TORONTO — The patient sits in her room on the palliative-care floor at Toronto Grace Hospital, her face expressionless as she quietly sips a mug of tea. She is pulled from her reverie by an unusual sound - two sneakers and four paws coming towards her door, and an almost-whispered "May we come in?"

Ardra Cole and her Portuguese water dog, Tattoo, have come to visit. As Tattoo stretches out his head to the patient's hand, a smile lights up her face. Moments later, she is laughing joyfully, chatting with Cole as she buries her fingers in the pet's mop of woolly brown hair, drinking in eyes the colour of melted chocolate.

Tattoo has left his mark on another heart.

The five-year-old pet is among six dogs and one cat that make weekly visits to Toronto Grace as part of the hospital's therapeutic pet program, aimed at helping dying patients through the last days of their lives and boosting the spirits of those receiving continuing care for chronic health problems.

Cole, a professor at the Ontario Institute for Studies in Education, and her dog have been visiting patients at Toronto Grace for about two years.

"And we keep going back there because of the patients' response to him and because of his response to them," she says, explaining that Tattoo is a calm animal that seems to know intuitively what each person needs.

"The patients really enjoy seeing him because it reminds them of a dog they might have at home or might have had in their life at one point. . . . There's a whole range of responses, from direct contact to just being in his presence to him being a vehicle for them to talk and to remember some lovely stories about animals."

Having pets spend time with patients isn't unique to Toronto Grace. There are similar volunteer programs all over Canada providing four-legged visitors to retirement and nursing homes, Alzheimer's day-care centres and hospitals.

But no matter the setting, the benefits of pet therapy are the same - from calming anxiety to providing companionship and a sense of belonging to promoting interaction with staff and other patients, says Susana Yan, head of therapeutic recreation at the 119-bed hospital in the heart of mid-town Toronto.

"All the nurses and staff here do everything they can," she says. "But there are some things that we can't do that a pet will do. And the pet doesn't judge you, so regardless of whether a patient's in a wheelchair or has difficulty in communicating or is not as alert or has some cognitive problems, that is nothing to a pet.

"There's that unconditional love coming from a dog or a cat, and they don't expect anything back."

Yan says that having the pets come in improves patients' quality of life by giving them something to look forward to.
For Kathleen Kilpatrick, who has been living at Toronto Grace for five years because of a severe leg ailment, the program means she has visitors several times a week.

"It just gives me a lift," says Kilpatrick, 74, who gets around the hospital for activities and meals using a walker that converts to a seat or her wheelchair. "I have no family at all, and I have just relied on the animals coming in. I just look forward to their visits."

Kilpatrick laughs as she tells stories of each of the pets - from the antics of Mickey the golden retriever to Babushka, the lone feline that happily submits to lots of petting or takes the occasional catnap on her pillow.

But it is not only patients who reap rewards from the program, which has been running for seven years.

As Tattoo pads down the hallway, continuing his rounds, smiles break out on the faces of staff like sunbeams parting clouds. Doggy treats materialize from pockets and drawers as voices up and down the ward call out: "Here, Tattoo. Good boy, Tattoo."

"One of the things we don't pay a lot of attention to in the health-care system is what the staff need," says Cole. "So I'm really happy for him to visit with staff and to be made a fuss of, because it's really important and he does have a wonderful effect."

But Tattoo and the other therapy pets aren't treated merely as cuddly playthings: they're considered valuable members of the hospital team, she says. Each animal even sports its own hospital photo ID tag, along with a pet-sized red vest carrying the logo for Therapeutic Paws of Canada, the non-profit, charitable organization that assesses whether a pet has the right stuff - good health, an easy temperament and consistent behaviour - for the job.

And it is a job, says Cole, and an often tiring one for Tattoo, who can see up to a dozen patients over the hour and a half they spend visiting on their designated day.

Nor is it always easy for Cole, who concedes that it's emotionally wrenching getting to know a patient, then returning one week to find that they've died. Still, she feels good about the time she and Tattoo spend on the palliative-care floor.

"Because providing even a few minutes of respite, release, happiness, comfort, distraction, whatever in the last days of someone's life is really worthwhile. So, yes, it's sad, but it's really important work."

Kilpatrick echoes that sentiment, explaining why the animals' presence is so critical to patients, especially those contending with the pain and debilitation of disease or the knowledge that life is coming to a close.

"I think the animals have a lot to make you feel better about, because when you look into their face and they're looking at you, you can't help but forget why you're here for a minute of two."