Dogs in geriatric care. Establishment of an animal-assisted visiting service

Table of contents

List of abbreviations

1 Introduction
1.1 Questions about the present work
1.2 Approach and objectives of the work

2 Animals as companions of humans
2.1 Historical development
2.2 Human – Animal – Relationship
2.3 Effects of animals on humans
2.4 Purpose of animal-assisted therapy
2.5 State of research

3 The elderly in our society
3.1 The aging process in Germany
3.2 Socialization in old age
3.3 Successful and productive aging
3.4 The health-impaired senior
3.5 Picking up older people where they are
3.6 Enduring disabilities with animals

4 Basics of a therapy dog team
4.1 The Therapy Dog
4.2 Forms of interaction and communication between humans and dogs
4.3 Holistic therapeutic effect of dogs
4.4 Various visiting services
4.5 Types of visits
4.6 Basic requirements for dog and owner
4.7 Training as a visiting dog
4.8 Animal Welfare Guidelines
4.9 The organization "Animals help people"

5 Establishment of a visiting service
5.1 Brief market analysis
5.2 Requirements for an animal-assisted visiting service
5.3 Stress-free animal-assisted work in the sense of the animal
5.4 Hygienic cauts
5.5 Legal aspects
5.6 Relevant insurances
5.7 Allowance
5.8 Agreements with institutions / individuals
5.9 Public relations
5.10 Preparations for a dog visit
5.11 Visit documentation

6 Summary and outlook

7 Bibliography

8 Appendix

List of abbreviations

illustration not visible in this excerpt

1 Introduction

The present diploma thesis deals with the requirements and the development of an animal-assisted visiting service in the senior sector, or the visiting dog.

We all know older people who walk their dog, do not feel lonely by this social partner and life partner at their side, but then suddenly e.g. have to move to a nursing home due to a fall or illness. Here often no animals are allowed or the dog owners can no longer take care of their own pet through a purchased Handycap and miss the contact with their animals. Animal-assisted visits are predestined here and can provide beautiful and familiar moments.

The demographic development in Germany, but also the longer life expectancy of single people who no longer live in large families, also play a major role in the loneliness of older people. The aging process with corresponding physical and mental changes and special diseases in old age continues to progress.

As a dog owner for over 30 years, I would like to install an "animal visiting service" in our community myself. Many elderly people live here, there are also two spa clinics, several old people's homes and outpatient care services that have already shown their interest. This also prompted me to take up the topic and take a closer look.

1.1 Questions about the present work

As the title already shows, this diploma thesis deals with the development of an animal-assisted visiting service, in particular with visiting dogs in seniors. Different questions about the human-animal relationship as well as the effect of dogs on humans are examined. But also the elderly in general and the consideration of age-related limitations as well as people with chronic diseases, disabilities, bedriddenness, dementia up to the care of the dying are discussed.

Aspects of visiting dog training, the legal field, the organization of a visiting service and marketing are highlighted. The preparation and execution of a visit hour under the observance of hygiene are presented.

Questions about the training of visiting dogs as well as about further training in animal-assisted interventions are also answered.

1.2 Approach and objectives of the work

With this work, which is created as a literature search under empirical aspects, the relevant aspects for the establishment of an animal-assisted visiting service are to be recognized and emphasized. For example, it is important to consider how an animal-assisted visiting service built up under health-promoting aspects and business management measures can be installed. Prospectively, targeted further training for caregivers and other groups of people in the health care system, e.B occupational therapists, dementia caregivers, etc. in the senior sector, should be offered and, if necessary, own animals should be integrated. In the future, the basics described here will be able to provide background knowledge for caregivers and interested parties in practice at the grassroots level (Figs. 20 and 21).

In order to be legally secure, laws, insurance and hygienic regulations must also be taken into account in order to be prepared for possible incidents.

This creates opportunities for seniors in the home and inpatient sector that "the tail-wagging, panting co-therapist can help his clients to reduce their loneliness and isolation, stimulate movement, give closeness and stimulate communication" (KAHLISCH 2010: 5). Satisfaction and motivation of both the visited people and the employees can thus be optimized.

In this work, I will limit myself to the dog visiting service, otherwise the topic would go beyond the scope.

For the most part, the masculine form is used, which includes the female component.

2 Animals as companions of humans

Nature and thus also animals are older than mankind. Depending on the cultural point of view, the relationship between animals and humans was shaped. On the one hand, as modern performance-oriented people, we are far removed from nature, on the other hand, animal behavioral research shows how closely we are still connected to the animal world and how we share our lives with them (cf. OTTERSTEDT 2001: 14).

Animals are good for both sick and healthy people (ibid. p.9). They bring life and joy. Even in old age, animals can provide people with quality of life, promote social contacts and protect against isolation, relieve pain and make the arduous sides of aging forgotten in the short term.

Animals are ideal as therapeutic companions, as they are very communicative. The dialogue between man and animal is special, even if it involves a different mode of expression than the human-human relationship (ibid.: 11).

2.1 Historical development

Animals have been used for thousands of years as working, guard and domestic animals. In addition to food production, examples include ploughing water buffaloes to the ground, sheep for wool for the production of clothing, horses as draught animals, hunting falcons for catching rabbits, etc.

These farm and workhorses lived alongside humans. Today we live together with the animals and consider e.g. B. Dogs as social partners. In the Federal Republic of Germany, cats are in first place and dogs in second place, followed by small animals such as hamsters, guinea pigs and rabbits.

When man was still dependent on hunting, the dog was not only regarded as a guardian, companion and hunting companion, but also as a pet and partner (cf. OTTERSTEDT 2001: 15).

In the Assyrian-Babylonian culture, the goddess of healing called "Gula" was depicted in the form of a dog. Even before Christianity, there were general ethical standards for dealing with animals, which also applied to dogs.

In the 8th century, animals, especially dogs, were already used in Belgium for therapy of sick orphans and disabled people. Florence Nightingale, the founder of modern nursing, had already recognized the positive benefits of animals in the healing process in the 19th century (cf. RÖGER-LAKENBRINK 2010: 12 ff.).

Today, in the time when machines have taken over the work of animals, we find only selected animals such as horses in the police, but also sniffer and search dogs in the drug search and earthquakes. Guard dogs are still used on company premises and government buildings today, as they work more reliably than some technical surveillance cameras.

According to the current state of archaeological knowledge, dogs have been around for 14,000 years. Skeletal parts from this epoch, the Upper Palaeolithic, were found near Bonn/Oberkassel in Germany and can be clearly assigned to the first dogs and no longer to the wolves. A criterion in the skull analysis is the shorter muzzle. Whether domestication took place at the same time or rather cannot be reconstructed exactly today (cf. SCHÖNBERGER 2010: 59 f.).

Some researchers at the Leipzig Institute for Evolutionary Anthropology, among others, do not believe in a coincidence that humans and wolves came together. The justification lies in the social order with complex rules similar to the human law firm (cf. ibid.: 87 f.).

Animal-assisted interventions are a newer and certainly the "most intensive stage in animal domestication" (OTTERSTEDT 2001: 20). The term domestication or domestication refers to the "gradual" habituation and taming of wild animals into tamed pets (cf.www.duden.de).

2.2 Human – Animal – Relationship

Farm and work animals do not live in a person's apartment, unlike pets.

"Domesticated animals were and are an integral part of human life and consequently also human quality of life" (HEGEDUSCH/HEGEDUSCH 2007: 34). People in small apartments in the middle of the city, where anonymity prevails, nature is far away, but also elderly and disabled people who live alone and isolated not only in the city but also in villages, benefit from animals with which they can share everyday life. Whether the chirping and singing of a bird, the purring of a cat or the petting of a dog: every animal has its own individual and soothing charisma on humans.

During World War II, soldiers in the United States were sent to a farm attached to the Army Air Force Convalescent Hospital to recover from war trauma (cf. HEGEBUSCH/HEGEBUSCH 2007:35).

In order to understand the human-animal relationship, various explanatory models were used. I would like to take up three interesting approaches (ibid.: 37 ff.):

1. The biophilia hypothesis comes from the theory of evolution and deals with physical, emotional and cognitive connection to nature and other living beings, as well as animals, which is anchored in us humans. This approach of affinity between humans and the biological environment is limited to mental and emotional healthy development, intrapsychic processes are not taken into account.
2. The depth psychological explanatory model includes the inner-psychic processes, even below consciousness. The basis of the various depth psychological approaches is that in human life at the beginning of childhood there is a comprehensive connection to the material and living environment, the so-called oneness with everything. This also includes animals that can often fade after childhood due to civilizational and cultural imprint, but become present again in old age. The well-known depth psychologists C.G. Jung and Sigmund Freud speak of consciousness (the EGO) that can only grasp a limited part of reality. Thus, unconscious components such as instincts in a deeper layer (the ES) or in the animalistic deep person can explain the connection between humans and animals.
3. Another explanation is the phenomenon of anthropomorphization and the resulting evidence. Anthropomorphism deals with the transfer of human emotions to non-human objects and is considered a prerequisite for connection with animals. You-evidence here means the agreement and perception with an animal on an emotional and social level. Other verified elements are the ability to communicate, even without language, and sociality, which enable commonalities and relationship building. Corresponding animal contacts can trigger emotional touching and lead to the humanization of the animal. This includes as a typical feature the naming of an animal. The behavioural scheme that Konrad Lorenz describes with a child scheme can also be applied to animals. Among other things, humans are attracted to certain body features such as large eyes and head, fulfilled by the desire to protect and care. In addition, it is a pleasant feeling to stroke a coat that can trigger positive emotions. Evolutionarily, social contacts, belonging and cohesion as well as a partnership relationship were built up and consolidated with the mutual body care.

2.3 Effects of animals on humans

"Animals allow sensuality", which often remains unsatisfied in our civilized world (GREIFFENHAGEN/BUCK-WERNER 2007: 39). Scientific studies prove that it is good for the soul and calms the soul to pet an animal, this lowers blood pressure and also slows down the pulse (see chapter 2.5). The immune system is also strengthened. These reactions are stimulated by happiness hormones, the endorphins. A dog also gets us out of cloudy thoughts, because he demands attention, play and walk. In this way, negative thoughts are expelled and depression is prevented.

By caring for the animal such as regular feeding and walking, it gives the daily routine a structure and regularity in the often limited everyday life.

However, a distinction is made between one's own animals and the animal companions who help and heal. People who cannot keep their own dog, whether through animal prohibition in the lease of apartments or homes as well as for health-related reasons, can still benefit from animals.

In the case of therapeutic companions, however, care must be taken to ensure that they are kept and trained in a species-appropriate manner and according to their needs. Only then is a casual and meaningful interaction with humans and dogs possible. Dogs are pack animals and are particularly well suited by their behavior. They do not understand our language, but are excellent at absorbing our non-verbal signals and sniffing out facts that we humans do not perceive. Animals promote our physical and mental mobility, our inner balance and lead from loneliness to a social community. However, we should not see them as miracle healers, but as social partners.

In addition to the visiting services with private animals or from the shelter, there are also the animal companions in occupational, physiotherapy and psychotherapy. Dogs can listen well without rating, which is why reading dogs are increasingly used in children with reading difficulties, which calm the children.

It has been proven that contact with a dog has a holistic effect, i.e. our physical, mental, emotional and social needs are satisfied but also promoted. (cf. KAHLISCH 2010: 14).

Examples of well-known therapy options and the different effects of animals on humans are thus the basis of the beneficial effects of animals. An overview of the relationships between the life phases and the effects caused by animals can be found in the appendix (Fig. 01).

Otterstedt has summarized a selection of healing effects by animals and their interaction with humans (Fig. 02).

Joy and laughter dominate in animal-human relationships and support positive well-being on all levels with strengthening of the immune system, mental enhancement and mental balance. In rare cases, however, sad memories can also be evoked.

2.3.1 Psychological effect

Psychic is defined as concerning the perception, experience and behavior of man. These include perception, feeling and memory. An animal/dog can comfort, distract from sad thoughts, boost self-confidence and reduce stress. Closeness and trust, motivation and relaxation distract from negative feelings and allow a disease to be better processed. Animals thus influence, among other things, the emotional level of humans.

Man has a need for perception, which involves a constant processing of stimuli. In a scientific experiment, several people were isolated from all environmental stimuli. As a result, there were decimations of mental performance. This manifested itself, among other things, in concentration and orientation disorders as well as mood swings with deception and outbursts of affect (cf. DUNKHORST 2006: 254). Animals can provide a new stimulation current here and thus promote the ability to perceive. As a holistic event, the somatic, visual, vestibular, vibratoric, olfactory, auditory and tactile-haptic perceptions in particular belong to it (ibid.: 256).

The sense of smell shapes our emotional mood, this applies to both a pleasant smell vs. stench, depending on how people first came into contact with a smell.

Not to be underestimated is also the joy that animals trigger, through the proximity of the animal or the anticipation of a visit.

The feeling of security arises. Man feels accepted in his existence, because animals do not care what humans look like and whether they have physical or mental limitations. "Where the animal accepts man as he is, man can also begin to accept himself as he is" (OTTERSTEDT 2001: 87). This should be considered as an important principle in the senior sector with lonely and sick people.

Animals can touch our soul in many different ways and promote our emotional well-being. Social loneliness and sadness fade away and thus have an antidepressant and antisuicidal effect (ibid.: 36 f.). Depending on the animal species, people can become stimulated and active or even come to rest.

2.3.2 Mental impact

The attention and receptiveness of animals increases, there are visual, tactile and auditory promotions. Communication also takes place with otherwise quiet people, memories are awakened and occupation and distraction can be stimulated.

Self-determined action can be promoted, as the anticipation of the visit also means considerations. "What do I wear? Do I have a towel ready if I want to take the animal on my lap? Where did I put the treat?" During and after the visit, thoughts and conversations promote the mind and promote active and independent action (OTTERSTEDT 2001: 33).

2.3.3 Physical effect

Studies from America and England prove (cf. OTTERSTEDT 2001: 28) that animals have a positive effect on the body. Thus, by petting and physical contact with an animal such as a dog or cat, blood pressure and pulse can be lowered. Breathing becomes calmer and the circulation more stable. Relaxation also protects the body from tension and the usually resulting consequential pain. Likewise, other physical acute and chronic pain are felt less and thus painkillers can be reduced.

Only the presence of the animals, e.B. also the slow gliding of fish in an aquarium can calm the sense of sight (ibid.: 28)

An appetite stimulance can be stimulated by the anticipation of an animal visit through increased breathing (ibid.: 31). This is a pleasant side effect in many older kachectic and underweight people, as they often no longer have an appetite and also taste less, as the olfactory senses decrease with age.

Strength, coordination and motor skills as well as balance can also be stabilized, physical weakness seems to be forgotten at least temporarily. For example, physiotherapists use animals to promote people's mobility. Older people are motivated to move more, to grasp, stroke, to move the joints, to walk a few steps and thus also to overcome pain (MAMEROW 2003: 59).

All our senses are stimulated by animals: visual, auditory, olfactory, haptile and tactile and work not only physically, but in the holistic sense of wholeness on the three levels body-soul-mind.

2.3.4 Social impact

Animals promote the willingness to open up, can improve communication and interaction, promote a new contact. It makes you want to observe the animal, feed it together and conveys the feeling of being needed. The social action group of visitors can be expanded over time (cf. KAHLISCH 2010: 15).

Animals thus help to reduce distances and build up alternative dialogues. Through equal interest and the affirmative commonality with the animal, a pleasant atmosphere of conversation can be ensured, the so-called Grooming Talk (cf. OTTERSTEDT 2001: 42).

"Life with animals offers relationship quality, that is, quality of life" (ibid.: 39).

2.4 Purpose of animal-assisted therapy

Animal-assisted therapies are all measures that have positive effects on the experience and behavior of humans through animals (cf. RÖGER-LAKENBRINK 2010: 30).

The different animal-assisted interventions and their influences are briefly described in the appendix (Figs. 03 and 04). Animal-assisted services improve the quality of life on several levels and promote various human aspects (Fig. 05).

"A systematic scientific investigation of helpful effects of animals on humans began in 1961" (HEGEBUSCH/HEGEBUSCH 2007: 35).

The occasion was the observation of a socially disturbed child and his dog by the therapist Boris Levinson, who recognized "the possibilities of using animals as co-therapists" (ibid.).

Research projects and studies on animal-human relationships have been carried out worldwide. As early as 2000, as mentioned in the doctoral thesis of the physician Arnim Claus, there were "at least 57 approved animal visits to hospitals, mostly in the field of psychiatry and geriatrics" (MAMEROW 2003: 59).

2.4.1 Which animals are suitable as therapeutic companions?

On the one hand, animals can increase the quality of life and, on the other hand, they can also provide targeted assistance. However, it is always important to take into account whether the respective person also associates positive or negative experiences with the corresponding animal, and which animals he prefers. One person may be a cat lover and another more of a dog advocate. These components shall be taken into account when using animals.

A wide variety of animals can be used. Dogs, cats, chickens, birds, rabbits, guinea pigs, horses, dolphins, sheep, goats and pigs find their justification in various therapeutic concepts. Very often, however, dogs are preferred due to their philanthropy, intelligence, adaptability and long domestication (cf. HEGEBUSCH/HEGEBUSCH 2007: 35).

2.4.2 Delimitations of animal-assisted intervention

The more literature I reviewed, the more different, not always identical definitions of animal-assisted intervention I found. Dr. Carola Otterststedt, also a member of the scientific advisory board of Tiere helfen Menschen (ThM), describes four areas as places of use for animals as therapeutic companions:

1. "Animal visiting service (with private animals or animals from the shelter) as an accompaniment of disabled, old, sick or even dying people.
2. Animals as therapeutic companions, e.g. in the context of physiotherapy, occupational or psychotherapy.
3. Animals as therapeutic companions, e.g. in the context of everyday hospital or nursing home life on the ward and during the ward round.
4. Animals as therapeutic companions, e.g. trained as companion dogs, e.B. for the blind, the hard of hearing and wheelchair users" (OTTERSTEDT 2001: 21).

The Delta Society, which was founded in the U.S. in 1977 to explore the quality of the relationship between animals, pet owners, and caregivers, distinguishes two areas:

1. Animal-assisted Activities (AAA) and
2. Animal-assisted Therapy (AAT) (cf. HEGEBUSCH/HEGEBUSCH 2007: 35).

Animal visit programs with pets belong to AAA, animals as an integral part of a therapeutic concept with explicit documentation to AAT.

2.5 State of research

In the 80s, the German gerontologist Erhard Olbrich from Erlangen published a visiting dog program with animals and old people. In 1989 he referred to a study of visiting dogs in inpatient facilities. For over 7 weeks, the seniors were visited twice a week with the dogs. His conclusion was that the people visited communicated more, became more independent and self-confident, but also seemed more alert and smiled more often (cf. GREIFFENHAGEN/BUCK-WERNER 2007: 115).

There are several international studies worldwide on the links between animal ownership and human health. As an example, two American medical-epidemiological studies from 1990 are mentioned here. One study dealt with "statistical comparisons of pet owners and non-animal owners in relation to visits to the doctor", the other made "a comparison of behavioural changes before owning an animal and later living together" (cf. HEGEBUSCH/HEGEBUSCH 2007: 76 ff.).

Since 1996, there have been several research projects regarding support from therapy dogs, but these have mainly been projects with children at the University of Leipzig, which had the goal of finding out to what extent animals favorably influence the therapy process (see RÖGER-LAKENBRINK 2010: 96).

In Germany, in 2004 there was a purely statistical survey on the possible health relationship between animal ownership, taking into account the frequency of visits to the doctor." There is now no doubt about the positive effect of animals, but this could only be evaluated statistically in the studies mentioned without conclusions and causal relationships (cf. HEGEBUSCH/HEGEBUSCH 2007: 76 ff.). According to "Studies on the influence of animals on risk factors of cardiovascular diseases", a positive influence was uniformly demonstrable, which must be used health-promoting in the context of prevention (ibid.).

"Studies on the impact of animals on human psychosocial well-being" looked at the following factors: Integration and social contact, experience of affection, physical contact and appreciation, of the ability to cope with stress or the feeling of being needed".

As a classic, the "Budgerigar Study" from 1975 should be mentioned here. In order to measure the psychotherapeutic value in 30 elderly people aged 75-81 living alone, half of the subjects were given a budgerigar, a flower pot and a television, the other half did not. Further research projects were: "Ein Hund im Heim – Eine Studie über Pets an der geriatrischen Klinik Caulfield", 1981, a German "Studie über die Bedeutung von Katzen bei kritischen Lebensereignissen" (o. Jg.), as well as a study "Betagte Menschen und ihre Pets – Förderliche und problematische Aspekte der Pethaltung und Implikation für die (Kranken-) Pflege: eine descriptive Untersuchung" (ibid.: 82 ff.). In all these studies lies the premise of the versatile and beneficial effects of animals, which provide both psychological support and life support for elderly and sick people, but also convey joie de vivre and are "social catalysts and icebreakers" (ibid.: 89).

"Studies on the importance of animals for people with dementia" such as the Alzheimer's study (o. Jg.) give a first impression, but are not meaningful enough with regard to the possible effects in terms of statistical surveys.

Further research is in the works, but in order to obtain reliable results, longitudinal studies with more subjects are needed to investigate "the health, emotional, social and cognitive status of people with dementia" by animals. In the present sample number, it can nevertheless be concluded that animals cause positive effects in the social-communicative area (ibid.: 90 ff.).

Katharina Hohmann describes in her book "Quality of life in old people's homes – on the importance of animal-assisted services" a qualitative survey with participant observation and episodic interviews among the elderly. The structured research design is intended to enable a professional approach in the field of animal-assisted interventions and quality standards.

According to a study by the Alzheimer Gesellschaft Bochum e.V., the most important needs of humans lie in social integration and communication (cf. HEGEDUSCH/HEGEDUSCH 2007: 60).

An overview of research activities and the corresponding addresses in German-speaking countries can be found in the appendix (Fig. 06 and 07).

3 The elderly in our society

In our society, the lifespan has increased explosively compared to earlier periods (cf. SCHROETER 2009: 5). There are more and more older people, graphically represented by the Federal Statistical Office 2012 in a diagram.¹ While the birth rate has been declining, longevity has increased. Due to the changed age structure, socio-cultural values and roles have changed, an ambivalence and dichotomies have arisen. Thus, among other things, a distinction is made between vital, committed seniors and the demented elderly in need of care, between productive vs. unproductive old or active young old vs. frail elderly (ibid.: 7). In addition to the biological process, ageing must also be considered from a social and societal perspective in order to respond to the needs of change and the needs of the "grey society" (ibid.: 5).

The elderly person not only lives in an age-unfriendly epoch, whereby there was youth delusion from a cultural-historical point of view again and again. Within the framework of social age, however, the elderly person may also determine his or her own life, travel, study, pursue hobbies and honorary positions, realize his own lifestyle. The classic idea of the grandma knitting in an armchair in a gray costume or the pipe smoking grandpa with ear tube in front of the TV is outdated. Overall, the diversity of interests and mental performance have increased in old age.

Today, however, the senior lives longer in the third life bunny, which is now divided into several sections and can no longer be clearly assigned to the calendar age. There is talk of the "young old" between 55 and 65 years, followed by the "old old". The "very old" from 80 years and the "long-lived" over 100 years are also newer differentiations (ibid.: 15).

Of the multidisciplinary different gerontological age definitions, I would like to mention only those that are the focus of my work. This is the biological and functional aspect of physical condition and social performance that needs to be taken into account.

Today people are getting older than in earlier times", but they are comparatively younger in both their "expressive and impressive state of mind" (ibid.: 17).

3.1 The aging process in Germany

Due to demographic change, however, the age structure change must also be taken into account. In addition to rejuvenation with a simultaneous increase in old age, this process includes de-occupation, singularization and feminization (SCHROETER 2009: 17).

Rejuvenation here means that older people today are more vital, feel mentally, emotionally and physically fitter than in previous generations. This subjective feeling is also objectively confirmed by investigations and studies.

Life expectancy is increasing, as can also be seen in the table of the Federal Statistical Office.²

By de-occupation is meant the retirement age, which today is strongly controlled by labour market policy. On the one hand, the retirement age has been raised from 65 to 67 years depending on the year of birth, on the other hand, employees take early retirement or early retirement. However, there is also the occupational disability due to disability (ibid.: 18) due to chronic illness or accident.

The singularization, the alone life of older people, can be caused by separation or death of the partner, but also intentionally. The single life is now a common form in postmodern society.

With regard to feminization, "two-thirds of older people – and among 75-year-olds even three-quarters of women" live alone (SCHROETER 2009: 21). Here it should be borne in mind that there are hardly any extended families in which family members such as widows are integrated. In addition, there is also a changed way of life, the "living-apart-together", the so-called "separate coexistence". Although there is a partnership, there are separate residential and economic communities (cf. SCHRÖTER o. Jg.: 47).

In the final report of the project mobil on the concept of preventive home visits to seniors, one goal is to maintain health and independence for as long as possible. However, there will be "a disproportionate increase in the proportion of people over 80 years of age". This is associated with further challenges for our society, e.g. with regard to normality, integration, participation and lifestyle (cf. GEBERT et al. 2008: 8).

3.2 Socialization in old age

Socialization is the lifelong process in society that shapes our various social roles in life, shaped by norms and values. Socialization allows the individual member of a society to develop his personality and understand the world. This process runs throughout life in three phases.

The primary phase takes place within the first years of life in the family, in which trust but also adaptation to the environment are placed. In the secondary phase, the person usually goes through kindergarten, then school, training or study. The tertiary phase deals with the life of the adult both in the workplace, in society and in the circle of friends.

Socialization is always to be seen in context and never deals with an individual alone. In this way, roles can also change in the course of life, daughter becomes mother and then grandma, employee becomes pensioner. This also changes attitudes and behaviors, also known as retroactive socialization. In the case of older people, sociologically, desocialization is also spoken, i.e. Detachment from social and personal roles. This negative term refers, among other things, to chronic diseases and the need for care. Here, post-professional activities such as hobbies or voluntary work can no longer be carried out (cf. SCHROETER o. Jg.: 18 f.).

During socialization, our understanding and handling of animals are also shaped.

3.3 Successful and productive aging

There are many theories of age that are used for understanding in the gerontological context. Successful and productive aging is just one variant to show this briefly. The two terms are intended to focus on age in a positive way, as today's image of old age appears to be rather negatively colored. Productive ageing sheds light on the social role and benefits. These include, among other things, individual productivity such as independent lifestyle and intergenerative productivity in the form of the exchange of young and old.

Successful ageing is mainly concerned with psychological, physiological and social skills and resources (cf. SCHROETER 2009: 36 f.).

In my opinion, "heteroproductivity" (ibid.: 38) should also be placed in the foreground with regard to healthy and sick seniors, which includes a wide variety of and also voluntary activities. These give meaning and support to life.

Intergenerational work as a task between the generations in so-called young-old groups can be contacts between different age groups and in different projects. From a sociological point of view, this applies to both the micro and macro levels (cf. GREGER 2001: 5).

As initiatives, there are care services such as surrogate grandmas, reading/math mentors or senior expert services by pensioners. Narrative cafes, remembrance projects and walks with dogs can also connect young and old and pass on experiences (ibid.: 67 f.).

The opportunity to support oneself applies to all human levels, both physically, emotionally, socially and mentally. In this way, every elderly person can still experience satisfied and balanced days.

3.4 The health-impaired senior

It is not absent that with higher life expectancy in addition to physiologically changed processes, typical age-related diseases also occur. The elderly person is prone to pneumonia and easier susceptibleness to infection due to a reduced immune system. COPD, heart failure, age hypertension and atherosclerosis are the most common cardiovascular diseases. In gastroenterological diseases of old age, constipation and tumors are the most common. On the musculoskeletal system, arthrosis and osteoporosis are in the first place. But also incontinence, carcinomas and neurological diseases such as apoplexy and Parkinson's disease are among the geriatric diseases (cf. KOCH 2008: 51 f.).

Everyone has their own attitude towards health and illness. The respective restrictions and disabilities are more or less compensated to compensate for the corresponding losses. One's own needs and talents change as a cause of illness. Self-esteem decreases.

Due to the aging process, the body changes, the affected people feel insecure and withdraw, avoid social contacts. Loss of communication and social isolation are thus inevitable (cf. OTTERSTEDT 2001: 73).

This can be very bitter for people, both for the person and in the social environment. New opportunities must be found. Self-esteem is often scratched, one's own perception shifted and values reinterpreted.

3.4.1 General age-related restrictions

On the physical level, strength and mobility mainly drop. Hormone change, medication and a deficient diet can lead to osteoporosis and fractures in addition to poor eyesight, and the risk of falling and tripping is increased.

On the sensory level, there are also deficits in taste, smell, touch and feel. Hearing loss decreases and, along with other impairments, can lead to orientation problems. Age-related diabetes (diabetes mellitus type II) can lead to confusion after insulin administration with insufficient or missing meal as well as fluid deficit.

On the mental level, memory slows down in the form of a slowdown in information processing, coordination and reaction. Occasional forgetfulness is part of old age and is not yet pathological.

These limitations affect the quality of life, which depends on many different factors (Fig. 08).

3.4.2 People with chronic diseases

Long-term ill people are similar to disabled people, regardless of whether they live at home or in a home. They often feel excluded, are significantly restricted and often immobile. Many are ashamed of their symptoms and no longer go out of the house. Thus, psychological withdrawal and social reduction with loneliness and depression are often the consequences. Animals can break this vicious circle. Michael McCulloch, one of the nestors of the human-animal movement, who has studied a lot of information about the connections between animals for the sick and the disabled, said as early as 1981 that there are many clinical indications for which animals should be prescribed. Although they cannot replace a therapy, they can supplement it (cf. GREIFFENHAGEN/BUCK-WERNER 2009: 149 f.).

3.4.3 People with dementia or gerontopsychiatric illness

Gerontopsychiatric disorders are after the triadic system according to Huber exogenous and endogenous psychoses as well as abnormal variants of mental nature (HÖWLER 2007: 91). Depression, confusion, neuroses and schizophrenia are some of the clinical pictures. With regard to the requirements within the scope of my work, I will only deal with dementia. An overview of mental illnesses for old age is shown in the appendix (Fig. 09).

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¹ http://www.bpb.de/nachschlagen/zahlen-und-fakten/soziale-situation-in-deutschland/61541/altersstruktur, Status: 15.04.2014

² http://www.bpb.de/nachschlagen/zahlen-und-fakten/soziale-situation-in-deutschland/61568/lebensformen-und-haushalte, as of 15.04.2014