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Sheba*, so named for her queenly demeanor and love of a red velvet pillow, lived with the Masons for over 12 years. They were her family and no one could have loved her more. In her twelfth year, Sheba developed an incurable cancer, but the Masons weren’t ready to let their little dog go. “We wanted to keep her happy and comfortable for as long as we could,” Sherry Mason* said. “We asked our veterinarian if there were some things we could do for her in our own home so we could enjoy whatever time we had left together.”
The family breathed a sigh of relief when their veterinarian suggested a mixture of palliative and pet hospice care for Sheba. “We thought we would feel pressured to put her down,” Jack Mason* said, “and we just weren’t ready to do that.”
Like the human population, our pets are aging. Scientific breakthroughs and more comprehensive veterinary care have allowed pets to live longer lives. Yet, longer lives often result in more age-related—and often terminal—diseases, like cancer. When a cure is not possible, because the disease is too advanced or perhaps because families can’t afford to pay for expensive treatments, our companion animals still need consistent, high-quality medical care. And, when death draws near, they deserve to be kept comfortable and as pain-free as possible. End-of-life support is known as palliative and pet hospice care. As a specialty area of veterinary medicine, it is growing in popularity, availability, and acceptance.
Palliative care is most often used when a disease or injury is considered to be terminal, but death is not yet imminent. The word palliative refers to medical care that treats symptoms, rather than the cause, of disease. The goals of palliative treatments are to make your pet as comfortable as possible and to enhance his or her quality of life for as long as possible. Veterinarians often accomplish this through a combination of medications, preemptive pain control, and supportive therapies like hydration. Sometimes you can administer some of these treatments yourself at home, with the guidance and supervision of your veterinary team.
When your pet begins to have more ‘bad’ days than ‘good’, hospice care may be the next step. The term hospice comes from the same root word for ’hospitality.’ It can be traced back to medieval times when a hospice was a place of rest for travelers on a long journey. In the 1960’s, a British physician applied the word to the idea of specialized care for the dying. Pet hospice provides specialized end-of-life care for your dying pet, as well as an emotionally-supportive grief process for you. This care is often provided in your own home. In most cases, a pet hospice is not a specific place. Rather, it’s a philosophy of care that offers an alternative to extended treatments and repeated hospitalizations for your pet. However, pet hospice doesn’t replace the option of a well-planned, sensitively conducted euthanasia. When it’s time, if you so choose, pet hospice programs can help facilitate a peaceful death in your pet’s familiar home environment or in a home-like setting called a ‘comfort room’ at your veterinary clinic.
Like the hospice model found in human medicine, pet hospice stems from the basic belief that death is not a medical failure. Rather, death is the normal and inevitable conclusion to life. The hospice philosophy teaches that, when all involved are properly prepared and guided, death can be experienced with dignity and compassion.
Your veterinarian may practice the concept of pet hospice care to some degree, providing pain medications to keep your pet comfortable and continuing to monitor the course of your pet’s disease when a cure is not possible. If your veterinarian offers a more formalized pet hospice program, care may be expand from the traditional model of in-clinic examinations and treatments to providing palliative care, end-of-life counseling, and even euthanasia in your own home.
Research conducted by the National Hospice Foundation (NHF) found that 80% of Americans want to die at home. The study also found people are willing to have outside organizations come into their homes and assist with care for a dying family member. Two of the services survey participants said were most important to receive were pain control and emotional support. Recent surveys in veterinary medicine say over 60% of pet owners consider their pets to be members of their families. It makes sense, then, that you might want the same services and end-of-life care for your pet that you want for yourself or for your human family members.
While the concept of pet hospice care is advancing in veterinary medicine, it’s still not widely available. Most veterinary practice teams are small and there are simply not enough staff members to meet the demands of both in-clinic appointments and home visits. However, with a little planning and legwork, along with the assistance of a willing veterinarian, you can often arrange your own customized “hospice” care for your pet. Keep the following guidelines in mind and remember that the most convenient and comforting options for you may not always be what’s best for your pet. For many reasons, even near the end of life, the best place for your pet to be cared for—or for you to say good-bye—may be at your veterinary clinic.
Key Guidelines for Arranging “Pet Hospice” Care
Talk to your veterinarian BEFORE you need home care for your pet. Many veterinarians are willing to provide palliative care and to consider pet hospice-like arrangements, but some simply don’t have the staff to do so. Know your veterinarian! Ask questions!
Expect to pay for the medical care your pet receives from a pet hospice program. While some formalized and well-funded pet hospice programs are able to provide emotional support and grief counseling at no charge, medical services are always on a fee-for-service basis. And, if services are provided in your home, fees may even be slightly higher.
Consider a team approach to end-of-life care. Pet hospice teams must always include your veterinarian to monitor your pet’s condition and to provide medical care. Other members of a team may include a veterinary nurse or certified animal health technician, a veterinary grief support counselor, a physical therapist or practitioner of alternative medicine who can provide massage, acupuncture, etc., for your pet, and a spiritual guide or clergy member. While these services may not all come from one “pet hospice” program, they may be available separately and serve the same purpose.
Please be aware that, in their eagerness to be of service to dying animals and their families, some programs call themselves a pet hospice, but offer only emotional support. Currently, agreed-upon standards of care and licensing programs for pet hospice are in progress but not yet widely accepted or implemented. Pet hospice care without medical supervision is unacceptable as animals often mask their pain and their discomfort can be difficult for non-medical volunteers to diagnose. Please ensure that the programs and services you elect to care for your pet are truly qualified to provide the care you and your pet need.
How can you decide if pet hospice is right for you and your pet? Ask yourself the following questions and discuss your concerns, specific needs, and plans with your veterinarian. Together, you can decide what kind of care is right for you and your pet.
Key Questions for Choosing Pet Hospice Care
Can I accept that my pet is dying and that my focus now is on providing comfort and care, rather than finding a cure?
Do I have enough time, energy, family support, and financial resources to care for my pet 24/7 until death occurs or until my pet needs to be euthanized?
Do I feel confident about my ability to administer medications, supportive therapies, and home treatments for my pet? Am I physically able to carry my pet, if necessary, to keep my pet clean, and to assist my pet with the daily functions of life (eating, drinking water, going to the bathroom, etc.)?
Am I emotionally prepared for the intensity of becoming my pet’s caregiver throughout the dying process?
If your answers to the above questions lead you to elect palliative or hospice care for your pet, please identify someone (your veterinarian or another medical provider) who can be available to you 24/7 if you change your mind or if your pet is in distress. It’s also a good idea to put some plans in place in case your pet dies suddenly or declines more rapidly than you expect. If you feel prepared to deal with your pet’s euthanasia, body care, etc., you will be more able to relax and enjoy the time left with your pet.
Making decisions about your pet’s end-of-life care is never easy. Please know that, even in human medicine, palliative care and hospice services aren’t for everyone. If you find that you prefer to help your pet die before his or her illness takes a huge toll, veterinary medicine is blessed with the option of providing a peaceful, painless end to the pain and suffering your pet may be experiencing. Euthanasia means ’good death.’ If pet hospice care doesn’t meet your needs, your veterinarian can help you and your family plan and prepare for a euthanasia that will allow you to be present with
your pet, gently stroking an ear and whispering good-bye.
*Names and some case details have been changed to protect client confidentiality.
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© 2013. World by the Tail, Inc. All rights reserved.
Laurel Lagoni is a nationally recognized veterinary grief expert and the former Director of the Argus Institute at Colorado State University’s Veterinary Teaching Hospital. She is President of World by the Tail, Inc., and directs the Veterinary Wisdom® Resource Centers at www.veterinarywisdom.com