PHILADELPHIA (AP) — As Dolores Esposito makes the rounds of hospice patients at Holy Redeemer Hospital each Monday with her dog, Daisy, she doesn't tell them why she and the brawny red golden retriever became a pet-therapy team.
She doesn't want people to think of pain when they see a tiny, outgoing woman and her 85-pound dog, decked out in a pink collar and clip-on bows that won't stay put. But as the dying and their loved ones stroke Daisy's soft fur, accept a lick, or simply look into her calming eyes, Esposito knows that this connection is therapy for everyone, including the therapists.
Daisy was her daughter Dana's dog. She came as a puppy to be a companion and helper for Dana, who had multiple sclerosis. When Dana died at age 25 four Januarys ago, Daisy was on the bed with her. She wouldn't get off when the paramedics came.
Esposito, now 60, was "crushed" by the death. There are still days when she feels she can barely breathe, but she feels better when she helps others, and says Daisy seems happier, too.
"This is my way of having Dana work through us, continuing Dana's legacy," Esposito said. "It's helping me to rebuild my life."
Hospices have embraced the volunteer ministrations of dogs, from teacup terriers to Newfoundlands. The dogs are in such demand that several local hospices, including Holy Redeemer, Abington Health, Life Choice, and Penn Hospice at Rittenhouse are looking for more canine/handler teams and having trouble finding them.
"If it was just my decision, we could have a hundred of them," said Marge Bowen, manager of Penn Hospice. "The therapy dogs are generally a really big hit on the unit."
In truth, Penn has two therapy-dog teams, but recently lost two others to injury and retirement. It would be pretty happy with three additional dogs.
You can't just walk into a hospice with your dog, no matter how adorable your pet is, and that is a barrier to recruiting dog-therapy teams, volunteer directors said.
Daisy went through training and had to be certified as a therapy dog. She had to prove she was mellow enough to handle lots of strangers, as well as the stimulation of a medical environment. Esposito got 20 hours of training herself - some hospices ask volunteers to do only nine - so that she understood what hospice was and was prepared to handle the conversations that people wanted to have in the last six months of life.
"People really have to be comfortable in their own mortality," Bowen said, "because you never know what kind of conversations are going to come up."
The human half of the team is not to be underestimated. "The dog is always a way to get into a room, into a visit, but it becomes less important as the relationship continues," said Jean Francis, Holy Redeemer hospice volunteer coordinator.
The work is not for everybody. Even some of the dogs find it painful. "Sometimes they burn out," Francis said. "That's what happened to (a dog named) Gillian. Gillian just stopped wanting to come. We had to face the fact that she preferred being with the kids."
Esposito, of Southampton, Bucks County, knew what she was getting into, because her father and father-in-law were in hospice. She makes sure Daisy gets a break. Second graders who need help with school read to her on Wednesdays. She also plays at home with another dog, two cats, and two grandchildren.
Patricia Veltri, LifeChoice's volunteer coordinator, said a pug who visits one of their facilities is as much a relaxing influence for staff as for patients. She "gets stopped about every two feet," Veltri said.
Francis said Daisy was unusually good at her work. "She's got a really calming presence," she said. "She's kind of a fluffy doormat." That's a compliment.
Last month, Daisy and Esposito - she calls herself Dee when she sees patients, because it's easier - started with Bertram Levy, who traces his mesothelioma to asbestos exposure while in the military in Korea. "It's terminal," he said matter-of-factly.
A big man who says he's 81 but looks younger, Levy has a little gray hair left and black, bushy eyebrows. He had dogs in the past, but not after he moved to an apartment in the Northeast. He talked about cancer that was beyond treatment, morphine and oxygen, but he also pointed with pride to a great-grandson's artwork.
He smiled and laughed as he petted the dog, who soon lay placidly beside his bed. "I get a kick out of her," he said.
"She doesn't take her eyes off of you," Esposito told him. "She never falls asleep, because she's on duty."
She and Daisy walked to the adjoining nursing home, St. Joseph Manor, to see another hospice patient, Doris Farrara.
On the way, Esposito let Daisy nuzzle an elderly woman with a walker who grinned broadly the moment she saw the dog. She had an Airedale when she was young, she said. "My father, when I brought him home, says 'That's not a dog.' "
Farrara, who said "don't even mention it" when asked her age, beamed when she saw Daisy. She stroked the dog gently and let Daisy press against her in a hug. "She does listen," she said in a shaky voice, "and she likes when people are fussing over her."
Esposito said people, in the beginning, often talk to Daisy instead of her. "The first thing you hear is, 'I miss my dog.' " Sometimes, they'll say things to the two of them that their families might find too painful. If families want, the pair will sit with them as death approaches. Daisy has licked away tears. She has sat with her paws on the bed, almost as if in prayer, as a priest gave last rites.
"I love watching Daisy make the connection with people who are disconnected or anxious," she said. "A visit from her warms the life of someone that has little life left."
Many hospices allow families to bring in their own dogs, and even the occasional cat, for visits.
Nancy Leporace, manager of volunteer services, Abington Health Hospice, said she even got a call from a woman who trained Shetland ponies and wondered about bringing one in. "I'm not quite there yet," she said.
"Dogs," Esposito added, "just seem to make things better."
Information from: The Philadelphia Inquirer, http://www.inquirer.com