Anatomy of a Vet Hospice Consultation
By Last Wishes
Our veterinary associations are getting better about teaching veterinarians compassion, empathy and respecting family’s wishes at or near the completion of their companion’s lives. The realization that a pet has been diagnosed with a life-limiting condition can cause a number of physical and emotional reactions in family members whom with they share a loving bond. A large number of veterinarians understand this feeling because we’ve experienced loss, too. Thankfully, due to the increase in the number of educational opportunities available for veterinarians in the fields of hospice and palliative care, we’ve been making great progress on knowing when to recognize and recommend a paradigm shift from one of curing to caring.
STEP 1: If your pet has a general practitioner already, you may want to ask them if they feel your pet’s condition could be better managed in the comfort of home with the help of a hospice team, or a veterinarian with a special interest in home senior pet care. If you do not have a general practitioner for your pet, it’s encouraged that you contact a provider who can help manage your senior pet’s condition in the home. You may be surprised to learn that a significant number of cats and dogs never see veterinarian once in their lives, let alone on a regular basis. Mobile veterinarians see pets all the time who needed someone’s help long before the day we arrive.
Patients who benefit most from this increased level of care have been diagnosed with osteoarthritis, cancer, chronic internal diseases, cognitive decline, and/or any condition that causes chronic pain or suffering.
STEP 2: Setting Up The Appointment. Most veterinarians and support staff who focus on pain management, palliative care, and hospice care are compassionate, empathetic, and non-judgmental. They WANT to help you and your family make decisions in the best interest of you and your pet. Many services are set up to handle requests online, have e-mail access, messaging capabilities on Facebook, and/or caring individuals who are a great help to worried individuals over the phone.
STEP 3: The Home Visit. After reviewing all available previous medical records from your general practitioner, referring veterinarian, or veterinarian specialist; a detailed patient and family history is discussed. The patient’s and family’s needs, including values, beliefs, care-taking capabilities, and goals are revealed. This information is important for the recommended care plan that is tailored to each patient and family. The patient’s appetite, willingness to accept medications, and the family’s ability to remain committed to compliance are essential factors in determining the best course of action.
A thorough physical examination is performed, including body/muscle condition scoring, and proper pain palpation and pain scoring. Fear free techniques are used to assess overall condition and co-morbidities such as skin, ear, eye and dental disease that many older pets deal with on top of their primary life-limiting illness.
Once an assessment is determined, we discuss options for care and monitoring of the patient with each family. Sometimes care is 100% in the home, and in some cases we work with the referring or speciality veterinarian to provide the most complete, interdisciplinary care possible. Our goal is to discuss ALL options and give each family choices. This means that if there is a part of care, diagnostics, or monitoring a home care practitioner or team cannot provide, a recommendation to a veterinary team that can provide the care needed at the moment should be discussed. Many home care veterinary teams carry most of the needed therapies with them and can likely start treatments immediately, which is very convenient to most families.
STEP 4: Home Care and Follow-Up. A summary of your pet’s assessment, information on your pet’s disease processes, home care instructions, and how to contact the team in the event of an emergency is an important final step in an initial consultation. It should also be determined at this time when a follow-up over the phone or in-home recheck is recommended. Some patients need exams every few days, some a couple times a month, and some every 2-3 months depending on the diagnosis and associated symptoms each pet is experiencing and how quickly the team is able to stabilize them. The mission of a veterinary hospice team is to tend to the patient, the family, and the community; and to offer emotional, physical, spiritual, and social support as and wherever needed.