Service dogs – a very important assistant in improving quality of life and function by Stephanie Sutherland, RN

Service dogs – a very important role in improving quality of life and function.

For individuals living with complex chronic conditions such as Postural Orthostatic Tachycardia Syndrome (POTS), Ehlers-Danlos Syndrome (EDS), and Complex Regional Pain Syndrome (CRPS), everyday activities can be exhausting, painful, or even dangerous. In addition to medical management, one powerful yet underutilized intervention I often recommend is the integration of a trained service dog into the patient’s care plan.

Understanding the Unique Needs of These Conditions

POTS affects autonomic function, leading to dizziness, fainting, and profound fatigue when standing. EDS, a connective tissue disorder, often causes joint instability, chronic pain, and mobility challenges. CRPS is marked by severe, disproportionate pain following injury, sometimes accompanied by changes in skin, temperature, or swelling. All three conditions may significantly impair a person’s ability to safely navigate their environment or perform daily tasks independently.

How Service Dogs Provide Support

A well-trained service dog can dramatically improve the independence, safety, and quality of life for patients with these conditions. Under the Americans with Disabilities Act (ADA), a service dog is defined as one trained to perform specific tasks that directly assist an individual with a disability. These tasks must be tailored to the patient's unique functional impairments. Here’s how they can help:

1. Mobility and Stability Assistance

Many EDS and POTS patients are prone to dizziness, falls, and joint dislocations. Service dogs can be trained to:

• Provide counterbalance support when walking or standing
• Help the patient rise from a seated or fallen position
• Retrieve dropped items to avoid painful or risky bending

2. Medical Alerts and Response

While some dogs naturally detect changes in heart rate or impending syncope (fainting), with training, this ability can become a reliable medical alert system. Dogs may:

• Alert the patient before fainting (common in POTS)
• Signal caregivers or trigger an emergency alert device
• Lead the patient to a safe area when symptoms escalate

3. CRPS-Related Pain Management Support

Though dogs cannot take away pain, their presence and task work can:

• Interrupt cycles of anxiety and stress, which worsen CRPS symptoms
• Prompt movement or stretching to prevent stiffness
• Offer grounding techniques during flare-ups or allodynia attacks

4. Task-Based Independence

Service dogs can be trained to:

• Press medical alert buttons
• Open and close doors
• Fetch medications or assist with dressing

These tasks help patients reduce reliance on others and regain autonomy in their daily routines.

Psychological and Emotional Benefits

While emotional support alone doesn’t qualify a dog as a service animal, there are meaningful mental health benefits tied to working with a task-trained service dog:

• Increased confidence to venture outside
• Reduced fear of being alone during a medical episode
• A sense of companionship that alleviates isolation

Considerations Before Recommending a Service Dog

It’s essential that patients understand the legal, financial, and practical aspects of acquiring and working with a service dog:

• Legal Eligibility: The patient’s condition must meet the ADA definition of a disability, and the dog must perform at least one trained task directly related to that disability.
• Training: It typically takes 18 months to 2 years to fully train a service dog, whether owner-trained or through a professional program.
• Cost: Expenses range from $20,000 to $40,000, not including ongoing care and maintenance.
• Daily Maintenance: Handlers must be capable of managing the dog’s grooming, feeding, and training upkeep.
• Public Access and Education: Patients should be prepared for public questions and know how to assert their rights under ADA, ACAA, and HUD guidelines.

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Assistance dogs international: https://assistancedogsinternational.org

International Guide Dog Federation: https://www.igdf.org.uk