49
Welfare assessment

Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Embed Size (px)

Citation preview

Page 1: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Welfare assessment

Page 2: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• How do we assess for welfare of individuals?

• Can we have a generic welfare assessment?

• Will it work for all shelters?

Page 3: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• There are a number of methods that have been used to assess welfare in the past; Bramble’s 5 freedoms are always a good base to begin but there is much more information we are now aware of that helps us identify poor welfare.

Page 4: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• 1. Freedom from Hunger and Thirst - by ready

access to fresh water and a diet to maintain full health and vigour.

• 2. Freedom from Discomfort - by providing an appropriate environment including shelter and a comfortable resting area.

• 3. Freedom from Pain, Injury or Disease - by prevention or rapid diagnosis and treatment.

• 4. Freedom to Express Normal Behaviour - by providing sufficient space, proper facilities and company of the animal's own kind.

• 5. Freedom from Fear and Distress - by ensuring conditions and treatment which avoid mental suffering.

Page 5: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Welfare principles and criteria are summarized in the table below.

Welfare Principles Welfare Criteria

Good feeding 1 Absence of prolonged hunger

2 Absence of prolonged thirst

3 Appropriate food for good health & growth

Good housing 4 Comfort around resting

5 Thermal comfort

6 Ease of movement

Good health 7 Absence of injuries

8 Absence of disease

9 Absence of pain induced by management procedures

Appropriate behaviour 10 Expression of social behaviours

11 Expression of other behaviours

12 Good human-animal relationship

13 Positive emotional state

Page 6: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

More detailed definitions of welfare criteria are described below.

• 1. Animals should not suffer from prolonged hunger, i.e. they should have a suitable and appropriate diet.

• 2. Animals should not suffer from prolonged thirst, i.e. they should have a sufficient and accessible water supply.

• 3. Animals should be fed the appropriate types of food to enhance growth and health throughout its life.

• 4. Animals should have comfort when they are resting.

• 5. Animals should have thermal comfort, i.e. they should neither be too hot nor too cold.

• 6. Animals should have enough space to be able to move around freely.

• 7. Animals should be free of injuries, e.g. skin damage and locomotory disorders.

• 8. Animals should be free from disease, i.e. animal unit managers should maintain high standards of hygiene and care.

• 9. Animals should not suffer pain induced by inappropriate management, handling, slaughter, or surgical procedures (e.g. castration,).

• 10. Animals should be able to express normal, non-harmful, social behaviours (e.g. grooming).

• 11. Animals should be able to express other normal behaviours, i.e. it should be possible to express species-specific natural behaviours such as foraging.

• 12. Animals should be handled well in all situations, i.e. handlers should promote good human animal relationships.

• 13. Negative emotions such as fear, distress, frustration or apathy should be avoided whereas positive emotions such as security or contentment should be promoted.

Page 7: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Animal welfare goes hand in hand with the feelings experienced by animals: the presence of strong negative feelings, usually called suffering, and the presence of positive feelings, usually called pleasure

Page 8: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Welfare assessment should evolve in much the same way as the methods behind positive training and behaviour have. (in some circles)

• We understand the effects that poor training methods have on the dogs welfare.

• So having a good understanding of both normal and abnormal canine behaviour is essential to identify poor welfare.

Page 9: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

How do we identify negative feelings?

• Lack of behaviour can say as much as the dogs that are jumping and growling at the gates.

• Social animals that no longer seek social interaction.

• Dogs that express excessive appeasement behaviours

Page 10: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Happy or sad ?

Page 11: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 12: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 13: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 14: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 15: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 16: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• In any assessment of welfare, it is these feelings that should be assessed. Because feelings are subjective, they cannot be investigated directly, however there are methods to assess the conditions under which they are kept and the procedures to which they are subjected.

Page 17: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Measurements of impaired biological functioning, particularly those connected to decreased health and increased physiological stress responses, can provide good corroborating evidence that welfare is compromised.

Page 18: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Health

• Without proper health checks it is difficult to fully assess welfare.

• But ….. Without proper health checks you could argue that welfare isn't being monitored ( Freedom from pain, Injury & Disease)

Page 19: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Increased physiological stress response

Page 20: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

WHAT IS A STEREOTYPY?

• A stereotypy is a repeated, relatively set sequence of movements which has no obvious function.

• The repetition may be regular, but it need not be, and the sequence of movements may be very short, as in head-shaking or long and complex, as in route-tracing by bears in zoos.

Page 21: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

WHY DOES IT OCCUR?

Stereotypies occur in animals that have no control over their situation and have been associated with environments that are;

• Barren and lack variety

• Disturbing or threatening

• And where the animal also experiences social isolation.

Page 22: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

THE PHYSIOLOGY OF STEREOTYPIES

• The physiology shows that stereotypies are primarily disorders of neurotransmission. The main neurotransmitters that are affected are adrenaline, nor adrenaline and dopamine.

• These three neurotransmitters when grouped are called catecholamine's and when a dog is suffering from an increase in catecholamine's called a catecholamine cascade the dog will find it extremely difficult to control himself during stressful periods.

Page 23: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

So essentially we are talking coping mechanisms

Page 24: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

They can be varied and often bizarre

Page 25: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• The term "welfare" refers to the state of an individual in relation to its environment, and this can be measured.

• Both failure to cope with the environment and difficulty in coping are indicators of poor welfare.

Page 26: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Animals have a wide range of needs that are a consequence of the many functional systems that make life possible. A need is a deficiency in an animal that can be remedied by obtaining a particular resource or responding to a particular environmental or bodily stimulus

(Fraser and Broom, 1990).

Page 27: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Some needs are simple, such as the detectable effects of a low concentration of body fluids or a high body temperature and require action.

• Others are a complex consequence of the mechanisms that have evolved in the species to promote survival and reproduction, for example the deficiencies in mental functioning resulting from too little variety in sensory input or insufficient contact with other members of the species.

Page 28: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• To develop good systems for the housing and management of animals it is of particular importance that studies of the preferences of animals be carried out.

• We need to know what animals prefer if we are to treat them in a humane way.

• Observations of how animals spend their time when they are in a rich environment are a useful preliminary guide in designing accommodation

Page 29: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Is space a priority?

Page 30: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Does design make a difference?

Page 31: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of
Page 32: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Welfare is a characteristic of an animal, not something given to it, and can be measured using an array of indicators.

Such studies are complementary to those in

which the subjective experiences of animals

are assessed using measures of preference.

Page 33: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• The assessing of welfare in kennels is a very difficult thing to achieve and as new information comes to light we should always endeavour to keep our methods of assessment up to date. By evaluating our own methods on a regular basis we can ensure we are always striving to improve our kennels and procedures.

Page 34: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Individual welfare scores

• To be completed by 2-3 carers

• Aims to identify areas to work on

• Can be used as a tool to corroborate pts requests

• Subjective

Page 35: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Home-ability Score Dog interaction Score

How likely is the dog to be rehomed? Is the dog happy kenneled with another dog?

Would the dog bite the owner? Can the dog meet other dogs on the lead?

Would the dog bite visitors? Does the dog vocalise when meeting other dogs?

Would the dog be a danger in public areas? Does the dog show fear when meeting other dogs?

Is the dog safe around other animals? Does the dog show frustration when seeing other dogs?

Can the dog wear a muzzle? Is the dog safe around other dogs?

Can the dog be let off the lead safely? Can the dog free run with other dogs?

Are they safe around traffic? Does the dog enjoy the company of other dogs?

Do they travel well? Can the dog eat/chew around other dogs?

Are they house trained?

Are they destructive? Total score

Total score Manage-ability in kennels

Human interactions Is the dog easy to get in/out of kennels?

Is the dog easy to get inside/outside as required?

Is the dog comfortable being handled? Are they ok being shut in/out?

Does the dog enjoy a fuss? How difficult are they to get harnessed?

Does the dog initiate the contact? Are they reactive to surrounding dogs?

Can the dog focus on the handler with distractions? Are they likely to re-direct?

Can the dog focus on the handler indoors? Is the dog a risk to unfamiliar staff?

Can the dog focus on the handler outdoors? Is the dog a risk to visitors?

Can the dog be trained using food? Can the dog be easily muzzled?

Will they play with toys and initiate games? Does the dog go out with volunteers?

does the dog choose to spend time with handler? Can the dog go off site?

Does the dog enjoy the compounds?

Total score Does the dog lunge out at people?

Does the dog resist going back to its kennel?

Total score

Page 36: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Score the individual questions with 0 being the most desirable

Stress levels and 5 being the least desirable

How comfortable is the dog in the kennel?

Do they show visible signs of stress?

Do they show any stereotypical behaviour?

Do they self mutilate?

Do they bounce of the walls? To gain the welfare score for the individual dog you need to add up all the

Do they chase their tail or spin? scores from the various categories

Do they bark a lot?

Do they sleep excessively? Welfare Score

Do they show any obssesive behaviours?

Do they show lots of appeasements? Home-ability

Do they stand for excessive periods? Human interactions

Do they hide away? Dog interaction

Do they toilet without fear in the kennel? Manage-ability in kennels

Do they toilet out of the kennel without fear? Stress levels

Does the dog enjoy its time out of the kennel?

Can they cope with new environments? Total Score

Does it take long to recover from a stressful situation?

Total score

The best score would be 0 the worst would be 300

This assessment can be used with new dogs that may have potential

welfare issues in kennels or to look at long term dogs on a regular basis

This assessment can also be used to highlight areas of concern and

aid in the improvement of an individuals welfare by targeting the areas the

dog is struggling with.

The ideal situation is to have more than one person who knows the dog

do the assessment to avoid bias

Page 37: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Can assessing the welfare of individuals tell us about the shelter?

• 100 dogs

• 15 cases of stereotypy

• 10 cases of shut down behaviour

• 15 cases of veterinary shortfall

• No enrichment

Page 38: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Welfare Audit

• Fill in the welfare audit by marking one circle on each question.

• Within this welfare audit there are 45 questions.

• 1 = Above welfare standard

• 2 = Acceptable welfare standard

• 3= Below welfare standard

Page 39: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• The top mark for this audit would be 45 the worst would be 135 and an average 90. Although this audit may give an overall score rating for the welfare of dogs in the kennels, care is needed when interpreting these results as it is possible to get a “pass” of 90 yet many aspects of the audit may have scored poorly and some above average. The main use for this audit tool is to identify areas that could be improved.

Page 40: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Kennel floor space (ref 1)

Kennel temperature regulation Kennel lighting (Ref 4)

Material used for kennel Kennel floor

Kennel drainage Kennel weather resistance

Numbers of kennels Per block Kennel noise level (Ref 2)

Dogs per kennel(size of kennels & dogs dependant) Sleeping options

Toileting options Kennel orientation

1. Larger than the dimensions indicated in category 2.

2.Small dogs (less than 12kg (26lbs) – sleeping area not less than 1.1 sq m (12 sq feet), width and length not less than 0.9 m (3 feet). Adjoining exercise area not less than 3.7 sq m (40 sq feet), width not less than 0.9m (3 feet).

2.Medium dogs (12kg (26lbs) to 30kg (66lbs) – sleeping area not less than 1.4 sq m (16 sq feet), width and length not less than 1.2m (4 feet). Adjoining exercise area not less than 5.5 sq m (60 sq feet), width not less than 1.2 m (4 feet).

2.Large dogs (more than 30kg (66lbs)) – sleeping area not less than 1.4 sq m (16 sq feet), width and length not less than 1.2 m (4 feet). Adjoining exercise area not less than 7.4 sq m (80 sq feet), width not less than 1.2 m (4 feet).

3. Smaller than the dimensions indicated in category 2.

1. Individually controlled, to change temperatue for individual housed in the kennel

2.Adjustable to control temperature in the block of kennels

3.No ability to regulate temperature in the facility

1. Both natural and artificail light, with options to reduce and increase as required

2.When using artifical light it should closely mirror that of natural light in both intensity and duration

3.No lighting

1. un-damaged, Fit for purpose, non porous, easy to clean & maintain

2.Un-damaged, fit for purpose

3.Damaged, dangerous & unable to clean

1. Un-damaged, non porous, non slip & comfortable

2.Un-damaged, non porous

3.Damaged, porous & unable to clean

1. Drainage for individual kennels to reduce cross contamination

2.Drainage for the whole block

3.No drainage

1. adaptable shelter to meet the needes of individuals

2.Provides shade and shelter from the elements

3.No shelter from the elements

1. Below 10

2.Between 10 & 20

3. Above20

1. Effective sound proofing within the kennel environment and around the site. Noise levels maintained below 80dB

2. Some sound proofing between the kennels. Noise levels between 80 & 100dB

3. No sound proofing. Noise levels above 100dB

1. Varied due to size and temperament

2.From 1 to 4 dogs

3. social isolation or above 4 dogs

1. As for 2 but with options for types of bedding and area away from sources of stress

2. Dry, clean bedding away from the elements.

3. No bedding or wet dirty & exposed to the elements

1. Multiple opportunities to toilet away from the kennel, preference tested substrate within the kennel

2. Area away from the sleep and feeding area

3. No options to toilet away from sleep area and feeding area

1. Variation of choices for the dog to enable self reguation of temperature

2. Not exposed to the elements

3. Exposure to the elements without the option to seek shelter

Page 41: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Kennel temperature regulation Kennel lighting (Ref 4)

1. Individually controlled, to change temperatue for individual housed in the kennel

2.Adjustable to control temperature in the block of kennels

3.No ability to regulate temperature in the facility

Page 42: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• Freedom from Discomfort - by providing an appropriate environment including shelter and a comfortable resting area.

Page 43: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

SOP 16 Annex B

Annex B to SOP 16

THE HOLISTIC APPROACH TO BEHAVIOUR MODIFICATION

Page 44: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Step 1. The dog's health should be considered. If there is a sudden onset of aggression then this is likely to be pain-related; dogs can be very stoic in nature and do not always have the courtesy to limp to let you know all is not well! More chronic pain (e.g. joints, hips, a poor digestion) can cause the dog to be more irritable and stressed (than normal). If you have any concerns, you should ask the centre vet to check the dog over. Step 2. The dog should be kennelled in a place where he feels safe and secure – this will help to reduce stress levels and allow for a successful BMP. This could be a kennel away from rehoming so that he doesn't have strange people looking at him, or it could be that you have to observe his immediate neighbours in case he is feeling intimidated by another dog, or give him a covered indoor kennel to hide in or to rest upon. Step 3. Further reduction in stress can be made by preference testing the dog where the 5 maintenance behaviours are concerned. These are urination, defecation, eating, drinking and sleeping. The importance of these behaviours should not be underestimated as they are vital for survival.

Page 45: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Steps 4, 5 & 6. These stages are actually interchangeable depending on the dog. We know that some dogs are more dog-orientated than people-orientated and vice versa. Dog interaction – 'find a friend'. Find a dog that he can kennel with, mix with or at least parallel walk with. People interaction – assess, identify and remedy the attachment issues that the dog has with people. Exercise – provide variety for the dog where toys are concerned and provide appropriate exercise for the individual. This may be gentle walks, running in a compound or even staying in and doing some training or low level problem solving games Step 7. Then we, eventually, arrive at dealing with the behaviour itself. Miraculously we find that the problem, ‘X’, often becomes an easier to deal with ‘X’. The issue can then be dealt with by desensitising, counter-conditioning or teaching an incompatible behaviour.

Page 46: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

WHAT CAN WE DO RIGHT NOW

• Sort out the base of the behavioural ladder including eating, sleeping, body care and social activities.

• Enrich the environment

• Change the environment

• Reduce the occurrence of the stereotypy by removing the stressor as often as possible.

Page 47: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

Environment is everything

Page 48: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

7

‘x’

6

Interaction with People

5

Exercise & Object Play

4

Interaction with other dogs

3

5 Maintenance Behaviours

2

Safety & Security

1

Health

Page 49: Welfare assessment - Dogs Trust Home Page€¦ · •Welfare assessment should evolve in much ... •Social animals that no longer seek social interaction. ... •Measurements of

• References

• Ref 1 = Defra.gov.uk quarantine kennel sizes • Ref 2 = Noise in dog kennelling: Is barking a welfare problem for dogs? Applied Animal Behaviour

Science 52 (1997) 32 1-329 G. Sales, R. Hubrecht, A. Peyvandi , S. Milligan, B. Shield • Ref 3 = European council. European convention for the protection of vertebrate animals used for

experimental and other scientific purposes, 1986; Available at http//conventions.coe.int/Treaty/en/Treaties/Html/123.htm

• Johnson T; The animal shelter building; design and maintenance of a healthy and efficient facility. Shelter medicine for veterinarians and staff. Ames, Blackwell publishing 2004 pages 55-66

• Institute of Laboratory Animal Research, commission on life sciences, national research council. Guide for the care and use of laboratory animals, US department of health and human service, national institutes of health, NIH publication No. 86-23, 1996

• Ref 4 = New Zealand ministry of agriculture. Animal welfare advisory committee. Code of recommendations and minimum standards for the welfare of animals in boarding establishments 1993. www.biosecurity.govt.nz/animal-welfare/codes/boarding/index.htm

• Ref 5 = National Animal Care & Control Association, Mays D (ed). Training manual 2009b Kansas City,MO: National Animal Care & Control Association

• Humane Society of the United States 2010. General staffing recommendations for kennel caretaking. www.animalsheltering.org/resource_library/policy_and_guidelines/kennel_caretaking_staffing.html