SINGAPORE – The weather on this September afternoon is hazy and humid, but it does nothing to dampen the spirits of the 10 nursing home residents – some of whom are in wheelchairs – who are eagerly waiting to walk with and groom two gentle beasts.
Argentinian former polo ponies Costera and Valentina are the stars of this session by charity Equal-Ark Singapore, whose Elderly Programme has used equine therapy to help improve the emotional well-being of hundreds of seniors with dementia or depression.
Working with the animals is a novelty for long-time St Theresa’s Home resident Bertha Hang, 74.
“I’m very happy with the horses – I can go round with them; touch them,” she said as she deftly slotted a body brush onto her amputated right arm to groom Valentina.
Ms Hang, who had lost parts of her four limbs to gangrene in 2003, had become downbeat after she was hospitalised for sepsis – a life-threatening illness as a result of the body’s extreme response to an infection – last year (2018).
Grooming the horses is a role reversal and an empowering activity for Ms Hang, who, like other nursing home residents, are usually the care recipients.
While the use of dogs and cats in animal-assisted therapy is more common here, equine therapy has been gaining some traction in land-scarce Singapore.
Organisations such as Equal-Ark, Therapeutic and Educational Riding in Singapore (Theris), Healing Horses Singapore and Hovi Club Horsecity have been growing their clientele and expanding their programmes over the last few years.
The goal of equine therapy is to help people develop necessary skills and attributes, through their interaction with the horses.
It includes therapeutic horseback riding, where riding lessons are adapted to the person’s disability and needs, and hippotherapy, which uses equine movement to engage the sensory, neuromotor and cognitive systems.
“Being prey animals – as compared to dogs, cats and even humans, who are predators – horses are incredibly sensitive to their environment, and are able to perceive and respond to the smallest of changes, including our tone of voice, body language, behaviours, emotions and even our biochemistry,” said Theris’ founder and managing director Jessamine A. Ihrcke.
“They also provide immediate feedback in response to these aspects, which creates an opportunity for people to reflect on or be more aware of their behaviours and emotions, and adjust themselves accordingly in order to build a relationship with the horse,” she added.
Horses can help calm the elderly, says centre manager of senior daycare centre Hovi Club Horsecity Gelena Anandarajah.
“Looking into the eyes of the horse and listening to the repetitive rhythm of their hooves as they walk also helps to calm the elderly, especially when they get agitated,” she added.
“The interaction with any animal is also often non-judgemental towards a person with disability, so it helps to build self-esteem and positivity.”
Increasing demand for horse therapy
Equal-Ark has grown from serving about 500 beneficiaries in 2015, when it was established as a charity, to its current 1,500 beneficiaries.
Starting out with a Youth Programme that helps children and young adults develop socio-emotional skills, the charity piloted the Elderly Programme in 2017, which has helped 350 seniors aged 65 and older staying in nursing homes or receiving community care.
“A lot of the elderly have complicated relationships with the people in their lives, (whereas) an animal is like a blank canvas,” said its chief executive Ng Tze Yong.
“You can project a lot of things (onto the animal), so it’s easier for people to open up.”
This April (2019), Equal-Ark added a Family Programme for families with members who have special needs and it plans to expand the programme to help more beneficiaries within the year.
Over at private operator Theris, the number of private therapy sessions it conducts a week has risen to around 30, up from 10 in 2016 when it opened, said Ms Ihrcke.
It clients – more than 100 in total since 2016 – are mostly children and young adults who have special needs, including autism, attention deficit disorders, emotional and behavioural difficulties and mental health issues.
“A horse might respond to a child who approaches it and behaves in an aggressive manner by becoming tense and moving away. However, when the child learns to regulate his feelings and change her or his behaviour, the horse responds differently as well,” said Ms Ihrcke.
“We can then use this as a learning opportunity to explore how this parallels their own social interaction with others, and how they can transfer the skills learnt in our sessions to their own lives.”
Social enterprise Healing Horses Singapore caters to people of all ages, from children with special needs to senior citizens with anxiety and depression.
It has 30 regular clients, and gets monthly visits from schools with between 20 and 80 students each time, said programme director and coach Chithra Rogers.
This is an increase of about 60 per cent from when Healing Horses opened in 2014, she added.
Is equine-assisted therapy effective?
While horse therapy is established in mainly Western countries including the United States, Germany and Holland, the evidence of it effectiveness remains inconclusive or limited by the small sample size.
Ms Ihrcke said that it is difficult to adhere to clinical guidelines when many variables cannot be controlled.
For example, the therapy has to be conducted outdoors instead of a controlled indoor environment, which can also affect the horses’ behaviour and how they interact with people.
In Singapore, where research on the topic is scarce, a 2017 study found that a three-month equine-assisted learning programme at a pre-vocational school improved the students’ character-building skills, which were associated with higher academic grades at the end of the semester.
Thirteen-year-old Lau En Cheng, who has mild intellectual disability, and his parents would vouch for these results.
The Year 1 student at NorthLight School first interacted with horses nine months ago (Jan 2019) during Equal-Ark’s Youth Programme at his school.
After overcoming his fear of horses, En Cheng has become an avid fan and now goes for either riding lessons at Gallop Stable or therapy sessions at Theris every week.
“He’s become more confident and reflective,” said his father Mr Lau Hui Cheng, 47, a teacher.
“He can get upset very easily, but this therapy (at Theris) has made him more sensitive about other people’s thoughts. Ameerah (the riding therapist) will link the horses’ behaviour, for example, if they’re distracted, to his friends’ behaviour to help him relate better.”
En Cheng said he finds it easier to talk to horses than people.
“Horses make me feel happy; you must understand their body language,” he added.
While it is expensive to care for a horse – between $1,000 and $2,500 a month – equine therapy charges are comparable to a regular physiotherapy session.
A 45-minute private lesson at Theris costs between $150 and $180, with subsidised lessons for lower income groups.
Healing Horses’ lessons start at $80 for a 30- or 45-minute session, with the cost depending on the child’s needs, said Ms Rogers.
Subsidised rates are offered to lower income families, while free lessons are given to selected single mothers with special needs children.
For Equal-Ark’s Elderly Programme, a one- to two- hour session costs $90 per senior, and the cost is covered through a mixture of donations and fees paid by the nursing home.
Horses get helped too
Even as the horses are helping people, their welfare is far from forgotten.
Being roped into therapy often saves many of these horses from being put down early, after they have been retired from polo, racing or even showjumping competitions.
Equal-Ark’s horses stay on at its premises until they die from old age or succumb to illnesses.
Ms Ihrcke has a retirement plan for Theris’ two horses – 14-year-old Smartie, a former dressage and showjumping competition horse, and 19-year-old D’Artagnan, who also previously competed in dressage.
Like all cushy retirement plans, it will not come cheap – a flat fee of between $10,000 and $30,000, and a monthly maintenance fee of between $700 and $1,200.
“When Smartie and D’Artagnan get too old, they will go either to Germany, Austria or Malaysia, where they will live in the paddock, eat grass all day and get fat,” said Ms Ihrcke with a laugh.