Horse therapy could help people cope with early-onset dementia

by Holly MacCormick | SCOPE, Stanford Medicine Blog

As a kid growing up in rural Minnesota, I spent many of my waking hours searching for a reason to be near the five horses that roamed the 40 acres behind our house. Their methodical munching and tail-swishing put me at ease and learning how to ride a 1,200-pound animal that could easily wipe me off on a fence post taught me much of what I know about courage and persistence.

A similar sense of calm, accomplishment and fortitude are among the potential benefits of a new pilot study at Stanford University’s Red Barn called the Connected Horse Project. This project aims to help people learn how to manage the symptoms of early-stage dementia through a series of workshops where they participate in supervised activities with horses.

The project is the brainchild of Paula Hertel, Nancy Schier Anzelmo and Elke Tekin, three senior care practitioners and equestrians who work at the Senior Living Consult. For this study they worked with Stanford’s Dolores Gallagher Thompson, PhD, and Nusha Askari, PhD, and Jacqueline Hartman at the Stanford Red Barn Leadership Program.

In the pilot study, five individuals and their care partners participated in a three-week workshop. The study measures the workshop’s effect on the participants’ stress levels, their quality of sleep and their ability to relate to and communicate with others. The results will be presented at Stanford’s Annual Community Health Symposium on Jan. 14 and will be used to develop programs that can be implemented throughout the country, including in rural areas where support services are often lacking.

Hertel and Schier Anzelmo told me more about the program and its potential applications in an email interview:

What prompted you to start the Connected Horse Project?

A shared passion is the simple answer. We are practitioners in senior care and know firsthand that traditional models of care are not adequate. We have also experienced the power of the human/horse connection on a personal level.

Why horses? Do you think a program that pairs humans with dogs or cats could work as well or in the same way? 

Many of us smile when we think about our favorite dog or cat, or in my [Paula’s] case, my first pony. Interactions with animals spark emotional memories that stay intact. Horses can be particularly therapeutic for people because they have an innate ability to sense what others around them feel; they depend on the herd for survival.

In the workshop, the equine facilitators guide the participants through activities that showcase the horses’ characteristics and abilities. This helps the participants recognize their own strengths and the power of their relationships with others.

Was there anything unexpected that you learned or observed as participants during first set of workshops?

A pleasant surprise for us was how quickly the participants developed trust with each other. The sense of community and trust was palpable. One participant said that she left with hope and a sense of encouragement; that she could walk this journey and be ok.

In your opinion, what are some of the biggest benefits of a program like this helps people living in rural areas where they lack access to organized services for dementia?

All people want to feel connected to a community. They want to feel love, experience a sense of presence and be part of a meaningful partnership. This program encourages just that. There are about 9.2 million horses in the United States and 2 million horse owners. We believe people and their horses can and want to be of service to their communities.

What are your future plans for the project?

We worked with amazing group of Stanford University professionals, volunteers and horses, and with the help of our donors and colleagues in the assisted living industry we made this dream a reality. Our pilot study shows promising results for all participants. Our next steps include looking for additional resources to develop training material, securing additional equestrian sites and securing funding for new programs.

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Innovative Dementia Research by UC Davis and the Connected Horse Begins

by Pam McDonald | Senior Housing Forum

Senior living dementia care experts Nancy Schier Anzelmo and Paula Hertel created an innovative research approach to explore how guided work with horses might improve the quality of life for those affected by dementia, especially those with an earlier onset diagnoses. They founded the Connected Horse, a nonprofit organization, to continue this effort.

Initial results from their pilot study conducted with the Stanford School of Medicine and its Red Barn Leadership program were very promising — virtually all participants scored significantly higher for social support, better sleep quality, and decreased anxiety and depression. But the impact on participants went much deeper. To illustrate Paula and Nancy shared Maria’s story:

Maria, a quiet woman, who for years advocated for the underserved until the effects of her dementia forced her retirement, walks slowly into the barn with her care partner.

The large bay horse named Axle pops his head over the stall door to greet the strangers. As Maria approaches this horse, at least 10 times her weight, he looks at her and she looks at him.

The workshop facilitator, who knows the power of the human-horse connection, brings them closer together. In only a few steps they are face to face. Axle unhurriedly leans sideways to rest his head on Maria’s shoulder and breathes.

The barn is silent. Maria is motionless. Then she smiles and for that moment it is okay that she can no longer speak. Pure joy fills the barn.

Beginning this month, Connected Horse will be gathering valuable comparison data to its Stanford study as the University of California, Davis’ research gets underway. Nancy and Paula are recruiting participants to continue testing their hypothesis that facilitated activities with horses focusing on verbal and nonverbal communication, self-awareness, self-regulation, and mindfulness might enhance those skills for individuals with dementia and their care partners.

Dementia has become more prevalent today – projected to adversely impact one in four individuals and their families as Baby Boomers age – but there is a lack of non-pharmaceutical interventions for enhancing the quality of life of those with dementia. Paula and Nancy are interested in developing additional approaches that are sensitive to the psychosocial needs of both the diagnosed individuals and their care partners/caregivers.

The two women were invited to present their findings at the Stanford School of Medicine symposium in January and the Alzheimer’s Association’s International Conference in Toronto in July. They will also be presenters at the Gerontological Society of America (GSA) conference coming up next month.

In addition to research, Connected Horse is developing a how-to guide and searching for other equestrian sites and partners to implement their program. They also continue seeking funding through the Connected Horse Campaign.

Learn more about the Connected Horse by clicking on the links below:


This article originally appeared in the Senior Housing Forum blog.

OFF TO THE RACES — Groundbreaking “CONNECTED HORSE” Pilot Project Launched

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They’re off! The trailblazing Connected Horse Project got underway this week, testing whether guided engagement with horses might strengthen the trust, cooperation and communication between persons living with dementia and their care partners.

The pilot study is the brainchild of Nancy Schier Anzelmo and Paula Hertel who coordinate the project under the guidance of Stanford University in Palo Alto and in conjunction with Stanford’s Red Barn Leadership Program.

“We wanted to develop a program to support those with dementia (especially those who are “young” at onset) and their care partners – spouses, adult children, other relatives, and friends – as they begin living with this diagnosis,” Paula stated.

“Over 5.3 million Americans (200,000 of whom are under the age of 65) are living with Alzheimer’s disease or other forms of dementia and that number is expected to grow by 40% over the next decade.”

Dementia is a term that describes a wide range of symptoms of progressive brain diseases, such as Alzheimer’s or Parkinson’s, that are characterized by a decline in memory, judgment, and other thinking skills that reduce a person’s ability to perform self-care and everyday activities.

Nancy is founder and principal of Alzheimer’s Care Associates, headquartered in the Sacramento region. She is also a gerontologist and member of the Gerontology faculty at California State University Sacramento. Paula holds a master’s degree in social work. Her consulting business, Senior Care Consult, is headquartered in the San Francisco East Bay Area.

The women are long-time friends and colleagues. They have advocated for quality care for those with dementia as consultants to the senior living industry for over 20 years. And both are avid equestrians.

“As equestrians,” Nancy noted, “we know there’s a very real healing presence about horses. There are also in-depth studies that show an almost immediate drop in the levels of the stress hormone cortisol with horse therapy. We hope our project is a way persons with dementia and their care partners can stay engaged, learn new coping skills, and reduce stress, anxiety and depression.”

“The need is there. We all know the numbers,” Paula said. “Every caregiver I’ve met has wanted to do the best job he or she can and that sometimes is hard. What really excites Nancy and I is the hope of giving them more options for care – choices that are less formal, but as effective.”

Horses are the most popularly used animals for therapy because they have the ability to work collaboratively and adapt to change. They are prey animals but have survived by cooperating in herds. Paulal pointed out, “You can’t push a 1200-pound animal around to get it to do what you want. Working with horses provides an easy way for people to understand that force may not be the best approach for getting someone to do something.”

The Connected Horse Project enlisted assistance with the study from Jacqueline Hartman, program co-founder and lead facilitator of the Red Barn Leadership Program, which is in the University’s Athletics Department. Jacqueline said, “We will adapt our curriculum for these participants and give them opportunities to lead the horses. The person with dementia and his or her care partner will experience how their own interpersonal skills and dynamics affect the horses, and, hopefully, gain strategies to be communicate and cooperate better together.”

Dolores Gallagher Thompson from Stanford University School of Medicine will serve as the project’s principal investigator; Liz Landsverk, M.D., principal of Elder Consult Geriatric Medicine in Burlingame, is the study’s Medical Advisor; and Elke Tekin, co-founder of The ElderHub, a virtual community providing education and elder care resources for San Francisco Bay Area residents, will assist.

The Connected Horse Project has the support of the Alzheimer’s Association of Northern California and Northern Nevada. Coordinators are actively seeking funds and sponsorships for their project through Go Fund Me / Connected Horse. Those interested in participating in the future phases of the study, can learn more and complete an inquiry card at

One of the Herd

by Cecilia Meis | Success Magazine

More than 5 million Americans are living with dementia. Around 200,000 of them are 50 to 65 years old. They could have children who still live at home. They could be visiting college campuses or planning baby showers for their first grandchildren.

Instead they’re forced to quit working and feel the stigma of living with a disease perceived to affect only the elderly.

The Connected Horse Project based in Palo Alto, California, in partnership with the Stanford Red Barn Leadership Program, is working to change that stigma through its equine-guided therapy workshops.

The program includes group therapy as well as one-on-one interaction with the horses, including petting, grooming and walking with them in the paddock or barn. Nancy Schier Anzelmo, the program’s education director, says the participants are thrilled for the opportunity to take risks again—to really live and forget their diagnoses.

“One woman said, ‘I have the strength now to take me on this journey,’ ” Schier Anzelmo says. “The interaction with the horse brought her back to a better time in her life. That makes it worth it.”

Horses have the innate ability to mirror people’s emotions, which allows people to address the complex emotions they’re feeling, such as anger, guilt and confusion.

Paula Hertel, the program’s director, says horses have the innate ability to mirror people’s emotions, which allows people to address the complex emotions they’re feeling, such as anger, guilt and confusion.

“We had one woman who had aphasia—difficulty talking—and didn’t fully want to participate. After spending a day with the horses, her language improved, her body improved, her outlook—in terms of smile and eye contact—all got better,” says Hertel. “She was able to express how grateful she was to be there.”

This article originally appeared in the September 2016 issue of SUCCESS magazine.

Pilot study suggests therapy horses may aid people with dementia and their caregivers

by Holly MacCormick | SCOPE, Stanford Medicine Blog

Family members provide most of the day-to-day care for people with dementia. Yet few resources are available for individuals in this common, and often times stressful, caregiving arrangement.

The Connected Horse Project, a program founded to involve people with dementia and their caregivers in guided activities that bolster their communication skills, could change this.

As described previously on Scope, the project’s guided workshops with therapy horses also help participants learn self-compassion and stress reduction techniques. Organizers conducted a pilot study at Stanford to test its effectiveness. Now that the study is complete, I followed up with co-founder Paula Hertel to get an update on the research.

The sample size of the Stanford pilot study was modest (26 participants), but the preliminary results are promising, she said.

The research team, led by Dolores Gallagher Thompson, PhD, and Nusha Askari, PhD, and Jacqueline Hartman at the Stanford Red Barn Leadership Program, found that supervised activities, such as observing herd behavior, grooming horses and leading horses with a lead and halter, helped participants recognize and use non-verbal forms of communication.

These preliminary results also revealed that workshop participants benefited from an increased perception of social support, less stress and better sleep. Participants also reported fewer of the undesirable behaviors associated with dementia, such as anxiety, agitation and paranoia.

The next step, Hertel told me, is a new study that began in November 2016 and is part of a collaboration with the University of California, Davis School of Veterinary Medicine and the UC Davis Alzheimer’s Disease Center.

An important aspect of the work is the unique relationship between people and horses, Hertel said:

We are grateful to the horses we work with for their generosity and gentle feedback as people practice collaborating and being in the moment with them. Until there is a cure, programs like ours help people affected by dementia stay engaged and provides opportunities for them to experience new activities.


This article originally appeared in the Stanford Medicine blog SCOPE.