columns

space, kitchen and bathroom. Thirdly, there are thewhich are much like the columns we have on campus.

‘two-bedroom apartments’. We have one lady who got

We wanted to be connected to campus, conceptually.

herself two of these two-bedroom apartments so she

So these are the dining rooms where the residents

has a 3000 square-foot living space at TigerPlace. That

have their lunch and dinner. They usually have theiris very big! People pay rent on a monthly basis which

breakfast in their own apartment. This is the lobby, a

includes all of the services I told you about, two meals

sitting area where they can meet family and where theya day, laundry and a kitchen. Here is an example of thecan sit. There is an area next to it where there is a poolliving space in the apartments, the small kitchen.

table – indeed, there are extremely keen pool players at
TigerPlace who take it very seriously.

And now I will tell you about our ‘TigerPlace Pet
Initiative’ which is what I think sets TigerPlace

There is also a sports bar. (It is named after the Bengal

incredibly apart from any other place in the world.

Lair tiger den - another silly Americanism). It’s a sports

Not only do we allow pets but we encourage pets. The

bar where happy hour is held everyday at 5 o’clock

mission and goals of the TigerPlace Pet Initiative, orwhere residents can come out for drinks and watch“TiPPI”, are to help people stay engaged with theirsports games on big screen TV.

companion animals and to provide good care for thecompanion animals also. As I said before, this is because

There is a walk-in swimming pool that also has a lifting

the animals are aging too. We also carry out researchdevice for people unable to walk into the pool. And weon the benefits of owning a pet and we provide foster

have a theater where movies are regularly shown andcare and adoption services if a resident has to go into

people from the university give presentations there.

hospital. We will take care of their pet while they are

And of course there is a beauty shop where everybody

there and if they pass away before their pet passes

gets their hair done. This is a view of the exercise room,away - a really major concern for older people - we will

and the library. It is all pretty nice !

take care of their pet and find it a new owner.

Here is ‘Tiger Total Fitness’ where the focus is on

So here are the rules. There can only be two pets inphysical activity and remaining active - keeping

each apartment. The pets can enter all the common

walking, doing exercises etc. There is a dance class, aspaces but they have to be on a lead. (We have a

Tai Chi class, a Yoga class - all kinds of exercise. There

security deposit in case a pet causes some damage

are group activities as well as individual training forto the building). Whenever a new pet moves in we

people to stay healthy. So if we have someone who

make an assessment of the animal. We make sure it

has come back from the hospital after some kind ofhas had vaccinations, we look at its behavior and wecatastrophic health event we will develop an individual

check to see if there are any health issues that may

program for them to return to physical fitness again.

need attending to. We keep records about the health

Here again is a view of the outside. You can see theissues in our own veterinary medical exam room whichscreened-in porches I was talking about, and the walkis right inside the building. We keep track of all the

trail going all the way around.

vaccinations for all the animals. This slide shows theexamination room, and this is our exam table. The

Within TigerPlace there are three types of apartment.

reason we do all this is not because we think it is fun or

One is what we call the ‘Efficiency’ type. This is

nice. It is based on science which clearly supports theessentially one big room that the resident lives in. The

fact that older people benefit from being with, living

kitchen is on one wall, the bed on another wall and thewith, owning and aging with companion animals.

living space is in between. Maybe some of you know
about that type of apartment. Then there are the ‘one

90

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

We know that pets give their love unconditionally.

In our society, in the US, when you are no longer an

in pain, I hurt, no one loves me and I’m all alone in thisincome producer you are not valued as much as theworld”. We want them to be more positive, thinking

younger people who are making money in the system.

things such as “I’m doing the best I can, I do have someBut pets are unconditional with their love. They don’pains but it’s not too bad. I have my companion animalt care if you are making money or not. They don’t

who loves me, someone for me to focus on and not justcare if you walk with a cane, they just love you. Older

my pain”. Having a more positive morale means thatpeople need this unconditional love as they face all thethe older person will be more engaged with the world

little declines in their health. They need their pets inand less isolated. Not just staying at home, sitting,order to have a reason to get up in the morning. Pets

watching TV, feeling bad and getting more and more

for older people are viewed as an individual member

depressed. If we can improve morale, then older peopleof the family, not as something they own or an object.

will remain happier and they will remain more active.

And they certainly do inspire fun. Older people need toWhen they are more active, they will stay physicallyhave a reason to have fun. Fun is important, we have tohealthier and be more active.

laugh. People who end up in nursing homes have fewer
and fewer opportunities to laugh or have fun. They

I have probably over-emphasized that point but here

need to feel the beneficial neuro-chemicals that occur

is some research data that’s very interesting. I willwhen they interact with a companion animal.

just explain what this chart means. These two columns[on the right] show that when animal assisted therapy

Here is an example. People out walking with a dog

was given to older adults, there was significantly lessare much more likely to have some interaction withloneliness. When people get to interact with an older

another person - whether that person be a friend, an

adult or with an animal they don’t feel so lonely. Thereacquaintance or a stranger - than people who are notare physical benefits and all the photos you see here

walking with a dog. We know that when you walk inwere ones I took here in Japan on my last visit. When I

the presence of a dog you get more attention, positive

see older people with pets here all the time I think it isattention. Older people need positive attention, we all

wonderful. I want to run up to them and give them a big

do.

hug (although they would probably think I am crazy).
Older people who own pets are more likely to exercise

So here are some of the psychological benefits.

because they walk more. If they have a dog it needs toOlder pet owners in particular are less likely tohave a walk. They are going to give it a walk because

become depressed. They have someone else to thinkthey are committed to taking care of their animal. So

about besides their own aches and pains and what’

it is good for both ends of the leash. Older adults who

s happening to them. They are thinking about theirowned a pet, walked longer and had much better, what

animal and they have better morale. Morale is a very

we call ‘lipid profiles’, in their blood. I am talking about

important thing for older people. Do you know what I

cholesterol. You know about good and bad cholesterol

mean when I say morale? Who can speak English andand triglycerides. Lab values are consistent acrosstell me what I mean? Thomas I will pick on you, what’s

several studies that, if you have a pet, your risk factors

morale?

for cardiovascular disease decrease. And if you do havea heart attack, or you have bad genes, you are more

Audience (Thomas): Morale means feeling positive,

likely to survive the heart attack one year later if you

optimistic.

have a pet. This is science, not ‘fluffy’ superstition.

Rebecca Johnson: Perfect, he is an A+ student! Yes,

To continue talking about cholesterol levels, ourmorale is about a positive, optimistic outlook. We wantcolleagues here in Japan, namely Motooka, Koike,older people to have a positive, optimistic outlook. They

Yokoyama and Kennedy, did a very interesting thing.

should not be thinking “oh, I am dying everyday” or “I’m

They studied older adults walking with Cavalier King

2nd Live Love Animals International Conference on Animal Care in Kobe 201291

Charles Spaniels and measured the High Frequency

whatever help is needed - they give eye drops, theyPower Heart Rate. This refers to the heart rate showing

give animals their medications, and they check on them

periods of rest between beats in the heart. We need

three times a week.

good periods of rest between beats because without
them the heart will wear out quicker. So we want thisThen we have a program called ‘PAWSitive Visits’

rate to be high. When people were walking alone they

where we bring animals to the facility. It is not enoughmeasured 60 Hz, as shown at this level. But when they

for residents to only have their own pet - we want

walked with the dog, there were significantly better

them to see other animals too. So the animals arrive

periods of rest between the heart beats than without

and we hold a session and bring in the animals. (I am

the dog. Next they measured the same thing for 3 days

going to show you this shortly). Then we have a fundto see what would happen. Again the white bars onthat enables us to take care of the pets whose owners

the chart are the measures ‘without the dog’, the green

die. Sometimes a pet lives longer than its owner whichbars are measures ‘with the dog’. What they found was

is obviously a reality with older people, but that fact

that, after the first day, the benefits were cumulative.

should not keep these people from having a pet. We

So there was even more benefit on day 3 than on day

should be able to provide help in these situations

2. I am eager for them to repeat this study and extend

and we do. And then, very gratefully, we have theit even longer. Let’s see how far we can go to increase

HILLS feeding program where we are able to provide

these benefits. I am getting old myself so I want towonderful food for the pets at a very low price to help

know the results pretty soon!

out the older people who only need that kind of help.

So I will return to talking about TigerPlace. We are

So we have in-house pet medical care. This slide showsbased on science not fluffiness. We have our own

our veterinarian Dr. Jim Creed, and this is our exam

veterinary medical exam room, as I mentioned. A

room. You can see the pet food on the side. Dr. Creedveterinarian comes once a month and visits all 17 of

takes any animal that needs treatment to the exam

the pets. I have to say that when we first started thisroom to carry out small procedures. I should also

service the old ladies thought it was very amusing that

note that we are not taking business away from thea vet would come to their home to see their cat or dog,

local veterinarians because what we are doing is ‘casewhile their own doctor would not make home visits.

finding’. Dr. Creed identifies the problems in the pets

Nowadays in the USA there are no house calls anymore

and tells the older person that their dog needs to see afor human medicine. When we asked our humanveterinarian. If they don’t have their own veterinarian

medical colleagues to keep an examination room atin the community then we take them to the Vet School.

TigerPlace and to come and make house calls they

So we are not taking business away from veterinarians

responded that the residents were welcome to come tobecause we are finding cases earlier than an older

their clinics. In other words, they said “no”!

person would detect by themselves if they didn’t haveour veterinarian visiting their pets.

So we have a veterinarian who makes house calls andwe have hired pet care assistants because, as old pets

This is a good learning experience for students. We

grow older they develop little problems and need help.

have vet students who are gaining an opportunity to

For example, older people cannot see the tiny numbers

work with older people and old pets. Here is Dr. Creedon the tiny syringe to be able to draw up insulin for

visiting some of the pets. Making house calls, he talks

their pet. If any of you veterinarians ever send an older

to the owner, asks how the pet has been eating, has

person away with instructions to administer insulin

the pet been going to the bathroom, does the pet seem

twice a day I feel I should scold you because they

well and regular or is there something different? He iscannot necessarily see well enough to do this. They

carrying out a little history taking.

need some help. So our pet care assistants perform92

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

We also want our people in TigerPlace to learn. Dr.

Here is case study 1, about successful pet ownership at

Creed gives classes about flea and tick prevention. He

TigerPlace. We had this lady who is 96 years old. Thatgives classes about how to recognize diabetes in cats oris very old and she was in really good health (I have arenal failure. He is teaching the residents of TigerPlace

picture of her here at the end) but she had a 28 year

how to know a problem before it happens if theirold cat. That too is very old for a cat, I am sure you

animal is in trouble. Together, working with our petveterinarians agree. The lady had had the cat since it

care assistants, we know that we will detect problems

was a kitten, 28 years before. My pet care assistantearlier.

went in and asked “where is Cleo, the cat?” The old lady
answered with “I know she is not feeling well, there is

By the way, if we identify behavior problems wesomething wrong with her”. The pet care assistant went

also work with them. You know about Miniaturein and found Cleo looking terrible, drooling and looking

Dachshunds already. They have quite a personality.

as if she was at death’s door. So the veterinarianWell, one little doxie suddenly started biting people.

examined Cleo and found that, at 28, this cat had

When the caregiver would come into the owner’s

developed diabetes. The vet prescribed insulin and myapartment or leave out of the door the doxie would run

pet care assistant now goes twice a day, morning andup quickly and try to bite the visitor’s foot. I wondernight, to give the insulin. The cat suddenly went into

if any of you have ever seen a doxie do that? Nobody?

remission. No more diabetes, no more need for insulin(Well I guess there are only good doxies in Japan !)and now the cat is running around like a kitten again.

This particular doxie’s name was Shadow and his owner

It is like magic. I don’t understand how that is possible

was able to have this problem corrected. Now, Shadow

but it is a wonderful thing that happened. The oldis contained whenever anybody is ready to leave. We

lady said to me that “Cleo is the reason I get up in the

don’t want people getting bitten as they walk out ofmorning”. Why would we ever think to take a cat away

apartment doors. So we work with behavior issues asfrom a lady who says that? We would not.

they arise.
Here is Case Study 2. We had an 85 year old lady who
The pet care assistants visit three times a week andowned a 12 year old Shih Tzu called ‘Rags’. All of athey check on the supply of food, to be sure the animal

sudden Rags’ eyes turned red. The veterinarian took a

has food. They check the water bowl, they clean the cat

look and prescribed eye drops. But the lady herself wasboxes and they do what is needed, and will also carry in

not capable of giving eye drops to Rags. She cannot

the bags of dog food. These are heavy and hard to carrysee well enough to apply the drops and hold him at theso older people just need a little help. It is inhumanesame time. So our pet care assistant goes twice a day,to tell an older person that “you can’t take care ofgives him the drops and the problem has been resolved.

your pet, so get rid of it”. I mean that it is inhumane
to the person because it could cause their health toThen we have the ‘PAWSitive visits”. This is a weekly

seriously decline. And it is also inhumane to the animal

program where we take a variety of animals to

to take it away from its loving owner. We only need

TigerPlace for an hour long session. Older adults get

to provide a little help. The pet care assistants not

to interact with the animals. From the photos you can

only help the veterinarian, they will also walk the dog

see that we don’t just have small animals. These large

if the older person is having a bad day and doesn’

ones are Missouri Mules. They are mules developedt feel up to walking. They will walk the dogs and givein Missouri and unique to Missouri. These two shown

medications. In this top picture, the assistant is giving

here, Tim and Terry, are mascots of the Vet School.

eye drops. The older lady shown here is not able to see

Yes we have mule mascots too! We also had a horsewell enough to put the eye drops in their dog’s eye. So

come visit and an Alpaca [similar to a llama]. We have

twice a day the assistant is giving eye drops.

seen a pot-belly pig and a whole range of dogs andcats. When the animals visit, the attending students

2nd Live Love Animals International Conference on Animal Care in Kobe 201293

prepare a tutorial about the particular animal and give

College of Veterinary Medicine, HILLS provides fooda little class. A lively discussion usually follows. Do you

so that we can sell it at a low cost to the residents.

know what older people do best? They talk about the

Look at the pure joy on this woman’s face. You canpast. If you believe in Erickson you know that there issee that TigerPlace has some wonderful outcomes fora developmental stage at each stage in life, and there

older adults in terms of their health. We are preventing

are certain tasks that a person has to work through at

nursing home placement and this has been very

each stage in life. The developmental task for older

successful. We are therefore saving a lot of money topeople is life review. They are trying to come to closure

the healthcare system in terms of the costs incurred byand to find acceptance of themselves and, in order topeople going into these very expensive nursing homes.

do that, they talk about the past. They tell the same oldThey stay in their apartment at TigerPlace without suchstory again, again and again. They think it through andterrible costs.

consider it and come to self-acceptance so that they are
ready to go to heaven. We want people to go to heaven

The nurse care coordination helps to find problems

feeling good. So during this PAWSitive class people

very early on so that they don’t become catastrophic.

start to talk about whatever animal they had. Many ofThat prevents healthcare dollars having to be spent on

the older men had their own horses or they had mules.

larger problems. Those are much more expensive toSome worked on the farm and many of the older ladies

address than meeting the smaller changes along thehad cats. They talk about the animals they had whenway.

they were children and they work through their life
task.

There are some other very exciting projects at
TigerPlace. I am not going to go into detail about themThis slide is about “Bereaved Pets Endowment”. We

because of the time I have but you will remember that I

have a very generous donor who feels very strongly

mentioned all of those other colleges at the university.

that, if a person dies before their pet, that pet should

One of the colleges involved in our project is thebe cared for. So she gave us money to start this fund.

School of Engineering. They are developing all kinds

By the way the photo shows Cleo the cat and elderlyof sensors and technology to help predict problems inlady I spoke about before. They were interviewed byolder people before they occur. So I am just going to

the USA Today newspaper. “It is very exciting”, she said,skim this topic… If a resident agrees to participate in“I have never been in a newspaper before”. Her family

the project some sensors are installed in various placesalso came along and they were all very excited about

within their apartment to monitor their walking andthe interview. Anyway, the idea of this endowment fundactivity. We know that activity patterns changes can be

is to have money to pay for care of a pet whose owner

an indicator of a healthcare problem or an impending

passes away. What we do is to provide foster care in-healthcare problem.

house. Another resident might say, “I will take careof Cleo when Mrs. X dies”. We then give that resident

So in this image you can see some sensors. There area little funding to help pay for the care of Cleo thelittle motion detectors in various places and there is acat. We have had two people die before their pet in

bed-located sensor that is a motion detector. Restless

TigerPlace. Another said “I want Hercules to be mysleep is a precursor to some very catastrophic healthdog”, which led to Hercules eventually being adopted

problems in older people, depression and also stroke orby another resident of TigerPlace who didn’t have a pet.

heart failure.

This is because all the residents know all the animals. It
is something positive that other residents want to adopt

So here is an example of an apartment. This is a one

a pet whose owner passes away.

bedroom apartment with the screened-in porch, a livingroom, dining area, little kitchen, and bathroom withThe HILLS Feeding Program is provided through the94

りぶ・らぶ・あにまるず 神戸アニマルケア国際会議 2012

walk-in shower and closet. The sensors are indicatedby the blue lines and they are able to detect motion

situation in the elderly, even when sleeping. This person

patterns. The sensor data is compiled into graphs, as

had a reasonably normal rate for quite a while but

shown here, and from these we can understand changes

suddenly there was a slowing of the heart rate. Thisin an individual’s activity.

data shows normal activity, and during sleeping when
there is some restlessness. It is not too bad but then,Here is an example chart. The black data indicatessuddenly, their heart rate dips and they are not moving.

when someone has left their apartment to go outside.

But this person was able to get care immediately. There

The large white space shows night time with nothing

is now also a proposal pending with General Electric togoing on because the person is asleep. Then they startuse ‘passive sensing’. GE is developing a carpet productto get up, become busy, move around and then theycalled a ‘Smart Carpet’ that can measure stride length,

have gone out of their apartment. This example is awalking speed and the gait stability.

very active person, in and out of their apartment all thetime.

Here is another example of a bed sensor. This one goes
under the mattress and detects changes in restlessness

This is data for the sensor in the bathroom whichand sleep. There is a also another new project for

detects them going in and out. It shows the days of thedetecting falls and I will show you that briefly. This

month and you can see the days and hours when thesystem uses radar so there is small radar device inside

individual never went into the bathroom at all duringof this box. The radar measures people’s behavior

the night. However the right hand side data shows thempatterns within their apartment. In the photo you canbeginning to habitually visit the bathroom at night.

see that a computer is located above the refrigerators,

From this data we know in a timely fashion that thewell out of the way. This is the data it creates. The

person is starting to visit the bathroom and the systemradar senses the person’s walking patterns and produces

sends some alerts to the nursing staff about increased

a silhouette image with a map of their footsteps. We

restlessness in bed at night. This tells us that we ought

can tell their walking speed and step length which, if

to be paying attention.

they change, may suggest a problem is going to happen.

So in this case study the person started going into

It is very impressive don’t you think? The older adults

the bathroom more. There were two alerts so thethink it is very cool and are responsive to having all

nurses checked it out. The resident was referred tothese sensors around them. They like the idea and feela physician who found that the person had a urinary

safe knowing that someone is keeping a track of theirtrack infection. These can be very problematic for older

progress. They do not feel that it is a violation of theirpeople and must be treated right away otherwise it

privacy because all the information is kept confidential.

can become septic. Fortunately, this person was put on
antibiotics early and was fine.

Here are my conclusions about the pet projects. In
short, older adults love having their pets around them.

We also have NIH funding for the research at

The number one reason that people want to enter

TigerPlace. We found that there are statisticallyTigerPlace is because they know they can have theirsignificant differences between the control group andpet and receive help keeping it. Out in the community

the test group in measuring some of these parameters.

they would be on their own and eventually somebody

What we measuring is the left hand grip strength andwill tell them to get rid of their pet if they cannot takegait. Here, again, is an example of bed sensing data,care of it. That does not happen at TigerPlace wherein this case heart rate data. The bed sensor actuallythings are more humane.

measures heart rate and this shows the incidence ofBradycardia when the heart beats or pulses less than 30

So we want everybody at TigerPlace to age in place,beats per minute. That is potentially a very dangerous

both pets and people. Here is where you can find some

2nd Live Love Animals International Conference on Animal Care in Kobe 201295

more information and now I would be happy to takequestions.

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