I’ve been inspired to write this blog by a Facebook group for the owners of horses with Cushings disease. I’ve been a member of the group for some years, mostly lurking, but reading the posts with interest.
Over the last year it seems that many of us in the group have lost our beloved horses after much care, love and management of this tricky disease. Recently, one member posted twice in one week. Both posts told of her heartbreak at loosing one of her horses. She lost two, unexpectedly, in one week- that’s a lot of trauma and a lot of grief.
I’ve been reading a lot about grief in animal owners in recent months. It was all prompted by a cutting from a professional journal that my friend and vet sent me. So, I thought I might share, in some short blogs, some of the information I have come across.
Lots of studies, over many years, have looked at how humans grieve when they loose someone close to them, but little attention has been paid to the bereavement processes for humans who loose animals. What literature is out there will probably not be a surprise to many of us who have loved and lost animals.
The grief experienced when an animal dies is often, for those who were attached to it, much the same as a bereavement reaction when a close human dies. Sometimes it can be more deeply felt and experienced. There are several issues that make grief for an animal more tricky.
One of these is that often other people don’t recognise the owner’s grief, or think that they are just being silly and sentimental. It’s common to be told that, “it was only an animal” or “you can get another one.” It is not unusual for a grief reaction for an animal to be considered as a sign of mental illness or instability.
All of this can lead to what is called ‘disenfranchised grief’ – when an individual is bereaved but can’t express it or explain it to others, but instead has to keep it bottled up inside. How lonely and difficult this must be. And how unhealthy. Rather than the expression of grief for a lost animal being a sign of illness, the suppression, due to disenfranchised grief, of those deep feelings is much more likely to cause emotional damage and mental health problems.
So, the ‘Equine Cushings Disease Horses’ Facebook group looks like it has a very important function as, in addition to all the practical support and sharing of ideas, it allows horse owners to openly express their feelings before and after the loss of their equine companions. With each post that tells of sadness, grief and bewilderment as another horse dies there are many replies offering kind words, support, warmth and virtual hugs.
That very special group is a superb example of how, when at its best, social media can be connecting and helpful.
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Walking with a purpose for those living with dementia – what role animals?
A few weeks ago I was asked to deliver a workshop, at a dementia leads conference, about starting to write for publication. I was fortunate to have the opportunity to sit in on the fascinating workshop before mine. A local lead nurse described and demonstrated the toolkit she had designed. The speaker had identified a significant number of reported falls by people living with dementia had occurred when they were ‘wandering’ and that carers and care providers struggled to both understand and manage this behaviour. The toolkit aimed to help carers to understand and manage when someone ‘walked with a purpose’.
A poster that the speaker had produced highlighted a number of different reasons that may drive a person living with dementia to walk with a purpose. Two particular reasons really resonated with me. These were when people were continuing a habit or seeking something they felt was missing. After the conference I talked about this with one of my colleagues, a very experienced Later Life nurse. She told me that, in her clinical practice, it had been very common for female service users to become very agitated around school finishing time. These service users were remembering a time when they had to be at the school gates on time to collect young children.
All of this made me think about those of us who own animals; farm animals as well as companion animals. Animals provide such rigid routines for their owners that form very clear demarcations to the day.
Those who walk their dogs every day at certain times, often with several, if not many generations of dogs, can have very specific routines. For those of us that have animals that live outside of the home, such as horses and farm animals, the seasons and available daylight are significantly important. For me, in the winter there is always a rush to try and get to my animals in the last of the fading light. My winter days become organised around morning and evening visits and feeds. At this time of year I become probably quite infuriating to friends when I tell them I have to leave at a certain time to be back to do my animals.
I wonder how these ingrained routines and behaviours surface for those living with dementia and how much these old daily patterns drive walking with a purpose behaviours. Added to this, those with behaviours that were carried out at particular times of day may be significantly affected by changes in light levels. This can be especially pronounced at dusk. I wonder how this interacts with the already recognised issue of changes of behaviour as the sun goes down when there can be increased agitation and distress.
What do we do about it?
I am amazed at the skill and knowledge that my Later Life colleagues have in their work and they will probably be much more skilled to answer these than me (and I hope they might comment). For me, it comes back to those core skills of mental health nursing – of knowing those who we are working with, understanding who they are and the importance of their histories. In an article written for the Care Coordination Association (CPAA) https://bronwizview.wordpress.com/2013/08/21/the-place-of-animals-in-mental-health-recovery/ I considered the place of animals in recovery but I had never really considered the role of animals for those living with dementia.
Whist visiting PAT animals are a wonderful, important service; at the conference I began to imagine how it would be to have memory problems. Someone brings me a dog to fuss. Then they take it way. At this point I suspect I would become distressed and very possibly angry.
Maybe we need to think about the possibility of residential animals wherever possible, but taking in to consideration both human and animal welfare. So, should I need care or nursing accommodation in the future please could I have a home with several cats, a dog and if possible two donkeys in a paddock outside my window? It’s really not much to ask for is it? It would make me much easier to care for. And happier.
This grief thing is a bit of a bugger
It is now over two weeks since my old horse, Badger, went. I’ve stopped crying so much. Now it mostly happens during the morning drive to work and in the evening, after The Archers on Radio 4. Why then? I have no idea. Although the script writers on the Archers are causing some angst amongst us regular listeners, I don’t think it is the storyline.
This grief stuff is getting better but I am still very sad. When I look back to the weeks, and perhaps even the months before Badger’s last day, the pain of the grief that I had then – knowing I would soon loose him and would have to make that awful decision- was perhaps worse than the sadness I have now. Back then I had continual anxiety about how, what and when. Now there is a final certainty which is easier to live with. Then, I experienced a mourning of him whilst he was still alive. It was a physical pain, a tightness that was like wearing an old fashioned, boned bodice of hurt.
On the morning I had made the decision and spoke to my vet I remember saying to her that there was very little left of who Badger was. Yes, he had slowly lost a lot of weight and was now thin despite increased Cushing’s medication and painkillers and 3 to 4 small soaked feeds a day. But what I really meant was that there was little left of who Badger was. He had always been a personality, sometimes he was hard work, but that had reduced over time and in recent months much of him had already left.
Last week my partner picked up the ashes and transported them so very carefully. He had offered to do this although, I knew it would upset him. He put the wicker basket on the passenger seat next to him, with a seatbelt around it. The ashes are now in my living room and I have to plan what to do with them. I never understood people who keep cremation ashes and never get around to scattering them. But now I do. Much of me doesn’t want to scatter them as I feel there will then be nothing left of my companion of 27 years.
However, I have started writing a list of all our favourite rides together. Then I plan to take a small amount of Badger’s ashes to these places and free a little of him in each. What is left on 1st October next year will all be finally scattered on the last field he lived in – for a third of his life.
So there is a plan and I’m working through it. But, this grief thing is a bit of a bugger.
Social inclusion and recovery – not possible without pets?
I was training a Psychosis Awareness course recently and a video clip that we use in it shows a service user describing how important his dog is to him and his recovery. This led to a discussion, in the group being trained, about the importance of animals to mental health – something that I am very interested in. I muted the idea that it is difficult, if not impossible, for many of our service users to own a companion animal. One of the students said, as a counter argument, that some of the service users, that her assertive outreach team work with, have animals. My reply was to quote the statistic that 50% of UK households have a companion animal and to ask her if 50% of her team’s caseload had animals. They did not.
We talk about recovery in mental illness and the importance of social inclusion for service users but rarely do we really consider these ideas in the context of animal ownership. Those with mental health problems are often discouraged from owning a companion animal by their families, the staff working with them, or other agencies. Usually there are worries about how that person may be able to manage to care for the animal, the cost of keeping it and the accommodation of it should the owner become unwell. Often service users are provided housing that prohibits the keeping of pets.
For many, companion animals provide company, structure to the day and important relationships. Our animals can make us laugh and some may make us feel safer in our homes and communities. Many animals help their owners to have increased social contact, routine and excercise. Why should someone be denied the chance to experience these things, that are options for many of society, just because they have a mental health problem.
Animal assisted therapy is well known and used now in many health care settings. It has a wonderful affect for many of those that the animals come in contact with for short periods, often on a regular basis. Professionals often refer to these experiences for people, thinking that this satisfies the need for contact with animals. Whilst I do not deny that animal assisted therapy is of great value, it is very different to having your own animal in your life on a full time basis. In fact, for me, whose animals are very important, a visiting animal which was not my own, would probably be more distressing than helpful as it would remind me of what I had lost and could no longer have.
We stigmatise people with mental illness if we do not ofer them support to own a companion animal, should they wish to. A large number of our service users can never experience social inclusion unless their wish to have an animal can be accommodated.
So let’s really start thinking about how we might support recovery for our service users who desperately want a companion animal. Instead of dismissing their desires and aspirations in this area, or trying to put them off the idea, let’s support them. Let’s help find them accommodation that suitable for them and their companion animal. Co-write with them care plans that include their pets and ensure adequate crisis and contingency plans are in place should things go wrong, including who they want to take care of their animals. We should be supporting service users to access information and services for their animals, so not only are we thinking of the humans’ welfare, but the animals’ welfare too.
Aniaml ownership is not for everyone, but for those for whom it is important, wherever possible, it should be facilitated.
Deliberate acts of kindness
Over the past week I have had cause to think a lot about kindness.
It started with a friend, who is also a trainer, being treated badly by colleagues that she was training. It made me reflect on the behaviours that we sometimes accept in training that would be unacceptable in any other setting.
I re-read the Nursing and Midwifery Council’s Code of Conduct and noted that it says, “You must treat people kindly and considerately.” As trainers I don’t think we should accept that we are ‘fair game’ for unhappy and disgruntled colleagues or even ones that just want a bit of fun at the expense of the individual standing at the front of the classroom. Recently I have started asking, at the start of a course, that people behave in the training room as they would in a clinical setting. In my training today I asked this and added, that we should aim to treat each other kindly.
The past few weeks have been hard for me. I had to make one of the most difficult decisions of my life. For a long time I knew it was coming, I had prepared for it and had even written some fiction based on it. I finally had to make that decision last Wednesday – that I would ask my vet to euthanise my 33 year old horse.
The kindness that I received from our vet and the nurse that accompanied her made such a difficult decision, and the required process, as easy as it could be. Our vet knows us and our animals well. We have had conversations over the last few years about end of life plans for my old horse. So when we got to the day it was made easier by having talked through what should happen. Both vet and nurse were visibly moved by my dear old horse coming to the end of his long life and by my distress. The emotion shown by them was not only congruent, but itself a kindness as it made me feel I was not alone and that it was right and proper that I should grieve for my horse.
I sat in the field with our other horse, and the body, for six hours until the cremation people came. They too showed me utmost care and consideration.
Our field is close to a village and next to a road and footpath. Many people stopped to say how sorry they were for my loss. Some I knew quite well, and others I had never seen before. One lady reached out and took my hand through our field gate and held it as she talked to me. So many deliberate acts of kindness.
Friends and colleagues have been extraordinarily supportive, some crying with me when I get upset.
I had to find a companion for the other horse, who was not used to being on his own, and I asked a small, local equine charity for a companion pony on loan. I trusted them to find the right pony to fill our vacancy and they brought me a stunning welsh cob who is a lovely chap and moves beautifully but has a native, wile streak. This pony is not a replacement for my dear old horse, but rather this pony has come to distract us all and keep us on our toes. He has some small behaviours I don’t yet quite understand and he and I are learning to work together. And of course, all of this needs to be done with the utmost kindness as he has his own difficult history and the recent stress of a new home.
Some years ago the rather lovely idea of ‘random acts of kindness’ was quite fashionable. With so much kindness shown to me very recently, by so many different people, it has made me think that we need to make conscious efforts to deliberately, “treat people kindly.” And kindness should guide everything we do with animals.
Information about the Society for the Welfare of Horses and Ponies can be found here. http://www.swhp.co.uk
Paces – a short story
The following, a short story, is my first piece of written fiction for over 15 years. In it I continue to explore my more academic interest in the impact animals can have on humans, on their mental health and how animals’ lives can be so intertwined with ours. It also examines companion animals end-of-life issues. Human end-of-life is a hot topic currently but it is important to consider this for the animals in our lives, companion or otherwise.
Paces
It would have looked peculiar to anyone out early, passing along the village road that ran beside the field. Had they glanced over the short hawthorn hedge they would have seen a small woman, slumped on the dew dampened grass, next to a prone horse. The tidy and precise figure in her late forties was speaking gently to the animal. Any passersby would not have seen the horse appear to register her and his breathing become slightly less laboured.
Libby could do nothing but sit, talk quietly to Dapper and lose herself in the memories. Watching his flanks she matched her breathing to his, aware that it was uneven. As she spoke to him, memories of half her lifetime and most of his, came in to focus. She reminded him of the many rides they had been on together. The summer rides with the smell of wild honeysuckle that grew in the hedgerows along with the short-flowering dog roses. The winter rides, often short, snatched around work and the available daylight, with Dapper delighting in dancing his way along bridle paths in the sharp, clean cold air.
Since buying Dapper Libby had become a one horse woman, she had hardly ever ridden another. Now she wondered how many hundreds, if not thousands, of rides they had been on together. During the years how many miles had they travelled, how many paces, across the open countryside afforded by being close to a network of bridleways, several large swathes of common land and access to a long hill range.
Libby could track most of her adult life thorough the days and seasons spent with Dapper, including her nursing career. She would see to him around her shifts, worked as a ward nurse, as her career progressed to the role of managing a hectic acute admission mental health ward. Winter late shifts gave her and Dapper the morning light and sufficient time to get out, even if it was just a walk and a brisk trot across the still, silent common land they would have to themselves. In the summer, no matter what hours Libby needed to work, there had still been time to ride. The evening visits after a late shift became something of a pleasure rather than a chore. She would sit on an upturned bucket next to Dapper as he ate his feed, the solid regular chewing soothing away the stresses of the day, allowing Libby to wind down. Occasionally raising his head, Dapper would drop small pieces of feed in her hair.
Dapper had a kind and generous ear, listening to all her work problems. In the early days it had been those tricky issues of finding confidence in her identity as a nurse and developing new therapeutic skills. There were the difficulties of fitting in to a busy ward team and the emotional toil of the work with her patients. The main tool Libby possessed to do the job was herself. She used herself as a person to connect and engage with patients, build therapeutic relationships and empathise with their distress and pain. She had to learn the fine balance of maintaining professional boundaries yet getting emotionally close to those she nursed, which could take its toll.
Her experience of horses had transferred to and supported her work, most markedly with those who had severe and enduring illnesses. Patients admitted with bipolar disorder who, when manic would be highly restless, agitated and over active. They often struggled to keep on track with their thoughts, becoming very distracted and distractible. The excruciating experience of elevated mood, rather than evoking happiness, made sufferers unable to sleep, or to stay sufficiently focused for long enough to eat, or to even drink. They could be highly irritable and angry, frustration sometimes moving them to tears. People with psychosis struggled with their inner torment, their difficulty to connect with the world, and they often experienced a lack of motivation to undertake even the most basic activities of living. Patients with severe anxiety or depression required from her a gentle confidence and an unrelenting hopefulness that things would improve. All those admitted to the ward needed compassion, quiet kindness and understanding.
Owning Dapper helped Libby to understand agitated and distressed patients, to see each as an individual with strengths despite their difficulties. Libby was able to approach them in the same way as she would Dapper when, during those early years, he was difficult, anxious and temperamental. Just as she learnt with Dapper, Libby the nurse learnt to present as calm and confident, slowing her speech, lowering her tone of voice, being unhurried in her movements and regulating her breathing.
Libby developed the ability to be comfortable with silence, fighting the compulsion to anxiously say anything just to fill the gaps, instead responding to another living being by staying quiet, waiting and watching as she did every day with Dapper. He taught her how to read body language and to watch for changes in another, a shift in posture, in movement, to observe if muscles were tense or relaxed. Dapper taught her to tune in to the slightest alteration in him second by second, so much so that it became automatic, intuitive and transferred to her work with people. She could not identify how and when this happened, it just did. She wondered now, as she gently smoothed the bleached out, faded grey fur on his neck, whether she would have been a different and probably a less skilled nurse if she had not had this old horse in her life.
Over the years Libby and Dapper developed into a team, with both able to read and respond to the other without conscious thought or deliberate attention. The steady pattern of routine, of always undertaking tasks in the same way, of seeing Dapper at least twice a day, no matter what, become an important core to her life, a comforting rhythm that was ever present for the past twenty-eight years. Like most people who owned horses, Libby moaned about being tied to the responsibilities of morning and evening checks, feeds, hay, picking up muck, grooming and, in recent years, of giving medication. Now Libby watched as his head rested heavily on the short grazed grass, his breathing shallow and too fast. She should feel guilty for having those past thoughts but rationalised that they were a part of the responsibility of owning a horse. Most horse owners probably thought similarly at times, but Libby hoped that she would not remember her thoughts sometime in the future and regret them.
Libby wondered if she would look back and agonise about not having spent more time with Dapper, not staying for an extra five minutes while he finished his feed, but instead rushing off to work and leaving him to it. The days when it had been too hot or too cold, the essential jobs done, and she had quickly left to get back to the air conditioning or the heating of the car. The routine of owning a horse, the day-in, day-out pattern of their life together, made Libby unthinkingly accept Dapper’s presence in her life, just as a long married couple might take each other for granted.
Like the start of many a relationship, it was exciting, scary and tricky when Libby bought him as a green six year old. She had been toying with the idea of getting a horse for some months, planning to seriously look at buying one after the coming winter. Several ponies in the past had filled her childhood and her heart. Once qualified and settled in to her first staff nurse post, she had wanted to start riding again. She had in mind a bright, neat chestnut, as shiny as a fresh conker and well schooled, who would help her to regain her confidence as a horsewoman and with whom she could have some fun.
It was autumn when her friend Jane suggested she should see the horse at the small yard where her own horse was kept.
‘Go on, what is there to lose? You are going to have to start looking at horses if you plan to buy one.”’
‘I’ll look after winter,’ Libby said, ‘not now.’
‘Just come and have a look at him,’ Jane had insisted.
Eventually Libby had given in and gone to look but she was unimpressed with what she saw. There he had been, standing in the middle of a rough paddock with his head up, on alert. He was a stodgy looking cob and evidently very unfit. He had the dark grey of youth that changed suddenly to smart white socks on his legs, with a clean, sharp definition that made it look as if his legs didn’t really belong to him, as if they had been borrowed. One walled eye gave him a permanently surprised, slightly shocked, look.
‘He’s not the right type or the right colour and he is unschooled – I need something I can just get on and ride without any faff,’ Libby said, ‘and what sort of idiotic name is Dapper?’
What did strike her however, were the bits of Dapper’s history that Jane knew. As usual, a personal history engaged Libby, made her curious and keen to understand the individual, be it human or horse.
‘Dapper’s mum was a Connemara brought over from Ireland by a local dealer,’ Jane said as they started to walk across the paddock towards him. ‘She was sold to a rough and ready chap who was somewhat surprised to find the mare was in foal.’ The dealer was contacted and he confirmed that an Arab stallion had been at his yard for several months around the same time as the mare. Consequently, quietly and alone one morning, the mare had produced Dapper.
‘So, he hasn’t had the best start in life. He was broken, not very well, and then sold to a local girl who was unable to manage him and so he had been passed on and then on. Not the best for any horse!’ Jane added, ‘I think his legs do give him a rather dapper look, don’t you?’
A succession of young women had found Dapper difficult and had given up on him when he frightened them with his behaviour, some of which had bordered on the dangerous. Sitting in the field with Dapper, now an old man with none of that sharpness of youth left, Libby wondered what would have become of him if she had not bought him. His passing from owner to owner, person to person, would have continued, instability causing him to become more anxious and difficult. It was very likely that he would have ended up in a market somewhere, being sold to the meat man, before even Galvayne’s Grooves appeared on his teeth.
Following Jane’s persuasion, Libby reluctantly agreed to have a ride on him, thinking that it would do no harm and would put an end to Jane’s pestering. Dapper proved to be green, unbalanced and unschooled with no ability to work on the bit. He was unruly and difficult and as soon as Libby settled in the saddle he quickly moved off and then skipped unexpectedly sideways. In that moment Libby immediately knew that he was the one. There was something about his movement, his paces, even though they were uncoordinated, that was absolutely right and resonated with her.
And that was it. Libby bought him. A raw six year old that had not been looked after or treated as kindly as a young horse deserved. He had little to recommend him, especially as he had built a reputation in the locality of being difficult and at times un-rideable.
Libby had not had him vetted, something she would never dream of doing now she was older and wiser. However, she had been lucky and he had been sound and fine once he had been thoroughly wormed. Looking back it seemed as if those decisions had been made by someone else, a young and unwise girl, and that the wound up, spooky horse of then could not be the animal now lying immobile beside her. They were both older, different, but that time seemed so close, as if it was merely several years, not decades, that had passed.
Within two days of seeing Dapper and the impulsive decision to buy him, Libby negotiated a price with his owner and found a small DIY yard to keep him. Mill Farm seemed perfect, with grazing, stabling and an outside ménage. It was when Libby foolishly decided to walk Dapper in-hand to Mill Farm, only a mile or so away across the local common from where he was being kept, that she discovered he did not lead well. The young horse decided to shy at everything that moved; every leaf, rabbit and squirrel on the way. Libby was desperately trying to hold on to Dapper as he danced, the Arab in him becoming very evident. As he flicked his feet out, hooves extravagantly floating above the ground, head and tail held high, she tripped up. This had really spooked him and he had tried to take off. In that moment Libby knew she could not let go, aware of the road that ran through the middle of the common, and that should he get loose she very probably would not catch him again. For some distance Libby slid as Dapper dragged her over the rough and bumpy ground. Libby hung on to the lead rein until her hands stung, burning with the friction of rope against skin. Eventually he stopped and Libby scrambled to her feet. As they both stood, breathing heavily, eyeing each other, they had begun to come to an understanding. Tightly grasping the rope in her still smarting hands Libby again started to lead him and they began to find a way of walking together, to attune, to synchronise human and equine paces.
One evening after the hot haze of a late summer day, riding along the hill range next to the common, their relationship changed. They had been taking advantage of the cooler air on the top of Raged Stone Hill when, without warning, a crashing thunderstorm whipped up right above them, the sky suddenly angry and black, lightening throwing the surrounding hillside into sharp and terrible relief. A short lull and then the rain started, soaking them both within seconds. Libby had been frightened, feeling so exposed on the hill, but Dapper had been calm and, keeping his head and his footing, had got her down quickly and then safely home. Steadily and surely he picked his way down the hillside by the shortest route, the Arab and Connemara in him providing sure footedness on the loose gravel moving under the small streams of water. Libby’s trust of the horse developed and deepened and she found that there was little now to faze her when she was out with him.
They stayed for some years at Mill Farm, a small yard with around ten acres of paddocks. On the surface it was a nice idyllic set-up, owned by a middle aged couple. The wife, Mel, had her own horse, as did their daughter, and there were four DIY liveries. Mel had welcomed her when she arrived with Dapper.
When Libby explained she had just bought Dapper, Mel said, ‘Ah! He’s new out of the box then!’ It was much later that this struck Libby as more significant than she realised at the time – a telling indicator of an attitude to the horses.
The farm was nestled in a slight dip at the edge of the common land. Once tacked up, Dapper and Libby could be straight out on to open riding with no need for road work, definitely an important factor in those early days when Dapper was so unreliable and often unable to walk in a straight line. This significant advantage was one of the reasons, Libby now reflected, that she and Dapper had stayed there so long.
They had settled in, quickly becoming part of the yard community with its ups and downs, although Libby was treated as the new girl and as someone who lacked horse knowledge. Libby had accepted the nit picking and the slightly pointed comments, disguised as kind information giving. She had instead focussed on the benefits of being on a yard. Someone was almost always on site and there was the genuine and kind advice from the knowledgeable and sensible Martha. Libby also learnt the downside of yard life with its minor squabbles. One annoyance was the obsessively tidy Dee, who would clean and brush the yard, even when it was not required, and then manage to make everyone else feel bad for not doing it. Dee’s unnerving habit of tidying away other people’s kit and tack without invitation or request was one of the yard jokes, but it was also exceptionally wearing.
Being utterly heartbroken was another reason that Libby had stayed at Mill longer than she should have done. It had coincided with that dreadful time when she could not contemplate more change, more upheaval. No matter how Libby had been feeling, Dapper’s solid presence had got her through all the heart ache and despair of her divorce. On the worst days Libby had wanted to pull the duvet over her head, to shut out pain in her heart, but she would have to get up and feed Dapper. Once up, she would reason that if she could get to Mill Farm and see to Dapper, she would then be able to go in to work. And so, one step at a time, one pace after another, Libby had got through each day.
The horse lying in front of her had now lost muscle as he aged, his withers and back bone becoming more pronounced. His rump, once rounded in a happy cobby way, looked like it had sunk in on itself. Back then Dapper had forced structure into her day, given her a tenuous framework on which to grasp, preventing her from completely drowning in misery. Dapper had gently taught her that she could face anything that life put in her way. His solid company gave her companionship when she could not face other people.
It was Dapper that provided Libby with the first small moments when she forgot her troubles and slowly these moments extended to minutes and hours. Riding him, discovering bridleways and paths that they had not ridden before, finding new views together and holding him back to canter when he was insistent he wanted to gallop, had all helped to stop her intrusive and repetitive thoughts. When there was a break from the ruminations, the pain in her heart reduced. Now, as her companion lay with his eyes closed, Libby realised that Dapper was focused on his own pain and it was now he who was shutting out the world. She felt an overwhelming rush of gratitude for all the times this horse had helped her come through difficulties and anguish.
Libby’s thoughts returned to Mill Farm and that, at the time, she had not realised how much the place had fenced her in, stifled her, until the events of a still, hot summer’s evening. She had been picking up muck in the paddock, the rhythmic thump of a hay bailer audible from the neighbouring farm. Dapper and Mel’s large bay gelding cob were stomping about, trying to find a spot with the least flies and Dapper wandered in to the open barn on the far side of the paddock for some shade. A sudden noise made Libby look up from her muck buckets to see Dapper cornered in the barn with the bay horse repeatedly turning his back to the grey and lashing out with his hind legs.
‘Whoa! Stop! Stop it you!’ Instinctively, Libby started shouting as she ran towards the barn and her raised voice sufficiently startled the bay for him to pause in his assault. Enough time for Dapper to lunge forward, squeeze past him and out in to the paddock to stand shaking and terrified. A gash to Dapper’s front leg was bloody, a sticky rivulet livid, first against grey leg and then white sock, as it tricked downwards. Several lumps were appearing on his chest where other kicks had landed.
This incident in itself had been shocking and upsetting, but it was what had happened after that completely stunned Libby. Hearing the shouts, Mel had come on the yard as Libby was pulling Dapper out of the paddock, away from the bay and on to hard standing. As Libby started to clean Dapper’s wound and ran cold water over the swollen areas, she briefly told Mel about what she had witnessed. Mel was casual and off-hand, insinuating that Libby was making a fuss about nothing. Libby told her that she did not want Dapper and the bay sharing a paddock together again.
Mel said, ‘Oh, for goodness sake! Stop being so dramatic, you’re over reacting.’
When Libby uncharacteristically persisted, Mel said, ‘We haven’t got the space to rotate the grazing and accommodate everyone’s slightest whim.’
‘I’m sorry but I cannot let Dapper be put in that situation again,’ Libby said, quietly sticking to her guns.
‘I really don’t understand you – it’s not as if he is anything special!’
‘Mel, he may not be anything special, but to me he is very special.’
There and then Libby gave Meg notice that she would be moving Dapper. She stood firm insisting that, in the mean time, he was not to be put in with the bay. Within the week Libby had managed to find grazing on a local farm which had no other horses. That rushed move, so stressful and anxiety provoking, had brought Mike in to her life just when she was adamant that she was not looking for anything else in her life, other than Dapper and work.
Once she moved Dapper, Libby was without others rely on and solely responsible to get to the farm to see to Dapper twice a day, every day, no matter what she was doing or working. She had to drag herself out of bed when she was ill, to check, feed and water him, but this responsibility was compensated by the freedom she now had.
Keeping Dapper alone negated the risk of him being beaten up by a field companion but Libby was acutely aware that, as herd animals, horses need companions. When the farmer asked if his nephew, Mike, could run his elderly ram in the horse’s field she tentatively agreed. The horse and the appropriately named Willie the ram quickly formed a strong bond and spent their time grazing together or sleeping under the cover of the wide boughed oaks that bordered two sides of their regular field. On hot, fly-ridden days Willie took to standing under Dapper for shade and to gain the full effect of an accurately flicked tail.
Gradually Libby took responsibility for checking Willie twice a day on her visits to Dapper. She was happy to do this, but when Mike dropped by several times a week Libby assumed he did not trust her minimal knowledge of sheep. Libby thought little of it, considering it to be mere coincidence, when his visits often coincided with the times when she was at the farm. When the winter came, with early hard frosts followed by snow, Mike helped her change rugs, put hay put for Dapper and Willie and break the thick ice on the water trough. She was grateful for his help and for his quiet company on the dark evenings. Libby told herself that he was being kind and helpful in exchange for her taking care of Willie through the late summer and autumn. When Mike did not show up for a week she became worried, found herself looking for his dark blue Land Rover, and discovered that she missed his company.
Libby was picking out Dapper’s feet one evening when Mike eventually showed up. She immediately saw that something was wrong, his tall frame looked gaunt from the weight he had lost, his face taught with worry and his usually clear, sharp blue eyes clouded. She straightened up, letting the nearside hoof go, and watched over Dapper’s back as Mike walked across the yard towards her. It was then that Libby realised how little she knew about him. With a shock she was suddenly aware how selfish she had been. Having been so taken up her own problems, so closed down to everything and everyone, she had not really, truly seen Mike as a person in his own right. They had spent time leaning on the old solid wooden field gate many evenings, talking generally about their work, the countryside and wildlife that surrounded them, but Libby had not registered just how much Mike had become a part of her daily routine until he was missing from it. She had treated him like one of the oak trees, reliable, always there, to give shade and shelter from the elements.
‘Mike?’ she said quietly, as he got close to where she stood.
As they faced each other over Dapper’s broad back, Mike met her concerned gaze and Libby felt that she was looking at him for the first time. All three, woman, man, and horse, stood seemingly frozen in time.
‘Mike?’ she said, ‘What is it?’
Placing one hand on Dapper’s neck Mike absently ruffled the horse’s mane and the contact with another being seemed to steady, to loosen him. He told it simply, as if he was reciting someone else’s story. ‘I’ve got two children, girls, Freya is nearly ten and Jen is eleven. They live….they lived, with my ex in Norfolk.’
Having started, he now seemed unable to stop. ‘I get to see them whenever I can but they are growing up and they want to spend their weekends with friends, not their boring dad.’
Mike took a breath and then said, his voice becoming so quiet that Libby moved forward to hear him, ‘Their mother, Jo, was on her way to a meeting. There was freezing fog on the motorway, a multiple car pile-up and several people killed. Jo was one of them.’
Both his hands were now resting on Dapper as his voice trailed off, his shoulders sagging. Libby automatically reached over the horse’s back and took hold of Mike’s hand, knowing that no words, nothing she could say, would make it better. Without looking up Mike took a grip on Libby’s hand with his own, ‘And now, I need to look after the girls.’
Then, taking a deep breath, he told her the rest. He had been living at Jo’s house in Norfolk to look after and support his children as the arrangements were made to bury their mother. He was going back to Norfolk that evening and would move to be with them, at least until they had finished the school year. Clasping Libby’s hand tighter in both of his, he fell silent and they stood, not speaking, hands held over the back of Dapper who now shifted his weight to one back leg, rested the other, and his head drooping, began to doze.
So it had begun, a relationship she had not expected, was not looking for and one that challenged them from the outset as Mike moved hours driving time away to be with his girls.
‘I’ll look after Willie, if you trust me to,’ she had said to him that evening in the yard, half joking, and it was the first time that Mike, albeit briefly, smiled.
The winter turned in to an early but wet spring. Libby missed Mike more than she could put in to words. She wanted to share with him the sights and sounds of spring as the weather improved and everything became vivid in so many different shades of green. The birds began to pair up. The rooks in the oak trees were busy choosing exactly the right sticks for nest building, then coming each day when she groomed Dapper, waiting until they could hop across the yard and stuff their beaks with his fur and carry it off to line luxury nests.
Mike came back when he could, to check on his house. At Easter he brought the girls to stay for a week. He arranged to bring them to the farm to meet Libby, having already told her that Freya and Jen would be moving to live in his home when their school broke up for the summer holidays. Two pale faced girls, slightly built but tall for their ages, had reluctantly got out of the Land Rover when prompted by Mike. They stared at their town-shoe shod feet when he introduced them to Libby.
Finding herself at a loss about what to say to these two unhappy children, Libby suggested ‘Come and meet Dapper, my horse?’ They hesitated, then, without meeting her eyes, nodded and so Libby went and slipped Dapper’s head collar on, attached the lead rope and brought him down from the field to tie him up on the yard. Instinctively Libby fetched his grooming kit and rather than working to engage the girls in conversation she started brushing Dapper. As she talked to him gently she noticed the girls move a bit closer and, for the first time, begin to take some interest. Not knowing how to engage with these sad and silent children, Libby thought desperately about how she might get them to come out of their shells. Having children was not something that she had really contemplated and a relationship with a man who had his own children had definitely not been on her radar. Until now. Suddenly, with a strength that completely took her by surprise, she felt an overwhelming need to get this right, to make it all tolerable for these two girls who were so hurt.
Sensing that the harder she worked to get them to talk the less they were likely to do so, Libby decided to use the same approach she would use to try and catch small wily ponies. Libby busied herself, waiting to see if they would come to her out of curiosity and sensed their attention moving from the floor to Dapper. Jen took a tentative step, one pace forward, watching what Libby was doing. Judging her timing, Libby handed Jen a body brush, one that was small enough for her slim hand, and demonstrated how to use it on Dapper’s coat. At first Jen dabbed at the fur but then, watching Libby out of the corner of her eye, she started to copy the smooth strokes.
In time the girls moved with Mike to his house and he and Libby began a slow, gentle, unhurried relationship. It was not easy; the girls were grieving and needed to acclimatise to a new area, a different school, and to make new friends. Mike was getting used to being a full time parent to two hurt and challenging adolescent girls. His focus was on them and Libby got what little was left over. When Mike and Libby made the decision, after months of discussing it, for her to move in to his house, Jen and Freya had alternated between sullenly ignoring her and shouting and banging doors. The girls, usually sulky and occasionally hostile, made it clear that they did not want to share their father with anyone. Once, Jen said to Libby, almost spitting the words, ‘You’re not our mum and you will never be.’
Dapper became Libby’s respite from the tensions at home, he provided her with an escape and time to think. Libby discovered that managing difficult and challenging behaviour at work was different to being the brunt of it at home. So, when Jen unexpectedly asked to come to the farm with her one afternoon Libby had to swallow her feelings of irritated disappointment before she said, ‘Of course you can, but put on your jeans and some flat shoes.’
Jen learnt to groom Dapper and soon she was going with Libby twice a day, making herself useful, taking on tasks. Brushing out the horse’s light, fine tail and mane became her responsibility. Dapper had never looked so well turned out and he stood stock still for the girl when she tentatively started grooming him. Jen progressed to tacking Dapper up, making sure that the saddle was sitting in the right place, stretching his legs out to ensure that the girth would not pinch him and that the fur was lying flat under it. Libby started to leave Jen to groom Dapper, using poo-picking as a valid excuse, when she realised that Jen was having long conversations with the horse. Jen always seemed to be less reserved, less closed off after spending time with Dapper.
Jen’s birthday, the first without her mum, was difficult. Libby gave Jen her present the day after, careful to not make a tough day more completed. The gift of jodhpurs, hard hat and boots were opened, tried on and put to use that afternoon when Jen had her first lesson on Dapper.
Now, sitting in the field, Libby realised that it was not just her memories that were wrapped up with this old, tired out horse. Those two girls, one now at university and the other about to start her training as a veterinary nurse, had memories too. Dapper had helped them through their grief and the many transitions they made from town kids to country youngsters.
Libby was jolted out of her memories by the sound of the chain being undone and the field gate opening. Rachel, her vet of many years, quietly let herself in. When Libby had phoned, Rachel was calm as always, saying she would be there within the hour.
Now Rachel walked towards them, Libby still sitting on the spring grass, the old horse lying prone and motionless beside her. The dew was gone, dried by the strengthening June sun. The day was moving on. Libby could not hold back time as it shifted toward something she struggled to contemplate. Libby knew this was the end, the end of routines, day in, day out. The end of the most significant friendship she had for over half her life.
Libby understood the decision was inevitable now; he could not go on. She knew that Rachel would have put the syringe, the needle and vial of medication in the pocket of her fleece.
Libby wondered how far it was from the gate to where she and Dapper were, how many few precious moments she still had with him, how soon it would be before he would be gone. Libby measured the final moments of Dapper’s life in those forty or so paces that took Rachel to get to them from the gate.
Libby felt abruptly overwhelmed with a raw grief that hung immense and heavy in her chest, and in her stomach. She found tears were silently dripping onto the almost white fur which still had a few dapples visible in the dusty coat.
She heard Rachel’s quiet voice,
‘Hello old man. You look like you’ve had enough.’
The grateful student nurse
I only occasionally come in contact with student nurses these days as my current role is now mostly to deliver training to colleagues. However over the past few weeks I have had a student nurse in one of my longer courses, on which we do not usually accept students. I made an exception this time for three reasons. Firstly, the student managed to impress me with his enthusiasm and drive to do the course, which came across with a courtesy and professionalism in his emails to me. The second reason was that one of his mentors, a skilled clinician and trainer, was co-delivering this course with me. She vouched for him and I knew he would have the opportunity of experiencing how nurses in clinical practice can be involved in training and can be very able educators. The third reason was that I knew my co-trainer and his other mentors would ensure opportunities for him to put his learning from my course in to practice in the clinical setting.
Since the student started the course I have not regretted my decision. He arrives early, always asks if he can do anything, is incredibly polite and has a lovely self effacing sense of humour. He tells me each week how grateful he is to have been given the opportunity to access my course and allows me to gently tease him by asking exactly how grateful is he? He works hard on the course, works to put his learning in to his clinical practice and is able to reflect on and synthesise his new learning with his current knowledge and skills. He wants to get everything right and works incredibly hard to do this, although this causes him some angst.
This week we both talked about our journeys to our current roles. Mine is a 31 year road of various roles, all of which have brought something to my learning about nursing. He has a shorter, but none the less significant journey through care work to becoming a student nurse. As he told me his story it struck me how others had seen significant potential in him and had offered him opportunities. What also was clear is that he holds a core, and unshakable, value of caring for others.
Reflecting on this experience I am struck by this young man, so keen and quietly determined to become a mental health nurse and, more than that, to do it well, to be the best nurse that he can be, for the sake of those who he will care for. I now see how well honed his engagement skills are and how he uses them for professional development and not for personal gain. I am also struck by how much I have missed working with student nurses and how invigorating their want and desire for knowledge can be and I wonder how we can reignite this in some of our now qualified nurse colleagues.
The tables have turned; I am now grateful to this young man for giving me the opportunity to work with him in one of my courses and for reminding me of how refreshing it is to work with student nurses. I see in him, what I think others have who have also given him opportunities have seen in him. I see someone who is worth investing in, as this will be repaid tenfold when he qualifies and where ever he works in his career. I am grateful to be playing a small part in supporting a future mental health nurse.
The Role of Cake in Course Evaluation
Some colleagues are currently looking at how we evaluate our training, something that seems to be a perennial and unsolvable problem. Everyone has a view on it, there is much education literature devoted to it, but there is never an ideal way of undertaking it. I was asked today to list my methods of evaluation for the different courses that I teach. I listed the usual; evaluation sheets, verbal feedback, self assessments, formative and summative assessments, trainer observation and reflection and so on.
Then I added in the lemon dribble cake method of evaluation which is used in my Motivational Interviewing courses. These are taught one day a week for five weeks. Students are introduced to the cake-o-meter on day one and it is explained that every time they use motivational interviewing approaches and techniques with me, to help motivate me to make a cake, I will fill in part of the cake-o-meter. If they are successful and fill the whole cake-o-meter (they have always managed to do this) I will make a lemon dribble for them on day five.
But how can cake be an evaluation method? By asking the students to use the knowledge and skills they have learnt during the course in a different and fun way, they have to really think about what we have taught them. Initially most, if not all, students in the group will resort back to the traditional methods of trying to get someone to change their behaviour. They tell me how nice it would be for me to make them a cake, how satisfying I would find it and how much they would like me to do it. They then try telling me that they have worked hard and they deserve it. Someone will say that they don’t like lemon cake, or even any cake at all.
Slowly they realise that they have resorted back to the traditional approach and will start to use reflection and paraphrasing, then ask me how ready I am to make them a cake, how important is it and how confident am I about making a lemon dribble cake. As they really start to get the idea they ask what would be the good and not so good things about not making the cake and making the cake. Some adventurous students will try asking me hypothetically how it would be if I made the cake for them.
The group stops focusing on their agenda of getting the cake and switch it to my agenda which is about making the cake. When this happens they start to find out all sorts of information about why it is called ‘dribble’ rather than drizzle, that it is made to a third generation recipe, that I make it whilst listening to The Archers and that it is important to me to mark the end of the course.
By asking the students to use their newly learnt interventions in an unexpected and light hearted manner they have to adjust and apply their learning in ways that support deep learning and help a transfer to the unexpected situation in practice.
I have observed that that, in any training, when students start playing humorously with something that they have been taught, deep learning has to have occurred. When they play with each other and those that have taught them, when they are able to make jokes using the course contents and when they can gently tease their teachers with their new knowledge deep learning is indicated. For something to be used humorously it has to be well understood through deep learning.
So, the lemon dribble cake allows us to deliver layered learning in motivational interviewing and to use it as one method of evaluation of the course as deep learning is required by the group to complete the cake-o-meter and get the cake.
Animal welfare crisis – a perfect storm that will lead to an increase in animal hoarding?
Social media and animal welfare
Having previously used social media to keep in contact with friends and up to date with areas of interests, I have only recently become aware of the world of animal welfare pages, especially the pages and groups focused on equine welfare. Initially I followed a few to keep abreast with what was happening in the UK, and further afield. Quickly I became saddened by the relentless stream of truly dreadful stories about equine abuse, neglect, suffering, damage and death. I’ve had a volunteer equine role for over 20 years, one that is well underpinned by my mental health training and experience, however the level of harm and deliberate pain inflicted on animals by some individuals was shocking.
I then became concerned about the use of social media, when combined with the general public’s kindness and concern about the welfare of animals, being used to generate scams or hoaxes, one of which I describe in an earlier blog https://bronwizview.wordpress.com/2014/01/01/animal-welfare-hoaxing-the-role-of-social-media-and-the-impacts-on-those-involved/
Animal welfare crisis
All of the horse welfare agencies, both large and small, are clear that there is a welfare crisis in the UK. Lee Hackett, Director of Equine Policy with the British Horse Society recently wrote about the current situation of many horses being ‘rescued’ to face further neglect. His view is that for some horses, euthanasia is preferable to being passed from pillar to post and experiencing chronic, long term suffering. His article can be found here; http://www.bhs.org.uk/our-charity/press-centre/news/jan-to-jun-2014/rescue-me.
It is not just horses; there is a massive dog, cat and other smaller companion animal problem too. The RSPCA states that its centres are now at crisis point and has just published report, “Tackling the cat crisis” which can be found here; http://www.rspca.org.uk/ImageLocator/LocateAsset?asset=document&assetId=1232734779317&mode=prd. It highlights the need for neutering and the concerns about multi-cat households where the welfare of both animals and people is compromised. Usefully the report describes the importance of multi agency working, especially involving housing providers.
A perfect storm
There is a perfect storm brewing where we are likely to see an unprecedented increase in animal hoarding cases involving all companion animals, including horses and ponies. All the equine welfare organisations are full. A small horse rescue centre told me recently that they get calls every day from agencies, such as councils, who phone round to all the rescue organisations, trying to persuade them to take in animals. There are thousands of horses deemed to be at risk of becoming welfare cases.
Rather than horses being euthanised or going for slaughter people are encouraged, especially on social media sites, to take animals on to avoid them being ‘killed’. These pages often use language such as ‘baby’, ‘poor’ and ‘cute’ when describing an animal promoting an emotional response in readers, some of whom will feel compelled to help, perhaps against their better judgement. It is likely that this will result in individuals taking on animals they cannot afford or for which they have no room. Very probably these recue animals will come with complex physical and behavioural issues and may be unmanageable.
Don’t get me wrong, I would, rather that horses (and other animals in need) had a good home and lived happily in to a ripe old age than go for slaughter or be euthanised. Some will be lucky, will find excellent homes and be fine, but a number will not. Many of the animals who become welfare cases will have been poorly bred resulting in conformation problems making them unusable for riding. They come with damaging worm burdens, other parasites or the effects of ragwort poisoning or consumed toxins. They can require significant dental work, farriery, veterinary attention and investigations. They may need specialist feed and medication. None of this is cheap. They may still need to be euthanised at the end of treatment that has been expensive for the humans and stressful for the animal.
Animal hoarding is often joked about and brings to mind images of the local cat lady. In reality animal hoarding is no joke for the people involved, their dependants, the animals hoarded, their neighbours and communities. Animal hoarding often starts by well meaning individuals rescuing and caring for animals which then gets out of hand and the animals end up in a worse state than before they were ‘rescued’, as described in my recent article in Mental Health Practice found here; http://rcnpublishing.com/doi/pdfplus/10.7748/mhp2014.03.17.6.35.e868
Before any of us takes on an animal as a ‘rescue’ we need to think beyond our current situation, what happens if we or a member of our family gets sick. How will we manage if we lose some or all of our income. If we take in an equine will our current grazing / stabling always be available. It may be possible to manage now but companion animals will live for some years and horses live for a long time, will we still be able to manage day to day when we, and they, are twenty plus years older.
Taking on any animal is a responsibility, taking on a horse or pony is a long term commitment and a rescue one comes with possible physical and psychological problems which require significant financial, time and emotional resources. Taking on an animal to make things ‘better’ for it may make life worse in the long run for it, and for the individual ‘rescuing’ it.
Forget Facebook Frippery – do something meaningful
There appears to be a Facebook trend this week. Women are taking ‘selfies’ without makeup, posting the photos on Facebook for, ‘cancer awareness week’ or, ‘breast cancer awareness’ and then nominating some of their friends to do the same. I wasn’t quite sure what the point was really, or how it was raising awareness of cancer. I googled cancer awareness week and actually there is neither one this week nor one in the past few weeks. The month of March is prostate cancer and ovarian cancer awareness month. There are various cancer awareness months in 2014 which can be found here; http://be.macmillan.org.uk/Downloads/CancerInformation/CancerAwareness/MAC1362914GuideCancerAwareness2014.pdf
Doing something for cancer awareness – be aware of the individuals
This all made me think about how easy it is to be caught up in to ‘doing something for cancer’ via social media and I got to thinking some more. So, this is what I really want to say is; forget Facebook, forget selfies – if you really want to help, want to do something for cancer awareness think about the individuals affected by it. Here is what you can do…
Think of someone who you know of who is going through or has had treatment for cancer or someone who is or has cared for a loved one with cancer. Then think about how you can offer them a little support. Send them a card, make a meal and drop it round to them or find some other small gift that is useful but also conveys that you are thinking of them.
Ask their partner, member of the family, carer how they are. Usually everyone asks after the person with cancer but the carer still has to do all the normal stuff of daily living, often still going to work and taking on extra responsibilities plus caring for the person who has the illness. It is exhausting, and often lonely being a carer, rarely are they asked how they are.
Give the person with cancer, or their carer, the gift of listening, really listening. Ask them how they are and then listen. Don’t offer verbal band aids of ‘it will be alright’ or ‘think positively’, but instead listen to their unique experience.
Offer to do some housework, some ironing, run the kids to school or an activity. By them a coffee shop gift card so they can have a little time out, a little treat that they might not actually be able to afford. If you are feeling really flush pay some of their electricity or gas bill (living with cancer is expensive and often more heating is essential) or put petrol in their car.
When my partner was having six months of chemotherapy many friends were very kind, those that listened and offered practical help were just amazing. I finish this blog with an example of some of the most moving support that was offered to my partner that was very specific and special to him.
The model steam engine
My partner’s late father had partially built a model steam engine and my partner was sad that it had never been finished. We slightly knew someone who, as a hobby, built model steam engines and we handed my father in law’s very precious model over to him, wondering whether this was really very wise. We should not have worried. It was methodically worked on with great skill and precision over many, many hours. The model builder became a good friend and gave us regular updates of his progress.
On the day of my partner’s last chemotherapy our, now, friend quietly took a day off work to finish the model. When we got home there was a video on Facebook of the engine up and running. We cried.
So, if you want to support someone with cancer, or their carer, you don’t have to spend hours of your time making a steam engine, but do think about what small thing would be helpful and meaningful to them. Social media can be useful but forget the frippery, make it real.
With thanks to Big Al.
viewfromthemalvernhills 