Veterinary Hospice Care
Hospice is a system which provides compassionate care to patients near the end of their lives and supports their guardians through the bereavement process. Hospice is built on the nursing model of care, in contrast to the medical model. Hospice is not about heroic medical interventions that prevent quality of life in a pointless attempt to prolong it. It focuses on pain management and symptom management, as well as other supportive medical care, with the goal of providing comfort (as opposed to cure). The patient’s condition may continue to be treated, but heroic measures causing significant loss of quality of life are avoided. It includes comprehensive nursing care as well as psychosocial and spiritual care for the patient and guardians.
At the end of a pet’s life quality time is precious to the family, and helps them cope with the approaching death of their companion.
Hospice care for animals is a welcome additional option at the end of life. It is an alternative to premature euthanasia. It is also an alternative to prolonged suffering either in the isolation of intensive care or at home without treatment.
Our team includes a registered veterinary technician and an experienced bereavement counseller who complete the circle of care for our hospice patients.
“Palliative care should not be the last resort ….. or about giving up. It’s about increased quality of life and enhanced coordination of care. It is not about dying. It is about living with cancer. It’s not less care. It’s more care.”
Fred Meyers, MD, University of California, Davis School of Medicine
Quality of Life Scale: The HHHHHMM Scorecard
A useful tool to evaluate the quality of life that our companions enjoy is the “HHHHHMM” scorecard, which stands for: hurt, hunger, hydration, hygiene, happiness, mobility and more good days than bad days. A score above five on most of these issues is acceptable in maintaining an end-of-life program. Each pet’s situation needs an individual, kind and supportive approach.
”Pet caregivers can use this Quality of Life Scale to determine
the success of hospice care. Score patients using a scale of 1 to 10.”
| Score | Criterion | Example |
|---|---|---|
| 1-10 | ||
| HURT | Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen necessary? | |
| HUNGER | Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube? | |
| HYDRATION | Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake. | |
| HYGIENE | The patient should be brushed and cleaned, particularly after elimination. Avoid pressure scores and keep all wounds clean. | |
| HAPPINESS | Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be close to the family activities and not be isolated? | |
| MOBILITY | Can the patient get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.) | |
| MORE GOOD DAYS THAN BAD | When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay. | |
| <– *TOTAL* (over 35 points represents acceptable life quality) | ||
Adapted from Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.
