Caregivers

[jean]

I work with Ken who has a TBI and is in a wheelchair with limited mobility and speech.  Ken's team hired a trainer to work with Ken and a dog.  Sophie joined Ken in March and it was great until Ken's caretakers did nothing to assist him with the dog.  Sophie began to take control and the team had Sophie taken away.  The trainer is looking for another dog for Ken.
I'm very upset about the lack of help Ken receives from his staff with a dog.  Am I being unrealistic?

[Kirsten]

I'm not sure what kind of help you're talking about.  Generally, it is not the caretaker's responsibility to care for the dog.  They shouldn't be damaging the dog's training either, say by playing with it or feeding it treats.  However regular caregivers, like the kind that come in and clean the house and help with personal care issues like bathing, are not responsible for taking care of the dog (feeding it, walking it, etc.).  They might reasonably be asked to help, say, fill a dog food dispenser the client can then operate so he can feed his dog, but not be required to feed the dog themselves.  If they do give extra services like that there would probably be mention of it in the contract.

Part of service dog ownership is stewardship.  If the person isn't able to clean up after the dog, then they can hire a service to do it, but in general, in order for the relationship to work, the handler has to provide the bulk of the care for the dog.  If he does not, the dog will not bond properly and will not obey him reliably.  One central responsibility is feeding the dog, but he should also exercise and groom the dog as well in order for their relationship to work properly.

Dogs operate in a hierarchical society.  The one who provides for the dog is also the one who controls the dog's behavior because that person is the leader.  If one person does all the providing, that person alone will probably be recognized as the leader and obeyed, especially if the non-provider is in no position to enforce his will on the dog, say by removing privileges or blocking the dog from reaching something.

Leadership is a three pronged affair:
1.  control of resources (such as food)
2.  control of behavior (such as who gets to decide who may be on the bed and when)
3.  stewardship (providing for the needs of the dog)

If any one prong is missing, then the person is not a leader and probably won't be respected or obeyed reliably.

[jean]

Hi Kristen:

I think that is what happened.  Ken has 24/7 providers.  He lives in his own apartment, his wife has the apartment next door, and the providers are in a community room a couple of doors down.  Ken can do things for himself, but with more and more seizures and hand tremors, he has been having more trouble taking care of himself.  There are many things he can do, such as feed his dog, groom the dog, take the dog out to the bathroom, etc, but with reminders.  He can't scoop poop as he can't be in the wheelchair on the grass and bend down, but his wife picks up the poop and Ken holds a bag open and then puts the bag in the dumpster. Bonding was great, as the dog was by Ken's side continuously.
The trainer had asked that staff work with Ken on teaching the dog to pick up items, etc. She also recommended one staff person volunteer to work with Ken and the dog. 
It was the provider agency's supervisor that recommended the dog for Ken, so the staff were to help with the care of the dog.
 

[Kirsten]

If he is not able to follow through with the training on his own, isn't it time to get a dog from a program?  Again, it isn't the providers' responsibility to help train the dog. 

A program dog would already be task trained and would know how to walk correctly on a leash.  That would resolve the two problems you've mentioned.

[Roxie]

Yes, Jean. You ARE being unrealistic. In many areas.

From your description, Ken may be too impaired at this point in his rehab. to benefit from a SD.

I know: that sounds cold.

This is what I understand from your posts and topics in other posts: Ken does not make decisions on his own. Ken is not able to care for himself independently. Ken has an abundance of specialized care givers 24/7 including a spouse.

It is my professional opinion that you are barking up the wrong tree. I believe the best choice is a Companion Dog that will do simple tasks (retreive, come, sit, catch, get it, stay, wait, back, no, drop it, give, pull... all very simple but engaging and useful)

I don't get the feeling that Ken needs more at this point that a pet he can bond with and enjoy the confidence building and therapeutic benefits of feeding, watering, kenneling, walking, playing with dog, and grooming/bathing the dog. He could use a small breed and experience very close and personal interaction with a dog! Maybe even a parrot! Maybe even just a really great cat!

Whose dream of having the SD is it? It sure doesn't seem to be his team! I don't get any feeling from your posts that Ken is the spearhead for this adventure. What are Ken's dreams and wants?

A dog will have a doozy of a time with the varied and transient caregivers. It won't bond with the person whom it is being purchased and trained to do work for. In order for Ken to be safe having/using a SD - they MUST bond very closely. The scenario you describe totally will prevent that from happening. Who will be legally and financially liable for Ken who may become injured (fatal is always a possibility)
as a result of the negligence you are creating while putting a SD in his life?

This situation really begs to be reasessed with more clearly defined goals, plus at least 3 trainers putting in a bid on training. From all you have said, I have no sense the trainer knows what she is doing.

Roxie

[jean]

Thank you for your input and honest opinions. 
Let me give you more background on Ken's situation.

Ken was hit by a car when he was 8 - he is now 27.  He does not have use of one side of his body and is in a wheelchair.  He comprehends, but has trouble expressing himself and has menory problems.  He does live on his own with a provider agency and his funding is through a Medicaid Waiver.  Ken's mother put him on the waiting list with Canine Companions.  When Ken and one of his providers attended the training, they said the provider was not consistently attending the training and Ken could not remember commands.  He was discharged from the Canine Companion program.

A few years later, the owner of the provider agency was accompanying Ken to a doctor appointment and talked with patients who had service dogs in the waiting room.  The owner took on the quest of looking into getting Ken a seizure dog.  A private trainer was hired with no contract and she was paid through the Waiver.  It was agreed that if a dog did not work out another dog would be found free of charge.
(The trainer said that you could not train a dog to detect seizures.)

I told the team that Ken would not be able to care for a dog and that his staff would have to help.  The owner of the provider agency assured everyone that staff would help.  Staff started out fine, until the owner wasn't around and yes, the dog did start to rule.  The dog barked at night when the staff went in to check on Ken.  The dog was a lab/hound mix.  She started to growl at a staff person and was taken from Ken.

I feel the dog was set up to fail.  I wrote a letter to the team that Ken could have the most perfectly trained dog and he would still need much help from others.

It sounds like a companion dog with simple training would work better.

[hopesclan]

I agree with your analysis.  CCI is a reputable program and if they determined Ken was unable to manage a dog, I would go with their findings.  I question of this would even be a good set up for a companion dog even.  May I suggest a cat?  Cats are MUCH easier to manage (well, they manage themselves), no need to remember commands (well, because the cat wont listen) and excellent companions.  They don't need walks or potty outings (litter box does need changed so make sure that basis is covered).  Best bet would be to work with a cat rescue to find a loving, mature, not too skittish cat.

We have to remember the home care workers are under trained, under paid, and filter in and out of the job like crazy.  Dogs really can't handle that amount of change in their primary caregivers and manage.  Personally, I can't handle that amount of change and would be much healthier if my caregivers were reliable and constant.  Primary care and control of a service dog is not at all something I would entrust them to.  They are not bad people, but generally not going to commit to the life of a service dog.

Frankly it bugs me that the trainer is working to place another dog after this failure.  All elements need to be evaluated so there is a set up for success, and it doesn't sound like that is happening.

[Roxie]

I totally agree with the cat idea!

Ken could get much therapeutic (emotional and physical) value from a cat.

But please: let him make the choice of which cat.... let him experience the pride and rewards of decision making.

I would check out the cats without Ken, and tell the shelter people what kind of cat is needed and for what purpose.

Roxie

[Roxie]

One more idea..... does Ken like to watch fish? They are quite rewarding too. Fish have personalities and a sense of humor.

Roxie

[Spectrum]

Fish are wonderful if you're up to it. Fish are what kept me sane the two years I lived on campus. They're not cuddly, but they're another living being. I don't know what I would have done had I not been able to have at last fish those two years.

Cats are great too. They're awesome stress relievers, which is why we have to at work 

[responsiblek9]

 
Yea I loved it when I had the blue and purple guppies in a 55 gallon tank. Kinda neat and fish WILL chase a laser pointer.. Gets interesting!

[state_of_nowhere]

I love Roxie's idea. Definitely tell the shelter what kind of personality you're looking for (I would go with an older cat, not a kitten), and maybe have them put those cats in a separate room. Then he can pick which cat he'd like. A "lap cat" would probably be perfect.

[Roxie]

I only know the snipets you have posted about Ken. I don't know who is making his decisions... and how active his treatment team is in being innovative with his rehab.

I'd like to suggest to you (as his advocate) some really important suggestions.  Work as hard as you canto increase his self esteem, pride, and sense of control over his environment.

So many times caregivers don't take the time to do these things because of laziness, ignorance, disinterest, transience of the job. By these actions they keep a person dependent and disabled.

Simple choices and preferences need to be provided daily and consistently. Perhaps over a few years learning to be more independent this gentleman just MIGHT be able to have a "SD" of sorts.... with the right supports from his care/medical team.

State's suggestion on how to stage his selection process to yield success is excellent. Screen several cats and let him select from the pool of good candidates. And ditto on NO kittens! A good old Garfield fat cat who rules from a laying down position!

As far as caring for the cat.... Ken will have to take some responsibilities toward the stewardship. Even if it is only opening a bag, or giving the cat a treat, or filling the food dish.

Also, Ken can make some cat toys and interact with the cat using his creations. Guided of course. But the whole point is the creativity of making something fun/useful, and seeing the enjoyment and silliness of the cat.

I have always "snuck" boring and hard physical and occupational therapy and problem solving - decision making skills into play activities and lots of laughing. It can take a tad of time.... but yields such miraculous results!

Roxie

[jean]

Thank you for all of your suggestions.  Ken has his annual "plan" team meeting in a couple of weeks and I will use much of your input.  You helped me face the facts!

Sounds like Ken is too impaired to have a service dog.  He could use a companion dog or other pet.  A stray cat came to his apartment last year and his wife has the cat.  It is skiddish but will climb up on his lap when things are quiet.  The only problem with the cat is that it is at his wife's apartment so it doesn't get outside and run off.  Ken needs to leave the apartment door open long enough to drive his wheelchair out the door and then turn around and shut the door.  Also, with staff in and out, the cat sneaks out.  It will eventually come back, but it freaks Ken's wife out.
Fish are a good idea, but then again, staff will need to help with the cleaning of the tank.

I agree with with your opinions of his caregivers.  They are underpaid and get no respect.  The good ones do not last long.  Ken does not like his staff as he is frustrated that he has to have them.  (It isn't anything personal against them)

I would love to see Ken have a pet as he could really use someone that loves him unconditionally and that he feels empowered by taking as much care of the pet as he can.

I will go to his team and see what we can come up with.