The End of the Partnership With a Guide Dog: Emotional Responses, Effects on Quality of Life and Relationships With Subsequent Dogs.

Guide dogs are mobility aids that facilitate independent travel of people who are blind or visually impaired. Additional benefits imparted to the guide dog handler include companionship, and increased: social-function, self-esteem and confidence. Some evidence shows that the end of the guide dog partnership can result in reduced mobility, and may have profound psychosocial effects on the handler due to feelings of bereavement and loss of self-esteem. However, this evidence is limited. This study examined the experiences and feelings of 36 people across New Zealand, who experienced the ending of at least one partnership with a guide dog (77 pairings), to explore issues arising at the end of the partnership and how this may impact on relationships with subsequent dogs. Results indicate that the majority of handlers experienced a reduction in their quality of life due to a decrease in independent mobility followed by the loss of a friend and companion, curtailment of social interactions, and loss of self-esteem/confidence. The end of the partnership affected people in different ways. Most handlers "accepted" the partnership had ended, but some felt guilty or angry with the guide dog school. Most applied for another dog immediately, as the need for mobility was high, while others preferred to wait and a smaller number did not reapply. Feelings at this time also affected the handlers' relationships with subsequent guide dogs, with over a quarter expressing a negative effect. Retiring a guide dog (for whatever reason) is not only difficult for the handler, but also for the handler's family, friends, co-workers, and doubtlessly, the dog. The majority of handlers expressed feelings of extreme grief when the partnership ended, whether it was successful or not. Feelings of extreme grief were more common for first than subsequent dogs. The depth of emotion was compared to losing a family member or other loved one, which has been reported in some person and pet relationships. A better understanding of issues surrounding the end of the partnership, including the human-animal bond, will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog users and the pet owning community.

An Investigation of the Complexities of Successful and Unsuccessful Guide Dog Matching and Partnerships.

Matching a person who is blind or visually impaired with a guide dog is a process of finding the most suitable guide dog available for that individual. Not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may result in reduced mobility and quality of life for the handler (owner), and are costly in time and resources for guide dog training establishments. This study examined 50 peoples' partnerships with one or more dogs (118 pairings) to ascertain the outcome of the relationship. Forty-three of the 118 dogs were returned to the guide dog training establishment before reaching retirement age, with the majority (n = 40) being categorized as having dog-related issues. Most (n = 26) of these dogs' issues were classified as being behavioral in character, including work-related and non-work-related behavior, and 14 were due to physical causes (mainly poor health). Three dogs were returned due to matters relating to the handlers' behavior. More second dogs were returned than the handlers' first or third dogs, and dogs that had been previously used as a guide could be rematched successfully. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches, suggesting that some handlers were retaining what they considered to be a poorly matched dog. Almost all the handlers who regarded a dog as being mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor working behavior may have shown good home and/or other social behaviors. The same principle was true for successful matches, where few handlers claimed to have had a perfect dog. It is hoped that these results may help the guide dog industry identify important aspects of the matching process, and/or be used to identify areas where a matching problem exists.

Riding into the future: a snapshot of elderly mobility scooter riders and how they use their scooters.

AIM: The purpose of the study was to understand the typical mobility scooter rider, how they use their scooter and the role it plays in their lives. METHOD: A 30-item purpose designed questionnaire was used to collect data on rider demographics and mobility status, reasons for purchasing and using a mobility scooter, patterns of scooter use, and the role it plays in the individual's life. Riders aged 65 years and older were recruited from the wider Dunedin community. RESULTS: Thirty persons (15 males and 15 females) aged 65 to 90 years participated. Most experienced walking limitations with only 5 participants able to walk further than one block. The majority (80%) purchased their scooter to address their walking limitations. They had owned a scooter for a mean of 4.4 (range 1-19) years and most had purchased it privately without the input of a health professional. The majority of the group used their scooter 2-3 days per week. CONCLUSION: This study provides a snapshot profile of mobility scooter riders and how they use their scooters to increase their mobility within the community. This information is useful for service providers and planners working towards providing services and infrastructures for the aging population.

Carbon dioxide insufflation during colonoscopy: a randomised controlled trial.

AIM: To determine if carbon dioxide (CO2), insufflated during colonoscopy reduces pain experienced by patients post colonoscopy compared to air. METHOD: A randomised, double-blinded, controlled trial with 205 consecutive consented patients referred for elective colonoscopy was undertaken at MidCentral Health Gastroenterology Department. Patients were randomised to colonic insufflation with either air or CO2. A comparison of reported pain was undertaken using a 0-10 point numeric rating scale at several time periods; intra procedure, 10, 30, and 60 minutes post procedure. In addition groups were compared on the proportion of participants reporting 0 pain levels at each of the same time periods. RESULTS: CO2 insufflation was provided to 108 patients and air to 97 patients. No differences in mean pain scores or the proportion of those who report zero pain were found between the groups intra procedure. However, those who received CO2 insufflation were found to have significantly lower mean pain scores (p<0.001) and to have a significantly greater proportion of persons reporting 0 pain scores (p<0.001) at all three observation times post procedure than those who received air. CONCLUSION: Those receiving CO2 during colonoscopy experienced less post colonoscopy pain than those who received air insufflation. Carbon dioxide should be considered as the insufflating gas during colonoscopy.

The impact of mobility on quality of life among older persons.

OBJECTIVE: The purpose of this cross-sectional study was to determine the extent and manner in which mobility is related to quality of life (QOL) in a representative sample of older adults. METHOD: Two models were assessed using structured equation modeling. The first hypothesized that mobility would have a direct effect on QOL along with other variables, including; number of health conditions and satisfaction with functional capacity, life essentials (e.g., transport, access to health services, and conditions of living space) and personal relationships. The second hypothesized that mobility would have its greatest influence on QOL through satisfaction with functional capacity. RESULTS: While both models found that mobility and all three measures of life satisfaction were significantly associated with QOL, goodness of fit indices were higher for the second model. DISCUSSION: The findings from this study suggest that mobility interventions designed to enhance QOL should address satisfaction with functional capacity as well.

The effects of staff education on the practice of 'specialling' by care assistants in an acute care setting.

This paper reports the results of a project aimed at decreasing the use of, and costs associated with, the practice of using care assistants to provide one-to-one observation or 'specialling' in five acute adult medical and surgical wards at a North Island hospital. Education sessions were provided to staff to prompt better management of patients receiving this level of observation. Using a time-series design, a retrospective study was completed for the six months pre- and six months post-intervention (staff education). Data were collected and analysed on all patients in the five acute wards who had required 'specialling' during the specified twelve-month period. Results showed that following the intervention there had been a reduction in the incidence and duration of 'specialling,' and a halving of costs associated with this practice. The findings have implications for patient management and cost effectiveness. Incident statistics were not retrospectively reviewed in this study.