Surprising Lessons Learned in a Year of Animal Hospice

“How did you decide to do animal hospice?”

I need to polish my response to this frequent question because, well, I tend to ramble. The seed was planted, I think, when I experienced hospice firsthand with my own dad. I subsequently developed a deep professional interest in pain management and quality of life issues. Seeing an unmet need in my community, I launched my practice in August of 2015. The most common service for which I am called upon is home euthanasia, and my hospice clientele is also growing steadily. It has been an incredible journey.

As I developed my business plan, I knew that confronting grief on a regular basis would be emotionally demanding; that I would need to learn how to both set boundaries between personal and professional time and to have the discipline to stick to them; and that I would need to educate my colleagues and win hearts and minds. The opportunity to give the gift of a peaceful end-of-life experience, however, has more than made up for these and other challenges.

 

What surprised me

 

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The most important lesson: just jump in and do it!

It’s not a sad job. At all.

Don’t feel sorry for me. Leaving behind the chaos of general practice for the living room floor has been a breath of fresh air. I genuinely respect my colleagues who continue to get up every day and do battle with parvovirus, deal with the emergencies that disrupt the most carefully planned day, and give the flea talk or the heartworm talk for the bazillionth time with no sign of boredom or weariness.

Having time to focus on the needs of one family at a time, with no distractions and responsibilities lurking just outside the exam room door, is a tremendous blessing. Often, most of the “heavy lifting” of decision-making has already taken place before I am called, and guiding clients through this process can be the most emotionally challenging aspect of end-of-life care. Families feel more at ease in their home environment, free to express their grief authentically. These advantages remove much of the stress that veterinary tearns often experience around euthanasia.

Many pet owners, of course, do reach out to me for guidance, help, or simply an attentive ear. Recently, as I left an appointment, my client commented that I must breathe a big sigh of relief when I get in the car and pull away. Actually, no. These conversations have become so familiar through repetition and practice that I am completely comfortable with them, enabling me to focus on listening and learning from the stories being shared by the really interesting and wonderful people who call upon me. Being invited into someone’s home when they are at their most vulnerable allows a depth of understanding, even intimacy, that is precious, sacred, and very rewarding.

 

The craft store employees know me.

Common recommendations for taking care of ourselves include meditation, exercise, eating well, etc.  All good advice, but this girl likes to do stuff. Without realizing why, I started putting considerable time into finding just the right wicker basket for cradling small patients, making fleece blankets, and experimenting with clay mixtures and techniques to create the perfect paw print. These arts and crafts activities are deeply therapeutic and restorative, and clients love and appreciate the little details. They are little acts of kindness that help all of us feel better in the face of sorrow.

 

Service often matters more than price.

When my mother-in-law died, we had to make a lot of decisions in a short time, when we barely felt capable of getting through the day. Years later, when my dad passed away, I was grateful that he had the foresight to make his arrangements in advance. His hospice team made sure we knew whom we needed to call when the time came, and the rest was taken care of for us. It was such a relief!

Throughout my career, I have always taken pride in being upfront with clients about where they can get the best deal, and providing referrals or websites in place of selling to them directly. “Hey,” I thought I was saying, “I’m not trying to sell you something here. I respect that you may need to save some money, and I believe this will help.”

One sunny morning, I sat down on the front stoop and reviewed several treatment options with an educated and intelligent client. I asked her what she thought. She sighed heavily. “I’m overwhelmed.”

When loved ones reach the end-of-life stage, families want and need for us to do things for them. They are overwhelmed. That level of service does come at a price, so I’ve had to make peace with the fact that…

 

Not everyone can afford me.

I really, really wish I could offer my services on the cheap and make them available to all. Home euthanasia and hospice are labor-intensive. A single house call to the outer edge of my territory can consume half a day. I am gradually becoming more comfortable with charging appropriately for that time, and I do my best to point folks toward more affordable options if they need them.

After a year of conversations, I’ve learned that many callers just need a little active listening and empathy, or perhaps access to resources and information. By putting articles about hospice care, grieving, and quality of life on my practice website, I feel I can offer at least some help to all pets and their families.

 

We in the veterinary profession are missing easy opportunities to help and bond with our clients.

When in distress, pet owners can’t always clearly articulate exactly what it is that they need. When I first opened, my most ample commodity was time. One day, I received a call from a woman who was desperately looking for someone to prescribe antibiotics for her dog. She had been turned down by several clinics, who rightly explained their doctors could not prescribe medications without an exam. Further exploration revealed, however, that paying for an exam was not her barrier to coming in. Her dog was large and extremely fearful of the car. She needed someone to make a house call. I gave her the names and numbers of some mobile vets in her area.

Limited finances are frequently an issue in our business, and it’s easy to slide into the assumption that all decisions to decline care are based on money. I have been as guilty of this as anyone else. I know those receptionists would have happily given her the information she needed if they had understood. A few clarifying questions can go a long way toward helping to solve problems and cultivate loyal clients.

 

Hospice for pets is still far from the mainstream

Build it and they will come, I thought. If I just dropped by my local clinics with doughnuts and brochures, the phone would ring. Not so fast! Relationships and trust, I have learned, must be built in order to earn those referrals.

Colleagues, with the best intentions of helping their patients, occasionally contradict my recommendations, or discourage pet owners from pursuing the hospice option in favor of more definitive care or euthanasia. I have learned to develop a thick skin and walk in their shoes. As a general practitioner, if I heard of a novel technique or approach recommended by a specialist, I’d look it up. Since there is no certification in animal hospice (yet – I’m in the inaugural class!), we are still a little on the “fringe” of veterinary medicine, much like acupuncture was a decade ago. Until hospice is established as an evidence-based specialty, I’ll need to rely on demonstrating impeccable integrity and professionalism in order to gain the trust and acceptance of my fellow veterinarians.

 

My patients are all dying.

“Wait,” you say, “this is a surprise?” Well, no. But I had failed to notice that after 15 years of a career dedicated to curing disease and fixing problems, I am reflexively disappointed in myself when my patients inevitably take a turn for the worse. Relaxing into the reality that the point is not to fix what’s wrong, but to make this final journey as comfortable and fulfilling as we can, takes an incredible level of Zen.

 

Starting a new business from scratch wasn’t so bad, after all.

For years, running a veterinary practice, to say nothing of building one from the ground up, seemed so complex and overwhelming. I’m amazed at what I have accomplished just by tackling one task at a time. So if you’re considering doing something out of your comfort zone, do your research, plan like crazy, then jump in and just keep ticking through that to-do list. Sometimes the list grows faster than it gets checked off, but it’s all worth it.

I’ve taken some lumps, and had one or two spectacularly failed ideas on the business end of things, but the creative challenges, problem solving, empowerment, and pride of ownership have made this the most rewarding year of my career. I can’t wait to see what lessons the next one brings.

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