Evidence and Recommendations for Pet Therapy and PARO Robot in Dementia Care

This article discusses the effectiveness of pet therapy and PARO robot in enhancing the mood and well-being of dementia patients. It explores the ethical considerations and provides suggestions for incorporating evidence-based nursing practice. The use of PARO robot is recommended over pet therapy due to its advantages and effectiveness.

Summary of Evidence and Recommendations
While providing effective care to the patients suffering from dementia, application of
healthcare intervention that could enhance their mood and increase their sense of
positivity should be applied so that their anxiety, stress and other complicated health
complications could be treated (Lundqvist et al. 2017, P. 358). The two main
interventions are pet therapy or PARO (robot). Firstly, The pet therapy is an effective
strategy that helps to target each of the critical aspects of mental illness such as
depression, social isolation, loneliness and mental trauma (Rhoades, Winetrobe &
Rice, 2015, p. 240). However, Animals are often not allowed in daycare centres or
nursing home, due to the possibility of an allergic reaction, the risk of injury to staff,
patients or visitors, and the potential annoyance of cleaning up after the animals
(Zafra-Tanaka et al., 2019, p. 43). Further, the cost of the pet care (time, money and
space) might exceed the benefits of a few hours of pet therapy per day (Bernabie et al.,
2013, p. 765). Cultural differences may also hinder therapy by use of animals; for
instance, some communities may view dogs as irritating (Mental Health Foundation
UK 2019, p. 2). Similarly another intervention PARO, which a therapeutic robot seals
that helps the patient to lower stress, reducing anxiety, and improving depression (Yu
et al., 2015). Use of PARO stimulates social interactions, enhances communication and
improves the mood of older people with dementia (Yu et al., 2015, p. 37). Research
shows that PARO is inclusive of five sensors namely tactile, light, audition,
temperature, and posture sensors, which perceives the patient's environment and then
helps to calm the person to lift their mood Parorobots.com)). Moreover, pet robot had
advantages compared to real pet: they do not carry disease; they need less care; and
their behaviour can be better controlled (Shibata & Coughlin, 2014, p. 422). Hence as
per the NHMRC clinical guideline, application of PARO robot in the mental healthcare

should be conducted so that the patient could be provided with effective intervention
without any risk (Laver et al., 2016 p.3). Finally, based on the facts presented, the use
of pet therapy should be avoided and the PARO robotics should be implemented in the
provided patient case.
Ethical consideration
To ensure that ethical practice is effected, healthcare professionals are guided
by certain principles which include; non-maleficence, beneficence, autonomy, and
justice. Autonomy gives the patient the right and freedom to make informed decisions
on personal matters. To ensure that this ethical principle is not violated, patients should
be allowed the final decision making on whether to incorporate PARO to their care or
if to use animal therapy at all. PARO has the ability to create connections with elderly
persons who are cognitively, emotionally, or socially isolated (Birks et al., 2016, p. 5).
The health practitioner should however not force the use of PARO on the patient even
in light of these benefits. Beneficence means that healthcare practitioners should act in
a manner that promotes the wellbeing of others. In this situation, the professional is
free to recommend the use PARO if he or she feels that it is in the best interest of the
patient but the latter should make the final decision on the same. Non-maleficence
indicates that it is more important for healthcare professionals not to harm their
patients than to help them while justice is concerned with the distribution of the limited
medical resources and the decision making on who obtains which treatment. Clinical
practitioners should not suggest the use of PARO to patients if they do not consider
that it will be helpful. If they realize that the cost of PARO is more than its benefits
they should refrain from recommending it to avoid violating the non-maleficence

principle (Broadbent et al., 2016, pg. 27). The principle of justice can be observed by
ensuring that the distribution of the robot begins with those who need it the most.
Suggestions for Facility to Incorporate Evidence-based Nursing Practice
While implementing the PARO robot in the care process of mentally ill patients several
aspects of care should be considered so that enhanced and increased benefit could be
provided to the patient. The first aspect would be associated with training and
education because the implementation of PARO could be challenging. However, with
proper education and training in the nursing staff, could influence the proper
understanding of how this robot pet could be used as a therapeutic intervention to
benefit the day-to-day experience of the dementia patient (Shibata & Coughlin, 2014,
p. 420). The second aspect would be associated with awareness. It is important to
understand without campaigning and proper awareness in general public, proper
acceptance of this intervention would remain stigmatised (McGlynn et al., 2014, p.
247). Hence, needs a proper multidisciplinary team, so that there could be proper
awareness as well as education among the people. Patient Informed Consent would be
the third aspect of the care. According to Nursing and Midwifery Board of Australia, it
is important to understand the needs of patient and customers, hence, the applicability
of any new intervention would require proper consent of the patient and then there
should be the implementation of the PARO robots in clinical nursing practice (Birk et
al., 2016). The final aspect of care would be the Family Centred Care. The patients are
socially and physically dependent on the family members, especially in the dementia
patients, hence, the implementation of the PARO needs proper discussion as well as
approval of the patients when it comes to the clinical practice (McGlynn et al., 2014, p.
246).

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