Animal-assisted interventions can have specific therapeutic goals of improving physical or cognitive functioning, or they can provide general “opportunities for motivational, educational, recreational, and/or therapeutic benefits to enhance quality of life” (Morrison, 2007). Although the most popular animal-assisted interventions involve companion animals—usually dogs, but not always—visiting residents in a care home or patients in a hospital, where they are encouraged to pet and quietly interact with the animal for a time, some of the most interesting new modalities of animal-assisted activities allow patients to be more involved in the lives of their therapy animals.

Another new approach to animals as partners in therapy involves bringing in fellow patients, family, caregivers, and the local community to a wide variety of activities that have the therapy animal as a focus. Teaching others about the animal, engaging in creative activities with the animal as a starting point, even participating in showing and selling animals can allow patient groups to connect with the community in new ways outside of the therapist-client paradigm. Having more opportunities to form relationships and have experiences as an integrated part of society is beneficial for seniors’ mental and physical health (Umberson & Montez, 2011).

HenPower, a program from the U.K.-based nonprofit Equal Arts Foundation, aims to cover both of these innovative goals for animal-assisted interventions in a senior care setting. The core of the HenPower project brings a coop of chickens into a care facility for a volunteer group of residents to look after.

We asked Douglas Hunter, co-director of Equal Arts Foundation, to tell us more about the HenPower program. Here’s what he told us:

“HenPower is a relationship-centred approach to improving the lives of older people, involving hen-keeping and creativity as a catalyst to reduce loneliness and increase social relationships. This is a very different ethos and approach from pet therapy or animal-assisted therapies, where the emphasis is on the relationship between the individual and the animal.

HenPower is currently delivered in a range of sites including community centres and schools but mainly older people’s residential care settings and specifically dementia care settings. Hen-keeping can be a communal activity where numerous participants are able to contribute in different ways and an onerous burden of responsibility is minimised and shared. Hens are very characterful, largely independent and generally low maintenance. Participating older people can spend a great deal of time with their hens or just as and when they are able to. A flock of free-ranging hens in the garden of a care setting is also a visual spectacle for the occasional observer from the lounge or dining room window. This shared ownership and responsibility is different from having a cat, dog, guinea pigs, or rabbits, etc., although HenPower projects often do grow and diversify into care staff having the confidence to keep other pets which may meet the needs of specific older people.

HenPower started when an older man was having respite care in a dementia care setting and talked of missing his friends with a list of female names. He also briskly made for the door at specific times of day. It turned out that his female friends were his hens, and he wanted to go outside to feed, water, and collect eggs throughout the day. The daily routines of hen-keeping can offer older people purposeful routines and positive distractions throughout the day when otherwise the hours might merge into monotony, lack of purpose, or depression.

Additionally, hen-keeping can be used by care staff as a diversionary tool to reduce agitation or challenging behaviour. It can also offer a different conversation when relatives and visitors arrive. Many older people have said how many more visitors they get since having hens, and especially from grandchildren.

HenPower is also a great vehicle for improving community cohesion through cross-generational working. Particularly working with primary schools, but also a range of other community based organisations, offers the stimulus, curiosity, and focal point for creative projects from gardening to local history.

A sense of purpose and ownership is also engendered and expanded initially through income generated through donations for the eggs, to designing and making aprons or gift cards for sale and growing into income from presentations at conferences, events, university or adult social care training.  Each individual project can feel empowered whilst feeling part of something across their community, across the U.K. and even being part of a global movement.

The HenPower programme has been underpinned with robust research undertaken by Northumbria University using recognised scales to measure reductions in loneliness and depression amongst participants as well as increased well-being.  We’ve assessed cost benefit analyses with Connell Consulting for the care provider in terms of reduced staff attrition alongside increased occupancy in addition to reduced use of antipsychotic medication.  Sheffield University is currently seeking funding to further strengthen the evidence specifically around the benefit for older people living with dementia in care settings.

Equal Arts as the charity which oversees HenPower has a strong track record in developing training for the creative ageing sector; we‘re keen to ensure care staff, artists, and participants have access to a range of appropriate training. This equally includes best practices for animal husbandry within care settings as much as supporting the Imagination Model of engagement within dementia care settings.

In a five-year period, HenPower has grown from a small pilot scheme to projects across England, Europe, Taiwan, and Australia.  The success factors are multiple and varied, but simply HenPower continues to meet a need amongst older people and offers other people an easy way to achieve this too.

Does HenPower work? How can we tell?

After a pilot project, HenPower was evaluated by a team of researchers from Northumbria University, led by Professor Glenda Cook. She and her team took both quantitative and qualitative data to assess the impact of HenPower on the mental wellbeing of senior residents of a care facility, particularly focused on depression and loneliness. The full report, “An Evaluation of ‘HENPOWER:’ Improving Wellbeing & Social Capital in Care Settings,” can be found here.

The team found that quantitative data they took—validated questionnaires measuring wellbeing, loneliness, and depression—didn’t show much change in the participants’ scores from before and after their involvement with the project. In contrast, the qualitative data from talking to the participants about how they interacted with the project suggested the participants felt that they experienced a variety of benefits. This raises some interesting questions about how we measure the effect of animal-assisted therapy on patient groups, especially long-term interventions and populations with complex needs. We asked Professor Cook to explain more about her results and what she thought about HenPower.

What first brought HenPower to your attention? What did you think when you heard about it?

In discussions with the Equal Arts team about what to evaluate and potential approaches, I thought it was a novel intervention for addressing isolation and loneliness, particularly in older men. For the older male generation, hen-keeping was something familiar to many who would have kept hens in the past. I was familiar with the idea of men’s sheds that was being implemented in Australia and how effective these were in increasing social networks for those who were becoming increasingly isolated.

Why do you think HenPower project was particularly successful in engaging older men?

Hen-keeping is something that is familiar to many older men. HenPower is more than hen-keeping. There are opportunities to design hen sheds, manage the financial aspects of the project, give presentations, and so on. In other words, there are different roles for a range of interests and talents.

Did participants learn about welfare and enrichment?

This was a key aspect of learning for some, whereas others had run hen farms in their younger years. Even those with knowledge and experience learned more, for example the needs of particular hen breeds, how to care for those breeding, dietary requirements, etc.

Why do you think the baseline follow-up for the DJG Loneliness Scale didn’t show any significant change?

The participant numbers were small, and this may have affected the outcomes. Also participation in the programme certainly increased networks and social contact, but other major issues in the participants’ personal networks were not influenced by HenPower. For example, further deterioration of a partner with dementia could not be changed, or death of siblings could not be influenced by HenPower. These circumstances did occur during the evaluation, and they certainly increased the loneliness that participants experienced. The qualitative data certainly highlighted the positive effect of the programme, and this needs to be considered alongside the quantitative findings.

Conclusions

Small numbers of participants, plus seniors in a care setting being a group that is particularly vulnerable to experiencing illness, the death of loved ones, and other causes of depression and loneliness that no amount of animal-assisted intervention can help with, are both contributing factors to the difference between the qualitative and quantitative data in the initial evaluation of the HenPower pilot project. These are issues that the research around animal-assisted interventions of all types face, which makes designing studies to test their effectiveness particularly difficult. It is also a potential barrier to future funding, as many grant-making organizations require quantitative data demonstrating effectiveness and value for money (Minocha et. al, 2015).

There are plans for a larger-scale evaluation of the HenPower project in the near future, now that it is out of its pilot phase and has attracted a lot of attention from the media and other organizations wishing to implement something similar in their own communities. More than 40 care homes in the United Kingdom are now running a HenPower project,

HenPower is an example of a creative program that specifically seems to appeal to an underserved patient group—older men—and has scope for a variety of different ways to engage with the animals and the community. As Professor Cook points out, it’s important to look at both the numbers and the experiences of people directly affected by the project when deciding whether a program has had a positive effect.

The Hen Men vimeo play

References

Cook, G. et. al (2013). An Evaluation of ‘HENPOWER:’ Improving Wellbeing & Social Capital in Care Settings.

Minocha, S., et. al (2015). Social isolation and loneliness in people aged 55 and over in Milton Keynes. The Open University, Milton Keynes, UK.

Morrison, M., (2007). Health benefits of animal-assisted interventions. Complementary Health Practice Review 12(1), pp. 51-62.

Umberson, D. & J. K. Montez (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior 51(Supp.) s51-s66.