Veterinary Hospice & the Human-Animal Bond
Posted: Mar 11, 2014
Veterinary Hospice & the Human-Animal Bond
Dani McVety, DVM, & Mary Gardner, DVM, Lap of Love Veterinary Hospice, Tampa, Florida
More clients are requesting hospice care for aging or terminally ill companion animals. Knowing what veterinary hospice care is, how to provide hospice care in the practice or home, and how to assist families in the mitigation of suffering helps ensure quality care. For clients, feeling prepared can help ease tension, strengthen the human–animal bond, and facilitate a peaceful end-of-life experience, helping them cope better with the loss—and possibly preparing them to get another pet in due time.
Veterinary hospice is a family-centered, medically supervised, and team-oriented service dedicated to preserving the human–animal bond by maintaining comfort and quality of life for the terminally ill patient until natural death occurs or the client elects euthanasia. Of note, natural death is not the goal of veterinary hospice—but it may be a reality for many pets. Care can take place at the practice, although the home is generally preferred, namely for patient comfort; however, education and medical direction begin at the practice. Using the term hospice to describe care will help clients comprehend their pet’s end-of-life status and that curative options are no longer being pursued, often providing a relief for clients.
Image. Dr. McVety administers subcutaneous fluids to Ace, a male Labrador retriever (10 years of age) with advanced lymphoma. His family chose palliative hospice care to keep Ace in the home for as long as he is comfortable.
The Hospice Consultation
Hospice and end-of-life options should be discussed openly and proactively with clients and could be considered as a discharge option. Clients are often anxious and distressed when confronted with the impending loss of a pet and may have difficulty bringing up euthanasia; hospice care can present a bridge between life and death. The veterinary team can help clients by asking about their expectations and fears, as well as explaining the process of a hospice appointment.
Hospice consultations usually require at least 30 minutes in the practice or 45 to 90 minutes in the home for observation of the patient in a home environment. Clients should be informed about the disease process and progression. The decision of when to euthanize centers around the disease process and the patient’s quality of life as interpreted by the client. Medical knowledge and experience can help teams coach clients and provide tools to make the experience as positive as possible.
It is a common misconception that hospice care inappropriately increases costs; however, hospice is not about cost but about adding value, service, love, and attention. In fact, forgoing nonessential bloodwork, diagnostics, vaccines, and medications can save money or allow clients to repurpose these costs for hospice consultation.
Targeting Geriatric Patients
Although practices usually have a standard of care developed for patients 6 years of age and older, geriatric patients have different needs. Targeting these patients reminds clients that we are not only animal experts but also animal advocates for all stages of life. An open conversation about the patient’s disease or age, appropriate therapy, and ancillary services, with the emphasis on comfort and quality of life, is a beginning step of hospice care. Discuss available comfort-care options for patients over 12 years of age who have not been to the practice in the past year.
Many clients want to lessen financial burden and pet stress and therefore may want to avoid “unnecessary” visits and procedures. Avoid making clients feel guilty if they choose to cease treatment or opt against it. Instead, ensure they feel supported, comforted, prepared, and not financially burdened:
Educate clients on potential adverse effects, which warrant emphasis on the treatment's importance
Have clients sign a liability waiver when refusing bloodwork to protect you and your practice
Help clients plan a compassionate approach to end-of-life care for their pet.
Although a patient’s terminal disease or old age cannot be cured, the team can truly help clients keep their pets comfortable, clean, and happy, which is important not only for the welfare of the pet, but also for the human–animal bond.
Image. Dr. McVety comforts a pet on the owner's bed immediately following euthanasia. Previously, hospice care focused on patient comfort with daily quality-of-life evaluations, helping the owner cope with the impending loss and feel more prepared for the decision to euthanize.
Client & Team Resources
Pet Hospice Journal (http://pethospicejournal.com/)
International Association of Animal Hospice & Palliative Care (http://iaahpc.org/)
Common Diseases & Hospice Care (http://lapoflove.com/Education/Common-Diseases)