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Untitled DocumentJuly 2013
Comfort Caring Beyond Curing How to help pet parents struggling with a terminally ill or geriatric pet -
The Emerging World of Veterinary Hospice
Mary Gardner, DVM
Lap of Love Veterinary Hospice
In our veterinary hospice practice, we are finding a great deal of families that wish to keep their pet alive for as long as possible while also maintaining a good quality of life. As a veterinary hospice practitioner, I am able and willing to help extend life as long as pain and anxiety are controlled, but this is always preceded by a lengthy discussion on the progression of the disease process present and a clear “stop point” which we agree is the ending of a good quality of life. Communication, preparation, and more communication is the hallmark of a successful hospice case.
Many of our clients are referred to us from veterinary specialists – mostly oncologists, cardiologists and internists. While much of veterinary hospice is ideally done in the home, where the pet is most comfortable – many discussions and treatments should be started at the clinic with the veterinarian that the client has had a long relationship with.
Setting up a hospice program in your clinic is actually very simple. However, you must first understand exactly what “Veterinary Hospice” is. We define it as, “A family-centered service dedicated to maintaining comfort and quality of life for the terminally ill or geriatric pet until natural death occurs or the family elects peaceful euthanasia.”
It is most important to help the family understand the disease process their pet is facing. Although we cannot predict exactly what will happened in the future, we can use our medical training and experience to give each family facing an end-of-life experience with their pet a possible and probable progression of their pet’s disease process. As doctors, this is the most important piece of information we have to give them and the most valuable tool families have in the decision making process. We must, to the best of our ability, explain the most likely “natural” method of death if left unattended. This educated approach to the physicality of death is essential to veterinary hospice care; by providing the family with knowledge and expectations, we give them the ability to make an informed decision based on their personal wishes for their pet with the gentle guidance of their veterinarian.
A clinic should have branded Hospice Handouts (similar to ‘puppy/kitten’ packages in general practice). This should include disease information, a quality of life scale (www.pethospicejournal.com is a free online Quality of Life assessment tool that we designed for pet parents), information on local adjunctive services (mobile pet grooming, acupuncture, etc), information on euthanasia (what to expect, how to make the appointment, local In-Home Pet Euthanasia veterinarians), information on aftercare (plus crematory contact information in case the pet passes on its own and they need assistance) and pet loss information.
By using the word ‘Hospice’ with your clients, it redirects their thoughts from curing their pet to caring for their pet and preparing themselves for death and grieving. Then tailor your medical management appropriately to make sure the pet is kept comfortable and safe.
Some hospice services your clinic can offer:
Consultations – This is our most common and requested hospice service. You may be surprised at how appreciative the client is for 30 minutes with a veterinarian discussing what to expect and how to manage their pet’s disease and progression.
Pain and anxiety management – This should also include emergency intervention the owner can do themselves. For example, the client with a dog with Osteosarcoma should leave your clinic with a dose of injectable pain medication and the knowledge of how to administer it in case of a pathologic fracture. That way the pet can have some relief while the next steps are organized.
In home technician visits and care – seeing the pets in their own environment is key as they act differently in their surroundings but also, modifications can be made that may have been overlooked and treatments can be done in the home without a distressing trip to your clinic.
While these offerings may not provide the largest avenue of revenue – the immeasurable benefits are great. The satisfaction your clients will have with the full circle of veterinary care you provide will be priceless. This will lead to positive word of mouth, referrals, better relationship between your practice and the general practitioner, repeat business with other pets from that client when necessary and most importantly – it is what is best for the pet.
Veterinary hospice is here to stay. When families have a better end of life experience with their pets, they heal more quickly from the debilitating emotional loss. They are better able to cope with their decisions, feel confident in their ability to care for their pets, and more quickly open their homes and hearts to pet ownership again.
Dr. Mary Gardner is co-founder of Lap of Love - the largest organization of in-home hospice and euthanasia veterinarians in North America. With now over 50 veterinarians helping families in 36 locations in 16 states (and growing), Lap of Love has helped over 6,000 families with their geriatric pets and end of life care. Dr. Gardne and her partner Dr. Dani McVety have not only perfected the medical side of managing hospice pets but have also succeeded in making the Lap of Love business model a profitable one for all of their veterinarians. (www.lapoflove.com)