The effect of owners’ end-of-life care on pets... - Veterinary Practice
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The effect of owners’ end-of-life care on pets…

FRANCESCA RICCOMINI looks at the issues arising when pet owners become too ill to look after their pets or even just socialise with them, as well as those which come with the end of owners’ lives

WE have, it seems, ageing populations where both our clients and their pets are concerned.

Now more than ever we can prolong life without this being at the expense of an acceptable quality or unacceptable suffering. And when it comes to the inevitable winding down period, we also have a range of legal options to hopefully ease an individual, whatever its species, gracefully from this world.

In all this we are fortunate, especially when considering the increased prevalence of the hospice movement in human medicine, as thoughtfully discussed by Periscope in July’s Veterinary Practice.

Putting aside my colleague’s concerns, which I share, about the growing tendency to apply similar principles to the care of our terminally ill companion animals, the greater availability of hospices and other support systems for home nursing of people near the end of their lives can additionally have implications for the welfare of their pets.

This is perhaps an issue that deserves more attention than it currently receives, particularly when these trends coincide with the increasing emotional demands many owners make upon their animals, which are now commonly regarded as “important members of the household and family”.

Like Periscope, I have personal reasons to applaud the skill our medical colleagues bring to this specialist area and the value of respite for both patients and carers associated with periods of hospice residence, especially when illnesses follow a protracted course.

When such dedicated facilities are not available, it is no longer unusual to also find people who experience numerous short hospital stays interspersed with regular and frequent home visits by a number of professionals from various agencies, often over months, if not years.

Unfamiliar environments

Strange people, novel equipment and domestic upheaval can have consequences.

Inevitably some, if not all such visitors, unfamiliar in the first instance, even if they later become accepted members of an animal’s social landscape, will be accompanied by the paraphernalia of medicine and nursing.

They bring sights, sounds and smells (some possibly associated with an individual’s own negative experiences at the veterinary clinic) into a pet’s home, somewhere that should be comfortably familiar and predictable enough to induce a sense of security but sometimes no longer does.

In addition, under such circumstances, disruptions invariably occur to a greater or lesser extent within the physical environment. A cloakroom for instance may be rapidly converted into a shower area – noisy building work, stressful at any time when people can make specific provision for pets; more so now when they have a great deal to think about, organise and attend to, leaving little time for consideration of the animal’s needs.

Or perhaps a rarely used dining room that was previously a dog or cat’s sanctuary and place of retreat from household tensions quickly becomes a sick room because the ill person can no longer climb stairs. The animal is deprived of a coping strategy at the very time it needs it most and invariably no one notices.

Add to this the grief and distress other household members are experiencing. This may in addition be accompanied by increased emotional reliance on the pet as a source of comfort or alternatively, if relations were originally far from cordial, rejection of an added burden, and for many animals the world may indeed seem suddenly a strange and scary place.

Where multipet groups are concerned the effects of previously existing unrecognised stress and emotional strain might well be magnified if these socalled bonded groups were never as stable and happy as owners believed, particularly where management and resource provision are inappropriate and/ or inadequate; a not uncommon phenomenon.

Patient concerns

What of the patient, their familiarity and predictability from the pet’s point of view?

People who are ill generally suffer from reduced energy levels and from mood changes, so it is understandable if they have less time for a pet, less patience and interest in interacting with it. Or they may feel more self-protective than usual, fearing inadvertent injury or infection from scrabbling claws for example.

Alternatively they can become more clingy, deriving comfort and emotional solace from its presence. All well and good when the animal too enjoys prolonged close contact, not so great if he or she needs a marked degree of space and solitude to remain emotionally comfortable.

People around this central dyad, out of concern for the patient’s well-being, can additionally “interfere” in a relationship between owner and pet in a manner that is well-intentioned but ultimately unhelpful and does little to maintain the predictability from the animal’s point of view of this important part of the home environment.

On the right scent

Scent is a further issue worthy of consideration. We understand its importance in our animals’ world and many of us utilise it when we go away, leaving well worn garments as “comforters” to maintain bonds with “stay at home” cats and dogs.

Owners also commonly report that upon return they are diligently sniffed for prolonged periods and then “sent to Coventry” for some time before relationships settle back into established, familiar routines. In addition, it is recognised that a cat returning to its bonded companion feline smelling “surgical” can undermine, sometimes disastrously, a previously equable relationship.

Is it then fanciful to suggest that the very process of supporting and nursing terminally ill people, often including as it does intermittent hospital and/or hospice care with all that involves, may for many ownerpet relationships be accompanied by considerable risks?

Risks that are frequently overlooked unless, or until, the pet’s behaviour is so negatively affected that it becomes unacceptable and is no longer tolerated – sadly at a time when human emotions are already running high and those concerned have many calls upon their time, energies and resilience – not therefore the best circumstances in which to tackle any companion animal behavioural issue.

Some of the referred behaviour cases I have dealt with suggest that it is not at all fanciful. And in view of current trends in human medicine and end-of-life care, this is an issue that may well affect those of us in veterinary and behavioural practice more frequently in years to come.

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