Can Equine Therapy Improve Quality of Life in Individuals with Dementia?

At several therapeutic riding centers across the country, horses have been interacting with an unlikely group of visitors  ̶  people with early stage dementia or mild cognitive impairment and their caregivers. Interacting with horses — called equine therapy, horse therapy, and sometimes hippotherapy (ancient Greeks wrote about the benefits of horse riding, calling this practice hippotherapy from the Greek “hippo,” meaning horse) has done amazing things for some of these people, including alleviating depression, anxiety, sleep disturbances, and other challenges affecting their quality of life.

The Connected Horse Project, a program that uses horses to help treat the symptoms of dementia, was initiated by Paula Hertel and Elke Tekin, co-founders of ElderHub and other organizations that provide elder care resources. Emphasizing a “care vs. cure” approach, the program offers participants in the early stages of dementia an opportunity to achieve a better quality of life while living with the neurodegenerative disease.

How the Connected Horse Project Was Developed

To develop the program, Hertel and Tekin partnered with Jacqueline Hartman, co-founder and head facilitator of the Stanford University Red Barn Leadership Program, to create workshops that offer participants a way to interact safely with horses and work on goals such as developing patience, overcoming a fear, or becoming more open to new experiences.

According to Hartman, “a combination of trained staff, horses, people, evaluation, curriculum and methodology helps facilitate collaboration and communication between patients.” Hertel added that “(w)e saw a great need and a great stigma [associated with early onset dementia],” According to Hertel, “the fact that individuals with the disorder have a tendency to isolate themselves indicates that patients need a way to stay connected with purpose and meaning.” Hertel also acknowledged that “(h)orses have the innate ability to pick up on emotions,”

Study Shows Equine Therapy Makes a Noticeable Difference for People in the Early Stages of Dementia

Studies show animal-assisted activities are associated with increased life satisfaction and decreased depression in older adults, including those with and without dementia or cognitive impairment.

One such study was conducted by Dolores Gallagher Thompson, professor of research in the Department of Psychiatry and Behavioral Sciences and director of the Stanford Geriatric Education Center. Seniors ages 70 and younger with a diagnosis of dementia, along with their primary care partners, were recruited to participate in the study.

Participants underwent a series of medical and safety screenings and a verbal interview, since written questionnaires can be difficult to fill out for those affected by dementia. Once selected, they participated in two Connected Horse Project workshops.

All of those involved in running the program said they noticed a clear difference in the confidence and comfort level of the patients by the end of the study. “In a world where people are losing intimacy skills, it’s really important to have the ability to connect,” Hartman said. “Treatment of early stage dementia is usually focused on one or the other [either the patient or the treatment], but in this project, treatment is a journey you [the horse and the patient] are doing together.”

Connected Horse Project Is Helping People with Dementia Throughout the Country

Horse therapy involves interacting with horses in a variety of ways, such as grooming and cleaning, riding, and even just observing them in the pasture.

At one equine center in Ohio, researchers saw obvious signs that the clients enjoyed their time on the farm: they smiled, laughed, and talked to the horses. Even some who normally acted withdrawn became fully engaged in the experience.

Through mouth swabs, researchers at the Field of Dreams equine center measured the levels of the stress hormone cortisol in the patients’ saliva. For participants with less severe dementia, the researchers saw a rise in cortisol levels, possibly due to the “good stress” of being in a new situation (or what psychologists refer to as “eustress,” the type of stress people feel when excited but there is no threat or fear). The therapy also boosted physical activity. The clients all had physical limitations, but when presented with the horses, they were inspired to push the boundaries of those limitations.

Family members reported that their loved ones remained engaged with the experience even after returning home. One commented to researchers that her mother “would never remember what she did at the center during the day, but she always remembered what she did at the farm.”

Local Equine Therapy Program is Under Way in Mason Neck, VA

Since 2017, Fairfax County’s Simple Changes Therapeutic Riding Center in my home neighborhood of Mason Neck, VA, has teamed up with Goodwin Living (formerly Goodwin House), one of the largest not-for-profit senior living and health care services organizations in the national capital region, to introduce residents with cognitive impairment and anxiety to the residents of its farm and stables.

At Simple Changes, up to six people at a time participate in four-week sessions, which include horse identification, grooming, feeding, leading, discussing equine literature, poetry and haiku writing, and making horse treats.

Similar to the experiences described in Ohio, after a session, participants with dementia talk about the horses and often ask to return. Staff acknowledges that these times of engagement typically divert participants from feeling isolated, lonely, or upset, enabling the participants to “come out of their illness” for a while.

Family members who join the visits are often shocked by their loved ones’ responses. In a recent article, about Simple Changes, The Washington Post describes Donald Pepper, 88, who has participated in the program. His daughter describes how it opens him up. “He is much more outgoing after he’s seen the horses, because he wants to tell you what the horses have done,” she said.

Families pay for residents to take part in the program. Goodwin Living has applied for grants to expand the program to other assisted living homes and help provide subsidies for people who can’t afford it.

For more details about the program at Simple Changes Therapeutic Riding Center in Mason Neck, Virginia, please click here.

Planning for a Loved One with Dementia

If you have a loved one who suffers from dementia, it is important to start appropriate estate planning and asset protection planning as soon as possible because those with dementia and their families face special legal and financial needs. If your family is facing a diagnosis of any type of dementia, please call us to make an appointment for an initial consultation:

Medicaid Planning Attorney Fairfax, VA: 703-691-1888
Medicaid Planning Attorney Fredericksburg, VA: 540-479-1435
Medicaid Planning Attorney Rockville, MD: 301-519-8041
Medicaid Planning Attorney Washington, DC: 202-587-2797

Print This Page
About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.