Veterinary Hospice: Deciding on Pet Hospice Care (Part 2)

In the past, options for a pet with a guarded or poor prognosis were often limited to palliative drugs to take home until “it’s time,” or euthanasia. We have learned about the concept of end-of-life care from human medicine and are finding that option of “do nothing” or “we’ll wait and see” can sometimes be averted. Veterinary hospice, which offers a new alternative for these patients, is part of the new era of specialty medicine that is coming into its own.

However, the same confusion exists in veterinary medicine as human medicine when it comes to deciding on the right time to transfer a patient to hospice care. In our hospice, we often hear a potential referring veterinarian or client say that a pet “isn’t ready for hospice, he still feels good.” This is precisely the time to transfer care to hospice services—the goal of palliative care within the context of hospice is to allow a patient to live “good days” longer and/or to transform “bad days” into better days. For example, if you have a cancer patient that can be sent home on prednisone and antiemetics, this is a good time to refer to hospice.

Questions to consider if a patient is a candidate for hospice:
• Is treatment being pursued? Hospice is usually not considered if curative treatments are being sought.
• Has treatment been sought, but the pet will not recover, or is in terminal stages?
• Is the word “failure” included in the diagnosis (eg, renal failure, liver failure, heart failure)?
• Is euthanasia being offered, but not because the patient is in crisis?

If treatment is not being pursued and the rest of the answers to the questions are “yes,” then it is appropriate to offer hospice care if it is available.

Client Discussion
Talking about the option of hospice care can be uncomfortable to initiate for a multitude of reasons. Common questions doctors ask are: “Will it take up a lot of time?” “What are the ‘right’ words to use?” “Are clients willing to consider this type of care?”

The client talk need not be time-consuming if team members are trained in end-of-life communication and willing to assist you and your clients. Once the veterinarian has given a diagnosis with a list of options and there is a veterinary hospice available, a well-trained employee can be available to answer many of the questions a client will have. Work with your veterinary hospice and see the online resources at the end of this article for training information.

Once the decision to pursue hospice care has been made, the largest barrier for the client is fear—fear of the unknown, fear of “what if?” fear of “how will I know?” A great deal of hospice time is spent providing emotional support to the clients who appreciate having a professional guiding them through this journey with their pet. A staff member trained in end-of-life communication can talk with this family and strengthen the bond between your team and the pet parent as well as support the bond the families share with their pets.

Veterinary teams often have an established relationship with their clients and may think they know what type of care owners are willing to pursue. In reality, it is difficult to know what a person may feel about end-of-life care for a beloved pet. Giving clients an opportunity to explore the option of pet hospice will allow them the opportunity to make a decision that is in both the person’s and the pet’s best interest.

It is incredibly rewarding to see and hear the stories from grateful families that have found peace as a result of the emotional, spiritual, and medical support they have been given during end-of- life care with their pet.

Read more about the Healing Heart Foundation here. Also, learn more about veterinary hospice by reading the article from our February issue, Veterinary Hospice: A Focus on Living.

Online Resources
Compassionate Veterinary Care
International Association of Animal Hospice and Palliative Care
International Veterinary Academy of Pain Management
Pawspice
The American Association of Human Animal Bond Veterinarians
The Argus Institute

About the author: Valarie Hajek Adams, CVT, is president of Healing Heart Foundation, Inc. and director of Healing Heart Pet Hospice. Email her at vadams@horizondvm.com