Euthanasia and client support

Flashcards about Euthanasia and client support

Human Companion Animal Bond (HCAB)

A mutually beneficial relationship between people and their animals.

Benefits of HCAB for animals

Food, water, veterinary care, and human benefits.

General health benefits of HCAB for humans

Improve mood, reduce depression, lower blood pressure and cholesterol, and lower the risk of a heart attack, motivate and encourage exercise, reduce and prevent stress, and help to prevent disease.

Other benefits of HCAB for humans

Increase self-esteem and sense of personal competence, lessen loneliness, encourage and enable socialisation, provide social support, provide unconditional acceptance and warmth, boost the immune system, decrease GP visits, and act as a health warning (dogs known to detect certain cancers)

Psychological losses associated with pet bereavement

Feeling needed and loved, play, fun, and companionship.

Social losses associated with pet bereavement

Social conversation, reason to get up, and reason to go out, security.

Physical losses associated with pet bereavement

Opportunities/motivation to exercise and reason to go out.

Reasons clients need support during pet loss

Pet loss is largely unrecognised as a loss in the UK, with no compassionate leave, no community support, not universally experienced, understood or recognised, and grief may be perceived as trivial or ridiculous, often alone with their grief.

Five stages of grief

Denial, Anger, Bargaining, Depression, Acceptance

Denial (Grief)

The individual refuses to accept the loss, or the news of impending loss is true.

Denying the truth.

Demanding 2nd opinion, internet research, disappear from the surgery.

Anger (Grief)

Overwhelming anger directed at the vet, themselves, relatives/friends, or the medical community.

Rarely rational, but overwhelming and consuming

Physical, verbal, and irrational

Bargaining (Grief)

Begging for the pet's life in exchange for whatever price such a bargain would demand.

money, prayer, time

Depression (Grief)

Realizing the situation is irrevocable and feeling sad, anxious, regretful, or guilty.

Apologising to the pet, needing support, become withdrawn

Acceptance (Grief)

Accepting that the pet has limited time and acknowledging that the pet is not returning.

Anticipatory Grief

Grieving that begins BEFORE the actual loss (e.g., known life-limiting condition).

This type of grief requires the provision of pre-euthanasia bereavement care

Responsibility Grief

Grief resulting from owners having personal responsibility for the death of their pet by euthanasia, leading to feelings of guilt, self-blame, and doubt.

How can we respond to responsibility grief?

RVN continuing care clinics (palliative care, pre-euthanasia consults)

Involvement & empowerment of the owner in palliative treatment and care of terminally ill patient

QOL assessment (include owners)

Do not rush clients into euthanasia decision-making

Choices & options to be explored (location, after death body-care)

Validation of euthanasia decision

Allow opportunities for discussion and questions

Quality of life (QOL) assessment

•       H – Hurt?

•       H – Hunger?

•       H – Hydration?

•       H – Hygiene?

•       H – Happiness?

•       M – Mobility?

•       M – More good days than bad?

How is quality of life measured

It takes into account all of the parts of a pet’s mental and physical well-being. This means it can be difficult to measure

Decision making

The HCAB is paramount to the feelings of clients at this time

If they perceive a mutual trust between themselves and their pet, trust will be a major issue within the process of decision making

Reasons for Euthanasia

Terminal illness, Palliative care is insufficient, Behaviour / aggressive, Financial, Unable to rehome

Euthanasia Process

  IV Access

Time (client needs for time) and resources

Quiet environment (Farewell room)

Personal space

Linking items

Things to do when children are involved

Decision to involve children is with the parent or guardian, but the veterinary professional will need to provide guidance.

Explanation needs to be simple and direct

If they are present at euthanasia need to explain in advance what they will see – NO SURPRISES

Children often form strong bonds with their pet

Losing a pet may be their first experience of death

Books such as ‘missing my pet’ can be very useful in helping children to understand and preparing them for the event

Remember that children, like adults, may appear to overreact to the loss of a pet if they have or have recently had other concerns in their life (e.g. family breakdown)

Encourage children to talk about their pet and perhaps draw pictures or make a memory box

Don’t use the phrase ‘put to sleep’ children might think they are going to wake back up or could make them think they will die if they go to sleep

Linking items

Small amount of fur, Collar, Clay paw mould / ink footprint

Different types of bonds

Working dogs with handler

Emotional support animals

Guide dogs

Animal therapy animals

What circumstances can lead to the loss of pet?

•       Acute illness (quickly)

•       Life limiting condition

•       Euthanasia

•       Accidental death (RTA)

•       Human illness

•       Rehoming pet

•       Moving abroad

•       Straying (gone missing)

•       Theft

•       Behavioural

•       Imprisonment

•       Divorce/separation

•       Forced to give up a pet

•       Mandatory euthanasia – dangerous dog act

When to have the pre-euthanasia chat?

The first conversation around euthanasia will be with the vet

•       Recognise and validate the HCAB

•       Recognise and validate anticipatory grief

•       Discuss quality of life

•       Thorough discussion of euthanasia procedure

•       Options for home or surgery euthanasia

•       Deciding who should be present

•       After body care options and financial considerations

•       Owner may want to sign euthanasia consent form prior to the procedure

RCVS Guidance on euthanasia

The decision to euthanise an animal will be based on an assessment of many factors. These may include:

(a) the extent and nature of the disease or injuries;

(b) availability of other treatment options;

(c) the prognosis and potential quality of life after treatment including whether an animal functions and feels well and has capacity for natural behaviours that are species specific; 

(d) the availability and likelihood of success of treatment;  

(e) the animal’s age and/or other disease/health.

Farewell Room

The provision of such a room can act as an alternative to consultation rooms, for clients who have made or are making the decision to have their pet euthanased

Less ‘clinical’ feel to the room, no barriers to communication

Create an atmosphere of calm for both animals and owners, a number of features could be incorporated into such a room:

Upholstered chairs

Framed pictures on the walls, plants

A sideboard/cupboard to house the range of caskets available

How to support the client during euthanasia?

Sensitive communication from the veterinary professionals is key!

Imagine how the client may be feeling – show empathy

Give the client time to think, speak & show emotion

Making sure the procedure goes smoothly

After Death body care options

Communal cremation

Individual cremation

Burial at home

Burial at a pet cemetery

Communal cremation

•       Organised by practice

•       Most economical

•       Unable to have communal cremains returned to owner

Individual cremation

•       Can be arranged by the practice or owner

•       Enables individual cremains to be returned

Large selection of caskets and urns

•       May be kept, buried or scattered

Burial at home

•       Legally must be 1.25 metres deep

•       Can visit the ‘grave’ anytime

•       Risk of exhumation by foxes & badgers

•       May cause problems when moving house (renting)

Burial at pet cemetery

•       Most costly option

•       Upkeep fee

•       Some cemeteries are able to provide pet & human burials

Bereavement cards

•       Bereavement cards may be sent to all clients, inside a sympathy card

•       NEVER send with the bill

•       Cards should be sent within 2 days of the loss

Pet euthanasia support

•       Pet bereavement support (Blue Cross)

•       Samaritans

•       Contact number for local pet loss group, trained counsellor

•       Self and team care

Bereavement cards

may be sent to all clients, inside a sympathy card

never sent with the bill

card should be sent within 2 days of the loss