INTRODUCTION

The issue of old age and aging is currently a much-discussed topic. The obvious reason for the visibility of this issue is probably the fact that the human age is getting longer and the population in our world is aging unstoppably. One of the most important priorities for nursing care is the psyche of the sick. Deterioration of the mental state of a senior can negatively affect the course of the entire disease. In connection with this knowledge, it is important to constantly look for new methods and activities that would make life easier for patients in hospitals for the long-term sick. Very often, the only closest being for this specific group of sick seniors is a domestic animal companion.

The reason for the visibility of this issue is most likely the fact that the human age is getting longer and the population in our world is aging unstoppably. The effort is to ensure a dignified and active old age for seniors, even when they are hospitalized in a hospital and then often in a hospital for the long-term sick. Separation from the family often results in isolation, which complicates therapeutic interventions. A sick person can withdraw into himself, not communicate, can refuse food. (Cetlová, Kopáčiková, Stanšiak, 2010, p.37). A lot has already been said about hospitals for long-term patients, and not always positive reactions. The work in these departments is very demanding. A nurse spends a large part of her working time in direct contact with patients, which places extraordinary demands on her mental and physical strength. To assess and manage the situation, it is necessary to empathize with the client's current mental state. (Cetlová, Kopáčiková, Stančiak, 2010, p.151). This leads to a large number of patients in the department and their diagnoses for which they are hospitalized. And last but not least, their fates in life, which are a frequent cause of their hospitalization. It is important to constantly look for new methods and activities that would make life easier for patients in hospitals for the long-term sick. Very often, the only closest being for these patients is a domestic animal companion.

Canistherapy is composed of the word canis (Latin dog) and therapy (Greek treatment), is considered part of rehabilitation and a method of therapy that uses the positive effect of a dog on human health, when health is understood according to the definition of the WHO (World Health Organization) as a state of psychological, physical and social well-being. Hrozenská et al. (2008) state in this context: canistherapy is based on a desirable positive interaction between a dog and a senior, which significantly affects the quality of life of seniors.

Animals kept at home can be of great importance for an old person at the end of life, which is supported by a mutual long-term relationship of coexistence. These animals can reduce the feelings of loneliness, social isolation, but also certain unnecessaryness for the environment in an old or lonely person. This attitude is based on a situation where animals are dependent on the individual and we have to take care of them, the old person takes responsibility for them, gets an important fulfillment of life and all this can lead to an increase in self-confidence. One of the most common animal companions of seniors is a dog. For seniors, the dog is also important in strengthening physical activity, whether it is during activities related to feeding, walking, hygiene or playing. Because it also requires a certain daily rhythm, it can also have an effect in reducing senile lack of concentration and confusion. Furthermore, they significantly participate in facilitating communication.

In follow-up care facilities or hospitals for long-term patients, patients are often found in a stable condition, with an established diagnosis. Patients who are polymorbid, require a longer treatment and rehabilitation program, patients in the terminal stage or patients who exceed the capacity of realistically claimed home care are also hospitalized here. The content of the work here is a comprehensive assessment of the patient, determination of a treatment, rehabilitation and occupational therapy plan (Komačeková, 2010).

The nurse's work focuses on meeting basic needs, prevention of immobilization syndrome, training in daily activities, activation and comprehensive nursing care. This care includes care for incontinent and immobile patients, treatment of chronic wounds, pressure ulcers, administration of drugs, administration of infusion therapy, monitoring of vital functions, sampling of biological material, treatment of stomas, drains or cannulas. (Jarošová, 2006)

Other nursing problems arise from the movement disorder, such as a disorder of self-care and self-sufficiency, a disorder of food and fluid intake. Improving dietary and nutritional care for aging individuals and especially sick ones significantly reduces the risk of developing and developing numerous chronic diseases, for example degenerative diseases of the cardiovascular, nervous, muscular and skeletal systems. (Cetlová, 2011, p.3).

Despite the imminent risk of falling and the danger of injury, when the nurse ensures the so-called safe bed - it has an adjustable height with side barriers that are divided or continuous. (Cetlová, 2010, p. 50). In addition to these activities, the nurse must provide comprehensive nursing care and adjust the environment in the way that suits the patient the most and always be helpful to him.

Research

The goal of our work was to map the effect of canistherapy on improving the self-care of sick seniors in a hospital for the long-term sick and to map the effect of canistherapy on improving the course of hospitalization of seniors in a hospital for the long-term sick (LDN).

For data collection, we chose the methodology of quantitative investigation in the form of anonymous questionnaires. The questionnaires were intended for seniors in two hospitals for the long-term sick. A total of 120 questionnaires were distributed. The return rate from LDN A was 45 (75%) and from LDN B 41 (68%) completed questionnaires were returned. A total of 86 correctly filled questionnaires were used. The questionnaire was anonymous, it contained 28 questions. All 28 questions were closed. Seniors marked the answers with a tick, multiple answers were possible for marked questions. The condition for filling out the questionnaire was a cooperating senior citizen.

A senior who is hospitalized in LDN may be limited in the area of ​​self-care. Topinková gives the definition of a self-sufficient person as a person who does not have significant physical or mental limitations and who independently and without outside help or assistance from other people manages all the necessary activities of daily life in the environment in which he lives (Topinková, 2005, p. 7)

We focused on whether seniors feel limited in this area and who helps them the most in improving these difficulties. First, we asked whether hospitalized seniors experience certain difficulties in the area of ​​self-care. In both LDN A and LDN B, more than half of the interviewed seniors feel these difficulties. Therefore, we believe that these seniors are not able to provide for all their needs for these reasons. Human life can be characterized by the constant satisfaction of various needs. Knowledge about basic needs forms the theoretical basis for the application of the nursing process. In our case, the interviewed senior has his needs affected by the illness and hospitalization in LDN. (Zacharová, Hermanová, Šrámková, 2007).

In order to find out which needs the interviewed seniors cannot satisfy due to their hospitalization in LDN, we asked another question. In which area do the interviewed seniors feel most limited. In LDN B, there were difficulties with hygiene, voiding, dressing and moving around in the room. In LDN A, there were difficulties with movement at rest, dressing, voiding and hygiene. So it is about the same areas, only in the completely opposite order. However, in LDN 2, 18% of seniors, which is the largest group, feel restricted in their movement around the room. This finding surprised even us. We know from experience that seniors in LDN feel their limitations in the area of ​​self-care most often in areas such as emptying, eating, hygiene, etc., but they usually refuse to move around the room and are happy to stay in bed.

In order to find out who helps the interviewed seniors the most in improving their difficulties in the field of self-care, we first asked whether the interviewed seniors had improved their difficulties since the beginning of hospitalization. 38% of seniors in LDN A answered yes to this question and 38% rather yes. They give the most credit to nurses (39%), rehabilitation nurses (29%) and doctors (24%). In LDN B, 40% of the interviewed seniors answered yes and 28% rather yes. This surveyed group credits nurses (28%), doctors (27%) and rehabilitation nurses (23%) for improving their self-care difficulties. We deliberately chose the designation rehabilitation nurse in the questionnaire, as the term physiotherapist is not known among seniors, which could result in distortion of the data in the answers. We believe that nurses are the ones who spend the most time with hospitalized seniors, and that is why the interviewees give them the most credit. Although rehabilitation nurses are assigned to improve mobility and the area of ​​self-care, their number is not sufficient to satisfy all patients 100%. We think that a doctor as such will not do much to improve the self-care of seniors. But people label doctors because they take them as an authority. We know from practice that when we require certain seniors to perform an action, the senior is not able to do so. If a doctor comes and asks for the same thing, suddenly he is able to do it. So even the merit of the doctor can be recorded.

Using these questions, it was not confirmed to us that canistherapy would help seniors to improve their self-care. Seniors give the greatest credit to nurses, doctors, rehabilitation nurses and family. However, it is worth noting the answers of seniors who use canistherapy. We asked them how canistherapy affects them. In the answers, they stated that canistherapy brings them a positive effect in improving the psychological area, even in moving from a bed to a chair. Therefore, a little credit can also be attributed to canisterapia.

Our second goal was to find out whether canistherapy leads to an improvement in the course of hospitalization. The course of hospitalization in LDN can develop in different directions, both positive and negative. One of the most important factors that can positively influence the course of hospitalization is if the patient is in a good mental state. If we think about what or who can induce a positive mental state in a sick person, the family is certainly one of the first that comes to mind. Another factor influencing the course of hospitalization can be its reason and length. We think that whether the patient is hospitalized for rehabilitation, when it is necessary to improve their mobility and self-care, or whether the reason is medical, when the patient has a chronic and often incurable disease, certainly has an effect on the course of hospitalization. In this case, patients often fall into despair, anxiety, do not communicate, and cooperation with such a person is very difficult. We believe that it is for these reasons that canistherapy could be beneficial for seniors in LDN. From the investigation, we found that in LDN A, the most common reason for hospitalization is medical, followed by rehabilitation, and the last reason is social. Here we can point out that in LDN A, the social reason for hospitalization is 17% of patients, because this LDN has 20 social beds available. In LDN B, the most common reason was rehabilitation, followed by treatment and finally social. The answers to this question cannot be assumed, because it always depends on the current diagnoses of the admitted patients and cannot be influenced. Patients who are polymorbid, require a longer treatment and rehabilitation program, patients in the terminal stage or patients who exceed the capacity of realistically claimed home care are treated here. We also asked the interviewed seniors how often their family visits them in LDN. With this answer, we wanted to find out how many seniors in LDN could feel lonely because their family does not visit them. This situation can lead to a deterioration of the psychological state, to a loss of motivation and subsequently to a deterioration of treatment and the course of hospitalization. In LDN A, the interviewed seniors are mostly visited by family once a week, and in LDN B there were two equally large groups in first place, also once a week and the second was three times a week. We can assume that the reason for the hospitalization or the frequency of their family's visits does not stress them in any way. But even so, we have to think about the small percentage of interviewees who do not feel well during the day in LDN, because the family visits them only once a month or does not visit them at all. If we want to believe that canistherapy could lead to an improvement in the course of hospitalization, we must first find out how seniors in LDN feel during the day, and whether they need any activities to improve the course of hospitalization. In LDN A, most seniors feel good during the day, but the next two biggest groups of answers were that they are bored and the day is long. In LDN B, seniors also feel most comfortable, the second largest group evaluates the day in LDN as long. It is gratifying that the largest group is the answer that the interviewed seniors feel good during the day in LDN. It is a reward for all the staff for their hard work. Even so, it is advisable to constantly look for new activities that would make the day at LDN more pleasant for hospitalized seniors. In LDN B, he tries using a leisure activity such as canistherapy. In LDN A, they use a form of occupational therapy to diversify their everyday life. We think that the answer to this question could not have turned out differently. There will always be seniors hospitalized in the department who are positively attuned and interested in their surroundings, but also patients who are negatively attuned with a loss of meaning in life. We certainly have to try to positively influence all patients. But hospitalized seniors are also entitled to a negative attitude towards life due to their age, illness and often difficult life stories.

We think that the reason why the interviewed seniors are bored during the day in LDN or the day seems long to them is the length of hospitalization. This is also proven by the answers to another question, which inquired about the length of hospitalization. Here we found out that in both LDN A and LDN B, most seniors are hospitalized for three weeks to a month and two often to three months. That is certainly a long enough time for a sick senior to miss home, family and the outside world, so that the day at LDN seems long and stereotypical. We think it would be appropriate to include a leisure activity such as canistherapy. 50% of seniors in LDN B, where canistherapy is used, said that after canistherapy they are in a better mood and look forward to their next visit, 36% said that they feel the same after canistherapy, but their day goes by faster. In LDN B, we asked seniors whether they believe that canistherapy is beneficial for them. 73% answered yes. 14 interviewees stated that in the psychological area, 6 in communication with other patients, 4 in the social area, 3 indicated the area of ​​communication with staff, cooperation with staff and in moving from bed to chair. Our investigation shows that canistherapy contributes to improving the course of hospitalization of seniors.

Conclusion

Seniors and their age group bring with them their illnesses, needs and specifics in nursing care. We can meet a sick senior in almost every ward, but most of the time, a sick senior is associated with a treatment room for the long-term sick. In these departments, volunteers are often used for canistherapy. Voluntary help in hospitals in the Czech Republic is anchored in the field of care for long-term hospitalized and seriously ill patients, and for patients who lack support from family and friends during hospitalization. The basic mission of the volunteer program in hospitals in the Czech Republic is to bring more human contact into the hospital environment, contribute to a faster return of the sick to normal life, and support the patient's mental well-being. A volunteer does not replace the work of professional staff, but appropriately supports and supplements it at the level of his possibilities and abilities (Cetlová, 2009, p.15).

Authors: Lada Nováková - Havlíčkův Brod Hospital, Czech Republic Vlasta Dvořáková - Department of Health Studies, Jihlava Polytechnic University, Czech Republic Literature CETLOVÁ, L. 2011. Nutritional disorders in old age. Logos Polytechnikos. 2011, year 2, no. 1, p. 3 – 13. ISSN 1804-3682. CETLOVÁ, L. 2010. Patient fall – the most frequently reported emergency/adverse event in a medical facility. In collection of lectures III. South Bohemian conference of non-medical health workers. České Budějovice, 2010. ISBN 978-80-254-7919-3. CETLOVÁ, L. 2010. Quality of life of a patient with Alzheimer's disease. In collection of contributions from the conference: "Health and quality of life". Faculty of Health, Catholic University Ružomberok, 2010, ISBN 978-80-8084-532-2.p. 34 - 38. CETLOVÁ, L. 2009. Volunteer program in a medical facility. In Ružomberské zdravotnické dni IV. year. Collection of abstracts from the international conference. Faculty of Health of the Catholic University in Ružomberok: Ružomberok, 2009. ISBN 978-80-8084-539-1, p. 17. CETLOVÁ, L., KOPÁČIKOVÁ, M. STANČIAK, J. 2010. Care of the sick in a psychiatric hospital. In collection of contributions from the conference: "Health and quality of life". Faculty of Health Sciences, Catholic University of Ružomberok, 2010, ISBN 978-80-8084-532-2. with 150. HROZENSKÁ, M. et al. 2008. Social work with older people and its theoretical and practical starting points. Martin: Osveta, 2008. - 181 p. - ISBN 978-80-8063-282-3. JAROŠOVÁ, D. 2006. Care of the elderly. 1st edition. University of Ostrava in Ostrava, Faculty of Health and Social Sciences, 2006. ISBN 80-7368-110-2. KOMAČEKOV Á, D. 2010. The nurse's influence on the aging process. Sister. 2010. no. 6, p. 66 - 68. ISSN 1210-0404. TOPINKOVA, E.2005. Geriatrics for practice. 1st edition. Prague: Galén, 2005. 270 p. ISBN 80-7262-365-6. ZACHAROVÁ, E., HERMANOVÁ, M., ŠRÁMKOVÁ, 1. 2007. Medical psychology - Theory and practical exercises. 1st edition. Prague: Grada, 2007. 232p. ISBN 978-80-247-2068-5.