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Budgerigars and begonias

Most of us will, from time to time, come across some interesting or amusing report which is just that bit different from usual. Bandolier vividly recollects a study in Nature (reference, alas, forgotten) which described the powerful anti smoking effect of alcoholic extracts of fresh barley shoots consumed in orange juice compared with drinking "screwdrivers". Why did we never manage to get out into the Oxfordshire fields, pick some barley shoots and do the 'definitive screwdriver study'?
So just in case Bandolier gets labelled with being "too techy", we though we would open an "Old Curiosity Shop" for some of those interesting findings. In the next few months we will carry some stories, with different levels of evidence, and invite our readers to give us their favourite papers from the past with a difference.

Evidence-based budgerigars

A study reported in 1974 [1] on the psychotherapeutic value of giving budgerigars to old people. The authors started with the premise that old people can suffer from periods of social isolation which can lead to substantial psychiatric deterioration - the "isolation desocialisation syndrome". While they knew of some substantial work on the beneficial effect of pets on all ages, they were unaware of controlled studies, so they did one.

Budgerigars and begonias

There were five groups, but with only six old people aged between 75 and 81 years in each. Each elderly person was interviewed by a psychologist and a social worker, and were asked a series of 22 questions about their life and attitude. Questions like "Do you have feelings of being fed up?" and "Do you feel time drags?" Favourable rapport was established by allowing each old person to choose a small gift, like a torch or a tray.

At this stage five interventions were set up:-
  1. Give a budgerigar, cage, tray and bird food to six people who had a TV set.
  2. Give a begonia to six people who had a TV set.
  3. Give a budgerigar, cage, tray and bird food to six people who had no TV set.
  4. Give a begonia to six people who had no TV set.
  5. Control group of six people, half of whom had a TV set.


The questionnaire was administered again, five months later, and items were marked as no change, favourable change or unfavourable change.

However, there were some problems:-
  • Six of 18 old people refused a budgerigar - mainly because they didn't like seeing birds in cages. None of the old people offered a begonia refused.
  • Some of the budgerigars died within six weeks of placement - but most of the subjects either had another bird given them or bought one themselves.
  • At the time of the follow up visit only just over half of the old people could be assessed. Some had died, some had moved, and some just couldn't be contacted. So analysis was on half the original number of subjects.

Results

All 12 old people who had budgerigars had given the birds names, and insisted on making arrangements for food and so on. Some had made elaborate playgrounds and many taught the birds to speak. It was not reported whether similar attention was given to the begonias.

Having or not having a TV set made no difference, and we have combined the data from the questionnaire scores. At five months the controls had an overall unfavourable change in questionnaire scores, people given begonias had no overall change, but those given budgerigars had dramatically favourable changes in questionnaire scores.

Comment

This trial was neither randomised, nor did it have particularly large numbers. It did show a big effect and tried hard to establish that the fact of the trial did not confound the effect of the budgerigar. The authors comment that it wasn't always so much the budgerigar itself, but the focus it made for discussion during social visits. For some of the elderly people the budgerigar stimulated visits, from local children, for instance, who came to teach the bird their names.

Evidence-based dogs

Alert readers will have noticed that the word random was missing from the budgerigar case. That cannot be said from an excellent randomised trial of the value of service dogs for people who need wheelchairs and published in JAMA earlier in 1996 [2].

Trial

Individuals who had been wheelchair mobile for at least two years and who had expressed an interest in a service dog were contacted in several US States. All had ambulatory motor impairment and many had additional problems. They were matched in pairs on criteria of age, sex, race, marital status and the nature and severity of the disability.

Individuals within the 24 pairs were then randomised to receive a dog immediately, or 13 months into the programme.

Dogs were initially raised in a family environment and then paired with a person with a disability. Individualised training was then given to expand the dogs' ability to meet the unique needs of its human partner. Total training time was six to twelve months.

Scoring

Lots of different scores were made at six monthly intervals. Bandolier concentrates on three - a self esteem score, and the number of hours of paid and unpaid assistance the individuals in the study needed.

Results

Dramatic changes took place after six months and were fully realised by twelve months. Self-esteem scores soared (as did psychological well-being, school attendances and employment), and the number of hours of assistance needed (paid and unpaid) plummeted. The same changes were seen in the control group as soon as they began working with a dog, while no changes occurred in the year they were waiting for one.

Comment

This is superb trial, showing what can be done with intelligence and persistence. There is even an economic analysis, also well done, which shows discounted eight-year savings of about $90,000. Eight years is about the effective life time of a service dog before they begin to get old themselves and deserve retirement.

What Bandolier particularly liked in this paper was the way it ended, with a quote from one of the disabled people who took part in the study.

"With my [dog], I feel safe and capable, and I am no longer afraid of the future. Everyone needs someone to care for, and we care for each other with dignity".

References

1 RA Mugford & JG M'Comisky. Some recent work on the psychotherapeutic value of cage birds with old people. In Pet Animals & Society (RS Anderson, Ed) Ballière Tindall, London, 1975, pp54-65. ISBN 0 7020 0539 8.
2 K Allen, J Blascovich. The value of service dogs for people with severe ambulatory disabilities: a randomised controlled trial. Journal of the American Medical Association 1996 275: 1001-6.



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