Veterinary Hospice: A Focus on Living (Part 1)

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If you ask a veterinary professional why they chose their career, the most common answer you’ll hear is the person’s profound love for animals.

If you ask a veterinary professional why he or she specializes in end-of-life care for animals, what you won’t hear is a focus on death. That’s because the primary focus of hospice care is livingwithout pain and minimal, if any, discomfort, in the pets’ own home surrounded by a loving family.

Companion Animal Hospice

The human hospice prototype came into existence in the 1960s. Today almost every community throughout the country offers a hospice program. Hospice care for companion animals was introduced into the veterinary community more than a decade ago. Each program may be structured slightly differently depending on locale and support staff, but all share the essential hospice philosophy:

  • Nonjudgmental end-of-life care for the dying patient
  • An emphasis on palliative (comfort) care
  • Emotional support for the human families
The Argus Institute, part of Colorado State University, utilizes veterinary students to assist families by providing emotional support and bereavement education for families caring for dying pets. Volunteer veterinary students are mentored by professionals whose specialty is communication in veterinary medicine, grief and bereavement and compassion along with veterinary medicine.
There are few, if any, compulsory classes for veterinary students or human medical students on subjects surrounding end-of- life care for the dying to such extent as even the basics like communicating bad news to a client!

Hospice Programs Today

It is difficult to say exactly how many pet hospice programs are actively functioning in the United States.  A new organization, the International Association of Animal Hospice and Palliative Care, is aims to be a national resource for those wanting to be in the field.
Many of today’s pet hospice programs involve mobile veterinarians who are already providing care for pets in their own homes. These veterinarians are in a unique position to provide everything necessary for end-of-life care in a home setting and, if asked, are able to provide euthanasia services.
Some programs empower pet families by teaching them the skills for caring for their pets with periodic visits to the veterinarian for assessment. These programs provide home euthanasia’s to some extent. The Argus Institute’svolunteer veterinary students take medical orders from referring veterinarians and provide in home nursing care. Still other programs, such as Healing Heart Pet Hospice (HHPH), are mirrored after human hospice in that the program focuses on a team or “Circle of Care” approach. Veterinarians are the medical directors and CVTs provide in-home care under their direction. If needed, other paraprofessionals trained in bereavement are included.

Veterinary Nurse’s Role

Veterinary hospice gives the veterinarian and veterinary nurse the opportunity to work in synchronicity around the (hospice) concept of caring. Once the doctor–client–patient relationship has been established with the doctor, the veterinary nurse becomes the extension of care, bringing it into the pet’s home environment; adapting nursing skills to meet the individual needs of each pet and family. The veterinary nurse is the eyes, ears, and hands for the veterinarian, from the ICU into the patient’s home.
 Veterinarians and veterinary technicians working in end-of-life care understand that the focus has shifted from providing patients with the latest in health care treatments and curing an illness to providing palliative care and support during the transition from life to end of life.
This new focus requires the veterinary nurse to be knowledgeable on end-of-life topics in order to educate, support, and guide pet families during this time of transition. A veterinary nurse needs to understand that hospice care goes beyond the clinical setting and requires a more defined set of skills and abilities to be able to deliver care to both patient and family. Staying current with up-to-date palliative care drugs, environmental, and spiritual comfort knowledge, as well as a complete understanding of the body during the dying process are but a few topics that are required.
It is the skill of the veterinary nurse that can either deliver necessary drugs or teach family members how to administer them, recognize side effects, perform or instruct how to deliver good hygienic care, and how to prepare for the events preceding and after death.
Astute monitoring skills are needed to recognize the shifting process towards dying. It requires maintaining patient records so that problems, plan, actions, and goals are accurately and clearly stated and changes are reflected as they occur. This documentation is also helpful when meeting with the hospice veterinarian to make necessary changes in the palliative care plan.
Assessing ones own views of death and dying and the issues surrounding this topic is an important aspect of a career in veterinary nursing. To effectively facilitate veterinary hospice nursing it will be essential for the veterinary nurse to have a strong foundation in this area. These views should also include respect for the pet family’s sensitive values, belief systems and spirituality while upholding the integrity of the veterinary profession. The comfort of the pet is first and foremost in the premise of hospice care.
If the time should come to facilitate euthanasia, it should be performed in accordance to state laws and with the reverence and sacredness this act deserves.

Circle of Care

There is a responsibility on both the part of the veterinarian and the pet parent to question and share knowledge as related to end of life care topics, which is a completion of the “circle of care.” As the availability of pet hospice programs increase and become more prominent as an option in veterinary services, utilization of such services will also increase.
Online Resources
About the author: Valarie Hajek Adams, CVT, is president of Healing Heart Foundation, Inc. and director of Healing Heart Pet Hospice. Email her at [email protected]

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