Wednesday, February 3, 2010

A Furry Angel? Cat Senses Impending Death

Oscar the Cat Predicts Nursing Home Deaths

PROVIDENCE, R.I. — Oscar the cat seems to have an uncanny knack for predicting when nursing home patients are going to die, by curling up next to them during their final hours. His accuracy, observed in 25 cases, has led the staff to call family members once he has chosen someone. It usually means they have less than four hours to live.

"He doesn't make too many mistakes. He seems to understand when patients are about to die," said Dr. David Dosa in an interview. He describes the phenomenon in a poignant essay in Thursday's issue of the New England Journal of Medicine.

"Many family members take some solace from it. They appreciate the companionship that the cat provides for their dying loved one," said Dosa, a geriatrician and assistant professor of medicine at Brown University.

The 2-year-old feline was adopted as a kitten and grew up in a third-floor dementia unit at the Steere House Nursing and Rehabilitation Center. The facility treats people with Alzheimer's, Parkinson's disease and other illnesses.

After about six months, the staff noticed Oscar would make his own rounds, just like the doctors and nurses. He'd sniff and observe patients, then sit beside people who would wind up dying in a few hours.

Dosa said Oscar seems to take his work seriously and is generally aloof. "This is not a cat that's friendly to people," he said.

Oscar is better at predicting death than the people who work there, said Dr. Joan Teno of Brown University, who treats patients at the nursing home and is an expert on care for the terminally ill

She was convinced of Oscar's talent when he made his 13th correct call. While observing one patient, Teno said she noticed the woman wasn't eating, was breathing with difficulty and that her legs had a bluish tinge, signs that often mean death is near.

Oscar wouldn't stay inside the room though, so Teno thought his streak was broken. Instead, it turned out the doctor's prediction was roughly 10 hours too early. Sure enough, during the patient's final two hours, nurses told Teno that Oscar joined the woman at her bedside.

Doctors say most of the people who get a visit from the sweet-faced, gray-and-white cat are so ill they probably don't know he's there, so patients aren't aware he's a harbinger of death. Most families are grateful for the advanced warning, although one wanted Oscar out of the room while a family member died. When Oscar is put outside, he paces and meows his displeasure.

No one's certain if Oscar's behavior is scientifically significant or points to a cause. Teno wonders if the cat notices telltale scents or reads something into the behavior of the nurses who raised him.

Nicholas Dodman, who directs an animal behavioral clinic at the Tufts University Cummings School of Veterinary Medicine and has read Dosa's article, said the only way to know is to carefully document how Oscar divides his time between the living and dying.

If Oscar really is a furry grim reaper, it's also possible his behavior could be driven by self-centered pleasures like a heated blanket placed on a dying person, Dodman said.

Nursing home staffers aren't concerned with explaining Oscar, so long as he gives families a better chance at saying goodbye to the dying.

Oscar recently received a wall plaque publicly commending his "compassionate hospice care."


Doctor casts new light on cat that can predict death

SYDNEY (Reuters) - When doctors and staff realized that a cat living in a U.S. nursing home could sense when someone was going to die, the feline, Oscar, was portrayed as a furry grim reaper or four-legged angel of death.


But Dr. David Dosa, who broke the news of Oscar's abilities in a paper in the New England Journal of Medicine in 2007, said he never intended to make Oscar sound creepy or his arrival at a bedside to be viewed negatively.

Dosa said he hopes his newly released book, "Making Rounds With Oscar: The Extraordinary Gift of an Ordinary Cat" will put the cat in a more favorable light as well as providing a book to help people whose loved ones are terminally ill.

"After the New England Journal article you got the feeling that if Oscar is in your bed then you are dead, but you did not really see what is going on for these family members," said Dosa, an assistant professor of medicine at Brown University.

"I wanted to write a book that would go beyond Oscar's peculiarities, to tell why he is important to family members and caregivers who have been with him at the end of a life."

Dosa said Oscar's story is fascinating on many levels.

Oscar was adopted as a kitten from an animal shelter to be raised as a therapy cat at the Steere House Nursing and Rehabilitation Center in Providence, Rhode Island, which cares for people with severe dementia and in the final stages of various illnesses.


When Oscar was about six months old the staff noticed that he would curl up to sleep with patients who were about to die.

So far he has accurately predicted about 50 deaths.

Dosa recounts one instance when staff was convinced of the imminent death of one patient but Oscar refused to sit with that person, choosing instead to be on the bed of another patient down the hallway. Oscar proved to be right. The person he sat with died first, taking staff on the ward by surprise.

Dosa said there is no scientific evidence to explain Oscar's abilities, but he thinks the cat might be responding to a pheromone or smell that humans simply don't recognize.

Dosa said his main interest was not to delve further into Oscar's abilities but to use Oscar as a vehicle to tell about terminal illness, which is his main area of work.

"There is a lot to tell about what Oscar does, but there is a lot to tell on the human level of what family members go through at the end of life when they are dealing with a loved one in a nursing home or with advanced dementia," he said.

"Perhaps the book is a little more approachable because there is a cat in it. We really know so little about nursing homes, and this tries to get rid of this myth that they are horrid factories where people go to die."

Dosa said the story of Oscar, who is now nearly five years old, initially had sparked a bit more interest in families wanting to send their loved ones to Steere House.

Oscar has even been thanked by families in obituaries for providing some comfort in the final hours of life.

But he said Oscar remains unchanged by the attention, spending most of his days staring out of a window, although he has become a bit friendlier.

"The first time I met Oscar he bit me. We have warmed over the years. We have moved into a better place," said Dosa.

"I don't think Oscar is that unique, but he is in a unique environment. Animals are remarkable in their ability to see things we don't, be it the dog that sniffs out cancer or the fish that predicts earthquakes. Animals know when they are needed."


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