Strengthening a Palliative Approach in Long-Term Care
Individuals in long-term care (LTC) who are reaching end-of-life have unique physical, emotional, social, psychological, and spiritual needs. A palliative approach to care ensures these needs are being met in a compassionate way that enhances the quality of life, limits suffering and provides needed comfort.
This podcast explores the palliative approach to long-term care through conversations with patients, health care professionals, family members, researchers and others who want to improve how we care for people in long-term care.
Production of these podcasts has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
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Strengthening a Palliative Approach in Long-Term Care
Equine therapy in long-term care: a conversation with Jennifer Semach
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"Sometimes people can really shut down and the horses can get in there and reach in and welcome them back to being present. The horses are gifted. It's all them."
Jennifer Semach is the founding Executive Director and program facilitator of Walkabout Farm Therapeutic Riding Association, a charitable organization in Minden, Ontario that offers free mental and physical health services on 100 acres of land with the help of therapeutic support animals: horses, cats, and rabbits. She also brings miniature horses to visit residents and their families in long-term care.
Equine therapy promotes the physical, neurological, and emotional well -being of all through human and animal interactions.
Learn more about Walkabout Farm: https://walkaboutfarmtra.com/
Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/
Welcome to the Strengthening a Palliative Approach in Long-Term Care Alliance podcast, exploring challenges and best practices and palliative care approaches for individuals in long-term care.
SPEAKER_01Jennifer Semack is the founding executive director and program facilitator of Walkabout Farm Therapeutic Riding Association, Inc., a registered charitable organization in Minden, Ontario, that offers free mental and physical health services on 100 acres of land with the help of therapeutic support animals, horses, cats, and rabbits. Equine Therapy promotes the physical, neurological, and emotional well-being of all by the way of human and animal interactions. Welcome to the podcast, Jennifer.
SPEAKER_02Thank you so much for having me.
SPEAKER_01I'm really excited about this podcast because I think a lot of people are really interested in working with animals and what's involved with that. But I'd like to start by asking you about your journey. What's your background and how did you get started in this type of field?
SPEAKER_02I didn't know that this is the direction my life was going to go in. I went to school for law and security administration. My plan was to become a police officer. And that fell away once we had a child who had special needs. And my husband also being a police officer, it just wasn't in the cards for me to go in that direction. So I started getting interested in youth mental health. And I've worked for the Ministry of Community Safety and Correctional Services with the OPP and for the Ministry of Children and Youth Services at a residential treatment facility for children struggling with serious mental health diagnoses, conduct disorders, addictions. I was also a crisis intervention worker for the YWCA and a firefighter with the Minden Hills Fire Department. So there was a whole mishmash of jobs in there before I got into my adult career. So I did a two-decade apprenticeship at a top-level equestrian facility just outside of Orangeville, where I really learned how to train horses, work with people as an instructor and as a stable manager. And I've been lucky enough to incorporate them into a career working and helping people in the social service field.
SPEAKER_01I think people have a really special connection with horses. Can you talk a little bit about that? What do you think it is that people really respond to horses?
SPEAKER_02Horses communicate and express themselves very much like people. They can display different attitudes and emotions, which make them relatable to humans. And in the company of people, horses can display happiness, stress, trust, worry, and many other moods just like we can. With the ability to convey and read emotions, human can humans can learn to understand horses' sentiments. And horses can communicate nonverbally with humans. And when you take away the fear that may be attached to such a large animal, people can see just a completely different side of this big, intimidating animal and realize that there's a lot of similarities between horses and people and the way that they interact with each other and the way we interact with people.
SPEAKER_01Tell me a little bit about Walkabout Farms. So you mentioned a herd of horses, but I also understand you have cats and rabbits and lots of things going on there.
SPEAKER_02We do have lots of things. So we, for example, have one cat who's about 22 pounds, and he's the laziest cat you're ever going to meet. He's actually TikTok famous. And this guy's like a weighted blanket. So if you have somebody who's, you know, maybe not ready to start working with horses, Sam will curl up on their lap and help ground them so that we can have a talk session. And then bunny rabbits, same thing. Some people are very, very nervous around cats. Well, rabbits take it one step further where they are quite still. They are happy to just be stroked. They have a calming effect as well. So those are the three animals that we work with. This summer I had a family drop in and they had a boy in the back seat. And they said, We have a son who has autism, and they had a place up here that we offered therapeutic variety, didn't know what it was, wanted to know if I can explain a little bit about what we do. And I said, Hey, why don't you hop on out, grab your son, I'll give you guys a tour. And you could see them looking at each other and feeling quite uncomfortable about bringing their son out to meet a stranger in a strange place because autism, there is sensory overload. From the moment his feet hit the ground, he was off running this direction, that direction while I'm carrying on until we got to the rabbit enclosure. And I asked the boy, I said, Would you like to meet one of the bunny rabbits? And he was still for the first time. So I grabbed one of the rabbits and I brought him out. And the little boy was stroking the bunny and he said, Cute bunny. And he's stroking and he repeats it two more times. Cute bunny, cute bunny, and I realized the parents were awfully still and awfully quiet. They said that's the first time he's ever spoken. We've never heard his voice before. On Mondays, we go into long-term care facilities with the horses.
SPEAKER_01I'd like to talk a little bit about long-term care because I understand that you do some very interesting activities within long-term care.
SPEAKER_02My baby. So I developed the recreational equine assisted participation program, REAP for short. And in part because there are higher barriers to participation in long-term care facilities. We took the miniature horses to long-term care to join the recreational therapy team. Horses provide full sensory engagement and spark renewed interest in movement for even the most reluctant participant or resident. Movement through grooming, leading, holding, hugging, or petting the horse activates the autonomic nervous system and releases endorphins brought about by physical activity. And we see the effects just lifting the mood and contributing to a sense of well-being with the people. I cannot believe how well we have been received in long-term care. So not only were we traveling to these facilities on Monday, busloads of long-term care residents come to Walkabout Farm to have the other end of the experience being on the farm, the sights, the smells, the sounds of the farm, the hustle and bustle, the multitude of horses that aren't just our little miniatures that come into their rooms at long-term care. We have the big animals that they can also engage with on the farm. And it has been so well received that it has opened up a whole different realm of possibilities moving forward in long-term care and advancement in dementia care.
SPEAKER_01Tell me about miniature horses. So are they like ponies?
SPEAKER_02They are like ponies. They're just even smaller than ponies. Our two miniature horses that we have are essentially Shetland ponies, but very small in stature. We acquired Sweet P back when COVID first struck, and people found themselves displaced from a farm that they were renting with their 30-plus miniature horses. And because she had had some experience going into long-term care facilities prior to our acquiring her, I thought she would be perfect for our program. She has a companion, Sassy. So Sweet P and Sassy have really made a mark in the community and have loved going into long-term care. The people are so welcoming.
SPEAKER_01That's so cool. So you walk them in, they go visit people.
SPEAKER_02It's we go up and down the elevator.Anywhere I can go, they can go as well. Family members are now coming on the days that they know the horses are coming. Everybody just has so much fun. We have some residents that want to take them for a walk. They can take them up and down the halls with their um their walkers or their walking aides. We can go out in the court courtyard together and walk around the flower gardens and have a great talk. It's just been so nice to see people get up and get moving and interacting and doing things that they haven't sometimes people can really shut down. And horses can get in there and reach in and welcome them back to you know being present. The horses are gifted, it's all them. I just watch them work in awe, and I just can't believe what I'm witnessing every time. We've had two incidences over the summer where Sassy in particular was drawn to two residents. One gentleman had late stages of Parkinson's disease, and he was very sporadic in his movements, and he really loved putting his feet on top of Sassy, and she was drawn to him, even on the days when he was asleep after a few of these visits. He passed away. So I really started to watch her a little bit more and observe how she was drawn to certain people. And we actually had another case of that as well, where she wanted to go into a woman's room who was bedridden, and she would go and rest with her and just keep her head near her face. And she also passed away. And these visits were so important to her. I'm always now more aware of who they're paying attention to, and I can certainly tell when they're leaving the session, when they're indicating that they need to spend a little more time with a certain person for whatever reason they're sensing. It's incredible. I have learned that horses, when they're in a herd, they can synchronize their heartbeats to one another. And they can hear a human heartbeat from four feet away. So when a horse is in a very relaxed state, and if we can bring a person into that environment, you betcha it starts bringing down their blood pressure, lowering their heart rate, helping them feel a sense of calm and at ease. So horses have taught me that there is so much more going on than we even realize. And the scientific community is taking notice. And the more research and studies that are being conducted into why this is happening is going to validate the work that I do and everybody else who is using horses as a tool to help people.
SPEAKER_01A charitable organization is a big thing to take on. And it sounds like you have people coming all the time. How do you manage that?
SPEAKER_02I do have helpers that are all volunteers like myself that come and help me. I never know when we're going to get a donation that will help carry us through. So far, the government funding has been incredibly challenging to achieve. We are persistent. We want to make sure that our organization is very inclusive and we are not going to turn anyone away because they don't have any funding. So across the board, we just don't charge anything for our services. People are welcome to make a donation. Many people do. And if they have their own government funding, then we will tap into those dollars to help offset some of our fees. So, yes, it's been a huge undertaking, but it was very, very important to me that we offer our services at no cost to our participants.
SPEAKER_01What's your favorite part of your work day?
SPEAKER_02I always take time for myself to sit with the cats and drink a cup of tea. That is my morning ritual. I'm listening to the birds, drinking a cup of tea. And then when I can have time to hold space with one of my horses and holding space with them and just really feeling, you know, the energy that they're giving off that day makes me more aware of how I'm feeling as well. Am I truly present? Am I being aware and listening to what's going on around me?
SPEAKER_01How can people learn more about the farm?
SPEAKER_02We have a website. I have put together as much information as I can on what we offer and what we're all about. And it's a good starting point for people to take a peek inside my brain and see what I've got going on at Walkboat Farm.
SPEAKER_01Thank you so much for speaking with us today.
SPEAKER_02I really appreciate the opportunity.
SPEAKER_00You've been listening to the Strengthening a Palliative Approach in Long-Term Care Podcast. For more information about our project, visit spawnltc.ca