The short answer
- Small studies since 2014 point to a real benefitThe best-known study found people with Alzheimer's were calmer and less likely to resist care later the same day after spending time with a horse.
- Your relative does not need to rideThe research this page is based on is built around touch and simple tasks: grooming, feeding, leading. Riding is a separate, more structured activity.
- What matters is mobility, not memorySomeone who can no longer stand unaided can still stroke a horse from a chair. What your relative can manage today decides the right level to start at.
- A carer can build this into a regular visitCompanionship visits on PrimeCarers run from £15 an hour with our fee included, and a carer who already visits your relative can plan a trip to see some horses around the rest of the day.
The research is promising but still based on small numbers of people, and it is set out plainly as each study comes up below. Ask the GP first if your relative has a heart condition, a history of falls, or any known allergy.
The evidence so far
What the research on horses and dementia has found
The idea of using horses as a form of therapy is old, but looking specifically at Alzheimer's and dementia is recent. Here is how the research built up, ending with the first attempt to pull it all together.
- 1950s
Riding becomes part of physiotherapy in Europe
After a paralysed Danish rider won an Olympic medal for dressage, therapists in Germany, Austria and Switzerland began pairing riding with physiotherapy for people recovering from illness and injury. That work grew into what is now called hippotherapy.
- 2014
The first study to look at Alzheimer's specifically
The Ohio State University worked with an equine centre and an adult day care to see whether people with Alzheimer's could safely groom, feed and lead a horse. The sixteen people who took part were calmer on the days they worked with a horse, and less likely to resist personal care later that day.
- 2010s
Pony visits to care homes become more common in the UK
Services bringing small, trained ponies into care homes for short visits started appearing around the country, built mainly around touch rather than a formal therapy programme.
- 2024
The first systematic review pulls the studies together
Researchers gathered every study of equine-assisted services for dementia published up to mid-2023 and found six studies covering four different programmes. Together they pointed to a favourable effect on mood, behaviour, quality of life and social connection, alongside the caveat that every study so far has been small.
The 2014 Ohio State study is still the one most often cited, and it was small: sixteen people from a single day centre, split between a group that took a weekly trip to work with horses and a group that stayed behind. The 2024 systematic review, published in the journal Alzheimer's Research & Therapy, is the first attempt to gather everything published since then. Its authors describe the evidence as promising but still limited, and call for larger, better-designed studies before the size of the effect can be pinned down with confidence.
What happens in a session
What a session involves, and why it is not about riding
Equine-assisted sessions for people with dementia are usually built around a small number of hands-on tasks rather than a lesson. What your relative is asked to do, and what they need to be able to manage, depends on the level of contact.
Watching and being close by
No standing and no fine motor control neededSitting a few feet away in a chair or a wheelchair is enough to take part, and it is where a first visit often starts. Some of the people in the studies behind this page did no more than this and were still calmer afterwards.
Stroking and grooming
One steady handA soft brush in one hand and the horse's neck or shoulder within easy reach. This is the level the best-studied Alzheimer's research was built around.
Leading and feeding
A short supervised walk, or a hand that can hold flat and stillHolding a lead rope for a few steps with a handler alongside, or offering a handful of feed from an open, flat palm.
Riding
Trunk control, and two people supervisingOffered only within structured programmes such as Riding for the Disabled Association groups, and not something a casual visit or a family day out would usually include.
A typical session runs twenty to forty minutes and involves a small group, a horse and someone experienced in handling both. Nobody is expected to ride. The tasks studied in the research so far, grooming, feeding and leading, ask for balance and attention rather than fitness, which is part of why they suit people who cannot manage a longer walk or a more physical activity. If your relative is at a stage where the seven stages of dementia means they need close support with most daily tasks, staying at the watching or stroking level is not a lesser version of the activity. It is where the research found a benefit too.
Why it might help
Why time with a horse can ease agitation and resistance to care
Nobody has fully explained why contact with a horse seems to help, but the studies point to a few recurring reasons.
A calmer mood that carries into the day
A connection that does not depend on conversation
A simple, repeatable task
Better quality of life, the 2024 review found
If a horse turns out not to suit your relative, the same four reasons, feeling useful, expressing a feeling, connecting with somebody, and reaching back to a memory, sit behind most of the 37 activities for someone with dementia worth trying, several of which use other animals instead.
How to get involved
How to find equine or pony therapy near you
There is no single national scheme to book through, so finding a session usually means asking around rather than searching one website. These are the most reliable places to start.
- 1
Ask if a visit already comes to where your relative lives
Free to askMany care homes and day centres already arrange visits from a small, trained pony a few times a year. Ask the manager or the memory service whether one is already booked before looking further afield. - 2
Look for a Riding for the Disabled group near you
RDAThe Riding for the Disabled Association runs equestrian sessions for disabled adults and children through local groups across the UK, and its website lets you search for a group by postcode. Not every group works with older people or dementia specifically, so it is worth calling first to ask. - 3
Contact a therapy charity directly
e.g. a local charitySmall charities such as Equine Pathways UK in Leeds run structured sessions with rescued horses for people facing a range of difficulties. Get in touch to ask whether they have worked with people who have dementia and what a first visit involves. - 4
Keep the first visit short
20 to 30 minutesLet your relative decide how close they want to get, and treat watching from a distance as a complete first visit rather than a step that has to lead to more. If it goes well, ask about a regular booking.
You do not need a diagnosis-specific programme to try this. A phone call to a local riding stables, explaining what your relative can manage and asking whether they would welcome a short, supervised visit, is often all it takes. A companionship carer who already visits your relative can also plan a trip like this into a regular visit, and companion care costs from £15 to £20 an hour with our fee included.
Before you go
What to check before your relative's first visit
A horse is a large animal, and a first visit is more likely to go well if a few things are checked beforehand rather than found out on the day.
Before you book a first visit
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Your relative
The visit itself
If a horse turns out not to be practical, whether because of distance, cost, or simply because it does not suit your relative, that is not a setback. 37 activities for someone with dementia covers other animal contact, including a visiting dog, and dementia cafes often build a similar kind of activity into an afternoon out closer to home.
Questions
Questions families ask about horses and dementia
No. The research this page is based on, including the best-known 2014 study, is built around grooming, feeding and leading a horse under supervision, not riding. Riding is offered separately by structured programmes such as Riding for the Disabled Association groups, and it asks for far more balance and trunk control than the activities most families try first.
Both. The 2014 Ohio State study looked specifically at people with Alzheimer's. The 2024 systematic review, the first to gather the evidence together, covered equine-assisted services for dementia more broadly, since later studies did not always separate Alzheimer's from other kinds of dementia. The findings across both point the same way.
Start at the lowest level: watching from a safe distance, with no expectation of getting closer. A bad reaction on a first visit is often about the noise and size of the setting rather than the horse itself, and somebody who knows your relative well should be there to judge how it is going.
It is not a routine NHS or council service. Most sessions are run by small charities or independent equine centres, some relying on donations rather than a fixed charge. Contact a provider directly to ask what a visit involves and what, if anything, it costs.
Yes. A carer booked for companionship on PrimeCarers can plan an outing like this into a regular visit rather than you having to arrange it separately. What carers do on a companionship visit has more detail, and companion care costs from £15 to £20 an hour with our fee included.
It varies a great deal by provider. Small charities that rely on volunteers and rescued horses often ask for a donation rather than a fixed fee, while commercial equine-assisted therapy services charge in a similar range to private counselling. There is no single published price, so ask each provider directly before you book.
Twenty to thirty minutes is a sensible length for a first visit. It is easier to stay longer if it is going well than to end a visit that has already gone on too long, and a short, calm first experience makes a second visit more likely to happen.