THURSDAY, July 26, 2007 (HealthDay News) -- When he curls up beside a frail, elderly patient in a Rhode Island dementia-care unit, Oscar the cat is telling the staff that death is near.
The two-year-old tabby has done so with almost perfect accuracy 25 times since he was brought into the ward as a kitten. He tends to ignore patients until the moments when his comfort is perhaps needed the most, staff members say.
"He has pretty much spotted each of our dying patients over the course of the last year," said Dr. David Dosa, a geriatrician who works in the end-stage dementia ward at Steere House Nursing and Rehabilitation Center, in Providence.
"He really seems to understand when it is about to happen, and he is there," added Dosa, who has brought Oscar to world attention in an essay in this week's New England Journal of Medicine.
Oscar, like his Sesame Street namesake, is not the friendliest of felines, avoiding most of the physically healthier patients on the ward as they shuffle by, Dosa reported. And yet, he has become an important source of information on something even the best doctors have trouble predicting: death.
"A day or so beforehand, he'll start to show interest in a particular room," Dosa said, and unfailingly, a patient in that room will die within the next 48 hours. "He will often curl up with the patient in bed -- sometimes, he'll just sit there on the bed, but often he will nuzzle up, particularly if the patient is alone," Dosa added.
Do patients understand that the cat is there?
Dosa isn't sure. "This is an end-stage dementia unit, so my sense is that, for the most part, most of the patients passing through here have lost the capacity to understand what is going on," he said. "Still, I do think that they take great comfort in the fact that there is an animal there."
Oscar's "sixth sense" is often of great importance to the dying patient's loved ones, as well. "Oftentimes, medical staff have a sense that somebody is nearing the end," Dosa said, "but it's anybody's guess as to when it might occur. And that's a problem for families, because they like to bring people in from outside, sometimes other areas of the country. Often you can't give people more than a ballpark estimate of death."
But Oscar has changed all that, allowing family members to gain a better sense of exactly when a loved one will pass on. "With him around, it's been much easier, because when he starts to mill around, we know that it's imminent," Dosa said.
The furry visitor also seems to know when life's final phase is over, leaving the patient's side soon after death.
Recognizing his unique gift, a local hospice agency has even placed a plaque on the ward's wall that reads, "For his compassionate hospice care, this plaque is awarded to Oscar the Cat."
An animal's uncanny ability to sense things humans cannot is well-documented. "I've heard of animals recognizing infection and cancer, bringing them to their owner's attention," Dosa said. "I know that they use animals for earthquake prediction in Japan."
Oscar's prescience doesn't come as any surprise to Jennifer Arnold, executive director of Canine Assistants, an Alpharetta, Ga.-based dog-training center. Her facility trains retrievers and other canines to accurately sense and warn a human companion of the onset of epileptic seizure.
"Some of our dogs have 100 percent accuracy in predicting the onset of seizures in people," Arnold said, and this ability does not seem to depend on any clue the average human might ever detect.
When a seizure is imminent, dogs begin to act out, licking the human's hand, or even gently sitting on top of them to help prevent seizure-related injury.
How do they sense seizure? Again, the answer to that is unclear, although a study performed last year seemed to rule out electrical changes in the brain, Arnold said. That probably narrows it down to the dogs' incredible sense of smell, she said.
Dosa, who is also an assistant professor of medicine at the Warren Alpert Medical School of Brown University, said theories also abound as to how Oscar understands the approach of death, but he favors the smell hypothesis, too.
"Perhaps he's sensing a pheromone that might be released [before death] that we don't smell," he said.
For Arnold, the lesson from these types of cases is clear.
"Surely, this shows people that we do have so much to learn from animals," she said. "They seem to reach parts of us that other humans have a very hard time reaching. I can certainly believe that that cat gives great comfort."
More information
There's more on dementia at the National Institute of Neurological Disorders and Stroke.
