Creator: Help Dementia Editorial Team
Published: 2026-04-06T18:16:18

Reviewed by the Help Dementia Editorial Team — our editors review every article for accuracy against guidance from the National Institute on Aging, the Alzheimer’s Association, and peer-reviewed sources.

Animal assisted sits at the center of this dementia and brain health question.

Animal Assisted Therapy (AAT) is being integrated into dementia care facilities across the United States, though not as a single coordinated 30-state program but rather through numerous independent healthcare systems and care communities adopting these interventions. With 6.2 million Americans aged 65 and older living with Alzheimer’s disease—the most common form of dementia—the demand for effective behavioral and emotional support interventions has prompted widespread adoption of animal therapy in memory care settings. ProMedica’s Arden Courts, for example, operates 57 memory care communities across the country, with nearly all of them incorporating animal therapy and allowing residents to keep pets, demonstrating how major healthcare systems are making AAT a standard part of dementia care.

The integration of animal assisted therapy represents a shift toward non-pharmacological interventions that address the behavioral and psychological symptoms of dementia. Rather than relying solely on medications, which can carry significant side effects for older adults, healthcare facilities are increasingly recognizing that interaction with animals—particularly trained therapy dogs—offers measurable benefits for cognitive function and emotional well-being. This growing adoption is backed by recent research, including a 2025 systematic review in Geriatric Nursing examining six studies with 632 participants, and broader meta-analyses of 11 randomized controlled trials involving 825 participants, all showing significant reductions in behavioral and psychological symptoms of dementia.

What Are the Core Elements of Animal Assisted Therapy in Dementia Care Settings?
The Research Evidence: What Does Science Show About Effectiveness?
How Major Healthcare Systems Are Scaling Animal Therapy Programs
Implementation Challenges: Cost, Liability, and Practical Considerations
Quality Standards: Why Certified Therapy Animals Outperform Untrained Pets
Expanding Accessibility: How Animal Therapy Programs Reach More Residents
The Future of Animal Assisted Therapy in Dementia Care
Conclusion

What Are the Core Elements of Animal Assisted Therapy in Dementia Care Settings?

Animal Assisted Therapy in dementia care typically centers on structured interactions with trained animals, most commonly dogs, though horses and other animals are also used. Standard AAT sessions last approximately 60 minutes and are designed to provide sensory stimulation, emotional engagement, and cognitive activation. The therapy works by creating points of connection and memory activation—residents may remember pets they owned decades earlier, or they may respond to the unconditional companionship that animals provide regardless of cognitive status. Unlike traditional therapy animals used in hospitals, some dementia care programs specifically use dogs trained to recognize behavioral changes and respond to agitation or distress, providing what’s sometimes called animal-assisted intervention rather than pure therapeutic companionship. The implementation varies by facility.

Some programs employ a full-time therapy dog that lives at the facility and interacts regularly with residents. Others schedule visits from certified therapy dog handlers on a weekly or bi-weekly basis. Still others allow residents to maintain personal pets within the facility. ProMedica’s Arden Courts model demonstrates how large systems can standardize this approach across multiple locations—their near-universal inclusion of pets and animal therapy represents institutional commitment rather than an ad-hoc program. This variability means that the “30 states” reference in discussions of animal therapy integration actually reflects dozens of individual facilities, healthcare systems, and programs scattered across the country, each implementing AAT according to their own protocols and resources.

What Are the Core Elements of Animal Assisted Therapy in Dementia Care Settings?

The Research Evidence: What Does Science Show About Effectiveness?

Recent research has quantified the benefits of animal assisted therapy for dementia symptoms with encouraging results. A 2025 analysis found that dog therapy reduced geriatric depression symptoms by 50 percent and increased average cognitive scores by 4.5 points in study participants. These aren’t marginal improvements—a 50 percent reduction in depression symptoms represents the difference between a resident who is withdrawn and resistive versus one who is engaged and cooperative. The meta-analysis of 11 randomized controlled trials involving 825 participants identified significant reductions not just in depression but in behavioral and psychological symptoms of dementia more broadly, including agitation, aggression, and anxiety.

However, a critical caveat emerged from this research: trained and certified therapy dogs produced significantly better outcomes than untrained dogs. This distinction matters because it reveals that animal therapy isn’t simply about having pets around—the animals need specific training to recognize and respond to dementia-related behaviors. A facility with a beloved but untrained dog on staff will likely see fewer benefits than one working with a certified therapy dog team. This limitation means that not all facilities claiming to use “animal assisted therapy” are delivering the evidence-based intervention. Some are simply allowing pets, which may provide comfort but won’t necessarily produce the measured improvements documented in the research.

How Major Healthcare Systems Are Scaling Animal Therapy Programs

ProMedica’s Arden Courts presents the most visible example of systematic integration at scale. With 57 memory care communities allowing pets and incorporating animal therapy, ProMedica has effectively created a network through which thousands of dementia residents have access to animal-based interventions. This represents not a single program but a system-wide policy decision to make AAT standard in their memory care model. Other regional healthcare systems have followed similar paths, though the specific implementation details vary. Some facilities have partnerships with local animal rescue organizations that provide certified therapy dogs for scheduled visits, creating a symbiotic arrangement where the animals receive care and socialization while residents receive therapeutic benefit.

The scaling challenge lies in ensuring consistency and quality. A facility with a well-trained therapy dog team and structured AAT protocols will deliver measurable results. A facility that simply allows a pet dog to roam the common areas is offering companionship but not formal animal assisted therapy. This variance explains why, despite the widespread adoption of animals in memory care settings nationwide, the research distinguishes between formal AAT programs (which produce the documented improvements) and general pet-friendly policies (which provide comfort but may not be systematically therapeutic). The “30 states” framing often conflates these different approaches.

How Major Healthcare Systems Are Scaling Animal Therapy Programs

Implementation Challenges: Cost, Liability, and Practical Considerations

Implementing genuine animal assisted therapy programs requires investments that not all facilities can make. A certified therapy dog from a reputable program costs thousands of dollars to train and handler certification requires specialized training and ongoing education. For facilities operating on tight margins, even a partnership arrangement with a therapy dog organization requires administrative coordination and space allocation. Larger systems like ProMedica can absorb these costs across their portfolio, but smaller independent memory care facilities must weigh the expense against other priorities like staff training or medication management.

Liability and health concerns present another trade-off. While animal therapy benefits are well-documented, facilities must manage allergen exposure, infection control, and the risk of injury (even small dogs can bite or knock down frail residents). Some facilities with particularly vulnerable populations—residents with immunocompromise or severe mobility limitations—may find the liability outweighs the benefits. Additionally, not all residents benefit equally. Individuals with dog phobias, animal allergies, or a history of zoonotic infections may need to be excluded from AAT, meaning programs can never be truly universal despite being offered facility-wide.

Quality Standards: Why Certified Therapy Animals Outperform Untrained Pets

The research distinction between certified and untrained animals reflects real differences in training and behavioral predictability. Certified therapy dogs undergo training to remain calm around medical equipment, walking aids, and unpredictable movements common in dementia care settings. They learn to respond to specific behavioral cues—recognizing when a resident is becoming agitated and moving closer to provide comfort, for example. They’re also socialized to multiple handlers and comfortable being petted by people with tremors, poor coordination, or unclear boundaries around personal space. A facility’s own pet dog, by contrast, may be friendly but isn’t trained for therapeutic work.

The dog might startle at a resident’s sudden movement or loud vocalization, potentially causing mutual distress. An untrained dog also won’t have the behavioral reliability that allows staff to confidently include it in structured therapeutic sessions. This distinction is important for facilities considering whether to invest in certified therapy dog programs versus simply allowing staff or residents to bring in personal pets. The research makes clear that if the goal is to achieve the documented improvements in depression reduction and cognitive scoring, certified animal assisted therapy is necessary. A well-meaning pet dog provides companionship but won’t deliver the same measurable benefit.

Quality Standards: Why Certified Therapy Animals Outperform Untrained Pets

Expanding Accessibility: How Animal Therapy Programs Reach More Residents

The integration of animal therapy across multiple states has been accelerated by professional organizations developing training standards and certification programs for therapy animals. The Delta Society, Pet Partners, and similar organizations have created frameworks that allow facilities without in-house expertise to bring certified animal teams into their settings through partnerships. This infrastructure makes AAT more accessible to facilities that can’t hire full-time animal care staff.

Visiting therapy dog programs, where volunteer handlers bring certified dogs to facilities on a scheduled basis, have proliferated as a lower-cost model that still provides evidence-based intervention. Some facilities have also explored using horses in equine-assisted therapy programs, which can serve multiple residents simultaneously in a single session. While less common than canine therapy due to space and logistical requirements, equine programs are operating in various states and offer particular benefits for residents with mobility issues, since interactions can occur while seated. These expanded modalities demonstrate how the field is adapting animal therapy to different facility contexts and populations.

The Future of Animal Assisted Therapy in Dementia Care

As the population with dementia continues to grow and family members and facility administrators increasingly demand non-pharmacological interventions, animal assisted therapy is likely to become a more standard offering. The research base supporting AAT is strengthening—the 2025 research activity represents continued scientific investigation, not a one-time finding. Emerging studies are examining which specific populations benefit most, optimal session frequency, and whether hybrid approaches (combining AAT with other interventions) produce even better outcomes.

The next frontier may involve standardizing animal therapy protocols more consistently across facilities, similar to clinical practice guidelines for medication management. This would help ensure that when facilities claim to offer animal assisted therapy, they’re delivering the evidence-based intervention rather than simply pet companionship. As more healthcare systems like ProMedica adopt systematic approaches, the infrastructure for quality animal therapy programs will likely expand beyond the current scattered adoption.

Conclusion

Animal Assisted Therapy is being integrated into dementia care across the United States through multiple independent programs and healthcare systems rather than as a single coordinated 30-state initiative. The research evidence clearly demonstrates that structured, certified animal therapy—particularly with trained therapy dogs—produces measurable improvements in depression symptoms, behavioral issues, and cognitive function for people with dementia. With 6.2 million Americans currently living with Alzheimer’s disease, and the evidence showing a 50 percent reduction in depression symptoms and 4.5-point improvements in cognitive scores, AAT represents a valuable non-pharmacological tool in the dementia care toolkit.

If you or a family member are evaluating memory care facilities, ask specifically whether the facility uses certified, trained therapy animals through established programs like Pet Partners or the Delta Society, rather than simply allowing pets. The distinction matters because the benefits documented in research come from formal animal assisted therapy, not general pet companionship. As this field continues to develop, facilities incorporating quality animal therapy programs are positioning themselves at the forefront of evidence-based, compassionate dementia care.