Equine-assisted services have become a popular and effective way to support people with physical, cognitive, emotional, and behavioral challenges, including PTSD, anxiety, depression, autism spectrum disorder, grief, and substance-use recovery.
However, incorporating horses to help older people suffering from Alzheimer's disease, Parkinson’s, Dementia, or those who have suffered traumatic brain injuries, is less common.
“I believe the geriatric population has been underserved because the risks have been not really considered in a strategic way. People worry about them tripping at the barn, or getting stepped on by a horse,” said Saly A. Glassman, president and director of the Kindle Hill Foundation in Blue Bell, Penn, which is a USEF Community Outreach Organization.
However, the benefits of equine-assisted services for these groups are insurmountable.
One of the symptoms of Parkinson’s is a depletion of dopamine, as the disease causes nerve cells in the substantia nigra — the part of the brain that produces dopamine — to slowly die off or malfunction.
“Dopamine is something we need in order to feel good, to be motivated, to carry on, to fight challenges. It's sort of our own little fulfillment genie,” Glassman said. “If a person is dopamine depleted, but they can help a horse do a modest task like putting their nose on a cone or walking backwards, then that creates a dopamine hit, especially if managing their own body and memory is a daily struggle. Their dopamine is low, their expectations are low, but they achieve something they couldn't even imagine being able to do.”
Neurologist Dr. Stephen Peters explained that dopamine is part of the brain’s reward and learning system. In horses, moments of relief, comfort, or connection can help reinforce learning, while people may also experience reward-system activation through positive interactions with horses.
“The real beauty of it is that interactions like these advance the human, and they advance the horse,” Glassman revealed. “We are helping people generate their own dopamine, making themselves smarter, and also making the horses smarter.”
Glassman realized that there are few equine-assisted programs serving the elderly and people with traumatic brain injuries, so she launched a program at Kindle Hill. “We want to serve as many people as we can, including this population of older adults, and people with traumatic brain injury or cognitive dissonance,” she said.
“To understand the deterioration of the brain, you have to be strategic about how you're relating to people,” said Glassman, whose mother is challenged by Parkinson’s disease. “One of the ways we know that can stimulate the brain to work better is through memory. When we're working with somebody who has Parkinson's, Alzheimer's, or has had some cognitive dissonance, we bring up things from the past such as by telling one of our own stories from childhood, then asking if they remember anything similar ... you get people talking and they're petting a horse while they're doing that.”
Glassman explained that people with cognitive impairment often have excellent long-term memory, but poor short-term memory. “By talking to them and asking questions about past events, you can gradually bring them to the present,” she said. “It stimulates their mind, and all the time they're in the magnetic field of the horse, so their blood pressure, heart rate, and cortisol levels are lower, and they're beginning to feel very relaxed, and they're really talking.”
Another technique they use at Kindle Hill is music, because music and lyrics are stored in a part of the brain that is not usually affected by strokes or traumatic brain injury. “You can get people walking or stroking a horse, while singing along to their favorite music on Bluetooth,” Glassman said. “Oftentimes they’ll immediately recognize performers from their era like Frank Sinatra or Henry Mancini. You connect their memories of that time with the music, and it stimulates the other side of the brain.”
You don't really focus on the horse per se, she explained, but the horse is like a buffer or an assistant. “If the person stalls or gets confused, then I jump in and start telling them facts about horses to help them refocus,” she said. “On their own, they're not going to just think about these things. You have to turn the key to make the engine go on, then often they’ll start asking questions about horse anatomy, behavior, or evolution.”
Glassman said that the older people get, the more likely they are to feel a sense of hopelessness, asking themselves: “Did anything I did mean anything? What is the point?” This can sometimes make them give up and feel like they no longer have a purpose.
“For many people, their job is their identity, then they retire and they don’t have that anymore. As they get older, they have less power over their body, and over their circumstances,” said. “They lose a loved one, they lose their pets, and they just basically watch everything they ever cared about being taken away. They often think that it’s not fair that their husband died, or they had to sell their home, but that is not the way a horse looks at things because horses know how to accept that life isn’t fair.”
Glassman currently has three cognitive-related groups at Kindle Hill: one for people with Parkinson’s and movement disorders; one for those with traumatic brain injuries and cognitive dissipation; one for anyone challenged by cancer. All the work is conducted on the ground, with a wide selection of horses ranging from retired ponies to show jumpes to Third Level dressage horses.
“Often, they are working with a horse who is still in competition. It's an assortment, and I'm careful about who goes with whom because we're closely supervising them,” said Glassman, who focuses on groundwork with clients. “When the horse is on the ground, it's free to be in an autonomous relationship and the horse has independence.
“It's about actually experiencing the horse as a sentient individual who has thoughts, feelings, and opinions, and letting them have agency,” she continued, explaining that if a person brings toxicity, hostility, or ill will, then the horse will not be judgmental, but will react by asking for space.
Kindle Hill has elder visitors from nursing homes, retirement communities, respite care, and YMCA groups. They will occasionally also take ponies to a nursing home to visit residents.
“We want to show that equine assisted learning can have a big impact on somebody who is older, has cognitive impairment, is dealing with a traumatic brain injury, or even somebody who's having trouble with their balance,” Glassman said. “If you have vertigo, it’s difficult to do anything. Actions like learning to groom with one hand or standing on one leg can help you rediscover your proprioceptive awareness.”
June is Alzheimer's & Brain Awareness Month. For more information on Alzheimer's, brain health and all forms of Dementia, please visit alz.org.