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I am a grouchy, bald headed old fart filled with opinions and not the least bit shy about sharing them.

Thursday, July 26, 2007

A feline escort into the next life.

Oscar is the mascot on a locked ward for the terminally dementia patients at the Steere House Nursing and Rehabilitation Center in Providence, RI. Oscar got a write up in the New England Journal of Medicine this month for his uncanny ability to identify a patient that will die in the next few hours and then stay with that person until they pass.

Making his way back up the hallway, Oscar arrives at Room 313. The door is open, and he proceeds inside. Mrs. K. is resting peacefully in her bed, her breathing steady but shallow. She is surrounded by photographs of her grandchildren and one from her wedding day. Despite these keepsakes, she is alone. Oscar jumps onto her bed and again sniffs the air. He pauses to consider the situation, and then turns around twice before curling up beside Mrs. K.

One hour passes. Oscar waits. A nurse walks into the room to check on her patient. She pauses to note Oscar's presence. Concerned, she hurriedly leaves the room and returns to her desk. She grabs Mrs. K.'s chart off the medical-records rack and begins to make phone calls.

Within a half hour the family starts to arrive. Chairs are brought into the room, where the relatives begin their vigil. The priest is called to deliver last rites. And still, Oscar has not budged, instead purring and gently nuzzling Mrs. K. A young grandson asks his mother, "What is the cat doing here?" The mother, fighting back tears, tells him, "He is here to help Grandma get to heaven." Thirty minutes later, Mrs. K. takes her last earthly breath. With this, Oscar sits up, looks around, then departs the room so quietly that the grieving family barely notices.

The New England Journal of Medicine: A Day in the Life of Oscar the Cat by David M. Dosa, M.D., M.P.H.

Oscar's sense for death is remarkable. In fact his record is so good that caregivers summon relatives when they find Oscar resting with a patient.

In the two years since Oscar was adopted into the third-floor dementia unit of the Steere House Nursing and Rehabilitation Center in Providence, he has maintained close vigil over the deaths of more than 25 patients, according to nursing staff, doctors who treat patients in the home, and an article in tomorrow's New England Journal of Medicine, written by Dosa.

When death is near, Oscar nearly always appears at the last hour or so. Yet he shows no special interest in patients who are simply in poor shape, or even patients who may be dying but who still have a few days. Animal behavior experts have no explanation for Oscar's ability to sense imminent death. They theorize that he might detect some subtle change in metabolism -- felines are as acutely sensitive to smells as dogs -- but are stumped as to why he would show interest.

"It may just come down to empathy," said Dr. Nicholas H. Dodman, a leading behaviorist and professor at Tufts University's Cummings School of Veterinary Medicine, when told about Oscar's eerie knack.

In any event, when Oscar settles beside a patient on the bed, caregivers take it as sign that family members should be summoned immediately to bid their loved one farewell.

"We've come to recognize him hopping on the bed as one indicator the end is very near," said Mary Miranda, charge nurse in the Safe Haven Advanced Care Unit, the formal name of the surprisingly cheery floor that is home to 41 patients suffering in the final stages of Alzheimer's, Parkinson's, stroke, and other mentally debilitating diseases. "Oscar's been consistently right."Read on...

The Boston Globe: With a purr, death comes on little cat feet

The experts are all guessing as to how Oscar senses the end is near. Others are speculating as to why Oscar holds his vigils with dying patients.

How Does He Know?

Explaining Oscar's track record and seeming ability to "read" a resident's end-of-life stages and predict death is a mystery, Dosa and others at the nursing home acknowledge. "Your guess is as good as mine," Dosa says when asked how Oscar picks up the sense of impending death.

"We know from some objective findings when death is imminent," Dosa says. For instance, if respirations grow difficult in a very sick patient, he says, doctors may tell loved ones death will probably occur soon.

The cat, however, might be picking up on specific odors surrounding death, Dosa and other says.

"I think there are certain chemicals released when somene is dying, and he is smelling and sensing those," says Joan Teno, MD, professor of community health and medicine at the Warren Alpert Medical School of Brown University, Providence, R.I., who also cares for Steere House residents.

Another possibility: "I think he is following the patterning behavior of the staff," Teno tells WebMD. "This is an excellent nursing home. If a dying person is alone, the staff will actually go in so the patient is not alone. They will hold a vigil."

Oscar has seen that pattern repeated many times, she says, and may be mimicking it.

"Animals are intuitive," she says. "We don't give them enough credit."

One of the first cases, Teno says, involved a resident who had a blood clot in her leg. "Her leg was ice cold," Teno says. "Oscar wrapped his body around her leg," she says, and stayed until the woman died.

Animal Experts Weigh In

Three animal behavior experts say the explanation about Oscar sensing a smell associated with dying is a plausible one.

"I suspect he is smelling some chemical released just before dying," says Margie Scherk, DVM, president of the American Association of Feline Practitioners, an organization devoted to improving the health and well-being of cats, and a veterinarian in Vancouver, British Columbia. "Cats can smell a lot of things we can't," she says. "And cats can certainly detect

"Cats have a superb sense of smell," adds Jill Goldman, PhD, a certified applied animal behaviorist in Laguna Beach, Calif. In Oscar's case, she says, keeping a dying resident company may also be learned behavior. "There has been ample opportunity for him to make an association between 'that' smell [and death]," she says.

While the sense of smell may be one explanation, there could be another, says Daniel Estep, PhD, a certified applied animal behaviorist in Littleton, Colo. "One of the things that happen with people who are dying is that they are not moving around much. Maybe the cat is picking up on the fact that the person on the bed is very quiet. It may not be smell or sounds, but just the lack of movement."

CBS News: Cat's "Sixth Sense" Predicting Death?

We know so little about what goes on inside the mind of an Animal. Animals know so much more then we could ever guess. Imagine what they could teach us if they could talk.

But would we have the wisdom to listen and learn?

- 30 -

I have it on good authority that Death likes cats and brings Oscar a Kitty Treat (tm) every time he stops by.
- Uplinktruck

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