Written by Shannon Fujimoto Nakaya, DVM
Veterinary hospice is about sharing an end-of-life journey.
As sad as it is realizing that our animal companions will someday cease to breathe, perhaps it is the one-of-a-kind and finite nature of each life that makes it so precious. Hospice is about celebrating a pet's life, in addition to acknowledging that it will be ending, probably sooner rather than later.
Hospice is not about rushing to the finish line. Sometimes hospice is about going from day to day, appreciating every good day as gift.
Veterinary hospice is about comfort care in a pet's familiar surroundings and involves attending to physical and emotional comfort, breathing, hydration, positive energy balance, hygiene, and sharing quality time together.
Whether it is for ourselves or our animal companions, hospitals are not fun places. Given a choice, most people and pets would choose to convalesce in the comfort and familiarity of home and family rather than in an institution. Patients tend to be more relaxed at home, rest more, eat and drink more, and require less medications for pain and anxiety. For our pets, there is comfort in being surrounded by those who understand your quirks and habbits. For ourselves, there can be comfort in participating in making every day as comfortable and good as it can be.
Veterinary Hospice is about alleviating pain and maintaining comfort.
In a study on humans diagnosed with terminal illness, there were two factors that influenced the patient's interest or disinterest in euthanasia. (1) Human patients with severe pain were more interested euthanasia. (2) Human patients with strong human connections had less interest in euthanasia.
There are many, many ways of alleviating pain and maintaining patient comfort. Pain should not be part of the living or dying process.
Veterinary hospice is about becoming a care giver and a pet nurse.
Not everyone is innately a care giver. Not everyone is comfortable caring for the infirm, which might require food preparation, assistance drinking, assitance feeding, administering medications, lifting and carrying, changing soiled bedding, bathing, cleaning up excretions, changing diapers, all the while keeping a compassionate, caring, upbeat, and realistic attitude.
We all have different experiences and comfort levels with aging, disease, and death. Becoming a veterinary hospice caregiver is about facing some of our fears, and sometimes about putting them aside to be functional for our animal companions.
Becoming a veterinary hospice care giver and pet nurse requires commitment, time, and financial freedom.
Becoming a veterinary hospice care giver for a pet is an experience that introduces us to lessons about living and dying and what's really important along the way. Providing veterinary hospice care for animal companion with whom we have a connection seals the bond and becomes a part of who we are there ever after.
Veterinary hospice is an extention of care into the home, not an alternative to care.
Veterinary hospice should be decided with the guidance of a (hospice) veterinarian. It would be negligent and tragic to presume that a pet's condition is terminal when it might be easily treated. Even when an animal is diagnosed with a terminal disease, secondary problems can often be treated improving quality of life and comfort for the patient during their convalescence. Veterinarians are trained and licensed to perform quality of life evaluations (more on quality of life evaluations in a different chapter) and coordinate pain management and palliative care plans.
Veterinary hospice should be supported by a veterinarian or a veterinary hospice team. (See Valerie Adam's article on being a professional veterinary hospice caregiver.) Some veterinary hospice teams also include nurses and counselors and volunteers to provide support for the caregivers and their families through and beyond the actual hospice period. Care givers that have opportunities for rests and breaks make better care givers.
Veterinary hospice should NEVER be an excuse for hoarding old and/or infirm animals without providing veterinary care.
Sometimes veterinary hospice is about choosing between an unassisted passing or euthanasia.
Much more discussion on this topic in the chapter on Graceful Exits. For this chapter on Veterinary Hospice, it should suffice to say that either way, a veterinary hospice team can be helpful. Whether it is helping you prepare for what to expect or when to call for help, their experience can help guide you and make your pet's exit as graceful as possible.