Kindred Spirit Kindred Care, LLC.

Shannon Fujimoto Nakaya, DVM


Complementary and adjunct care for dogs and cats with special needs.

Caregiving: perspectives of a veterinary hospice professional

Signing up for veterinary hospice care, how it works, benefits for your animal companion and you.

 

Written by Valarie Hajek Adams, CVT
President, Healing Heart Foundation, Inc.
Director, Healing Heart Pet Hospice

For many, providing palliative (comfort care) and hospice care for their pet is their final gift for a lifetime of rich memories. Often, the situation kind of sneaks up on them. Yeah, s/he has been slowing down. This comes with age, doesn't it? Okay, let's do some tests just to make sure . . . and then a diagnosis is made. And particularly when that diagnosis is about an incurable condition, the question asked is, "What now?"

Typically, the veterinarian would prescribe a couple of medications with a parting direction of "Let us know when it's time." When a family would counter with the question of, "How will I know when it's time?" a confident statement like, "You'll just know," would be the response. This can lead to a multitude of uncertainties and an onslaught of guilt that can haunt a caring pet owner long after the pet is deceased.

If we were to travel the road of human medicine this "What now?" question would be answered with either (a) an attempt to treat the disease process, or (b) sign the patient up for hospice care. The stigma in our society, with respect to both human and veterinary hospice, is that hospice care is looked upon as "giving up". In human medicine, long after someone has exhausted chemo and radiation options, with little to no success, we encourage them to continue to fight something like cancer with every last breath. Once passed, this person is heralded as courageous and a fighter to the end. There is less of this stigma in veterinary hospice. More people do not want to put their animal companions through demanding treatments that might do more harm than good. But still, "giving up" is acknowledging defeat, even if it is the same enemy – mortality -- that has eventually outwitted all life for time immemorial.

Another misconception, with respect to veterinary hospice, surrounds the topic of euthanasia. Because euthanasia is an option with animals, there are passionate and heated debates even amongst veterinary hospice providers about if and when to euthanize an animal patient. There are those who believe that life is sacred and that dying is a natural process that should never be hastened by euthanasia, and there are those who believe that allowing an animal to die naturally forces it to deal with unecessary pain and suffering. The truth is that it depends on the patient and the circumstances.

It IS my opinion that we have interrupted the "natural" order of life with domestic animals by bringing them into our homes and caring for them with good nutrition, safe environments, medical intervention, etc. Left to be in the wild these animals would be following the 'natural' order of prey vs. predator along with the hazards of living in nature. Therefore, I don't agree with the term 'natural' death vs. euthanasia. I believe a more appropriate term is 'unassisted death' vs. euthanasia. Case in point is my 20-year-old cat, Sergio. Were it not for the fact that his mommy, me, is a veterinary hospice nurse, he wouldn't have lived with the quality that he did for as long as he did. Nor would there have been the need to euthanize him when palliative care was no longer possible. I believe when we made the commitment to bring them into our side of life then we must also be prepared to help them out of the world.

What happens is that some people perceive veterinary hospice as hastening the death of their beloved animal companions, and some perceive veterinary hospice care as not allowing euthanasia. Neither is true! Veterinary hospice care has more to do with living than dying! It has to do with building memories to last a lifetime as well as giving back for previous memories. It has to do with focusing on and preserving quality of life for as long as life can be good, and facilitating a graceful passing either naturally or facilitated by euthanasia depending on the situation.

The most difficult thing for someone to do is to make the initial phone call to inquire about the way our hospice program for pets works. Making that phone call is often the first time someone is facing and accepting the fact that something very serious -- serious enough to end life -- is happening to their pet, and that the time is coming, perhaps sooner than later, to say goodbye. Mortality has come knocking on the door and they are seeking help to provide comfort for their pets as they transition from life into afterlife, and support for themselves and their families.

Veterinary hospice care is patient centered medicine that has the ability of smoothing out a journey and avoiding tragic pitfalls. Home visits consist of both assessing and tending the pet, addressing all aspects of patient comfort and what to be mindful of in the periods to come. It also consists of meaningful, supportive time with the caregiver and providing them an outlet to express their worries, frustration, anger, love, whatever needs to be released. By virtue of their needs and my calling, we often end up forming a close, trusting, honest relationship in short order. I find myself often telling clients that our relationship with them is like no other. We're not family, were' not friends in the classic sense, we're not primary care veterinary professionals, we are the people that are going to walk the road of losing their pet with them. We are always mindful of the one concrete fact – they are going to lose this particular pet ONCE. Our purpose is for that passing to go smoothly for the pet and the family.

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