Update 4/29/2020
We are accepting new appointments beginning May 1st! Thank you so much for your patience. We encourage you to plan ahead as we’re limiting the number of appointments for enhanced safety. Online scheduling is still disabled so please call or email us to schedule – and do bear with us, our scheduling process is a bit more complicated to accommodate additional safety and screening measures.
Update 4/20/2020
We have been busy writing protocols to resume services while keeping you and your family safe. At this time we are planning on opening in early May. To allow time for proper disinfection between appointments, availability will be limited. We really miss helping our community and are looking foward to offering you the solace and comfort of home services in a way that protects your health and safety. Stay tuned for updates and pre-register your pet here for priority scheduling.
The very point of Arms of Aloha, the reason I built this business from scratch five years ago, is to alleviate suffering for humans and animals. It is against our mission to amplify suffering in our community, even if inadvertently.
In the interest of everyone’s safety, I have reluctantly made the heartbreaking decision to suspend house calls until further notice. This is the best option for our familes, our clients, and our community at this moment. I am actively devising strategies to safely handle house calls sometime in the future. We will be shortly rolling out a plan for doing palliative care consultations via telehealth. In the meantime we continue to offer guidance, grief support, and educational resources at no charge to our community.
I (Dr. Naun) intend to use this space to keep you updated on our plans for dealing with this pandemic. I will try to be as transparent as possible – about our situation, about our evolving action plan, and about my personal thoughts on this unprecedented crisis. As you can imagine, we’re winging it as much as you are right now, so you can expect the information in this space to change as events unfold.
I realize this may be tough for you to hear – it’s tough for us, too. Frankly, it’s been devastating economically because home euthanasia is our main source of income, although I am personally striving to keep our team employed as long as possible despite the budget shortfall created by this crisis.
More significantly though, it’s been tough emotionally. Everyone on our team is passionate about helping you navigate the end of life process with your loved one – and it hurts every time we have to say “no, we’re sorry but we can’t do that right now.”
So why are we suspending house calls? Mainly because it truly serves the greater good, but also for a mix of personal reasons which I will explain below.
The big picture
“It’s not about you, it’s about everybody else”
Hugh Montgomery
People are dying of COVID-19, and they are dying horribly, struggling for air, trapped in isolation, deprived even of the comfort of having loved ones at their sides. Each and every time I enter someone’s home, I elevate the risk of this awful suffering to scores of unseen people. Maybe it wouldn’t be me or one of my loved ones who became gravely ill, but it could be someobody further down the chain of contagion – perhaps one of our kupuna, a vibrant young man, or a vulnerable homeless person.
I strongly encourage you to read this story and watch the accompanying video to understand how critical social distancing is in the fight against this pandemic, and how making an exception even once can create devastating ripple effects down the line.
This is why our local authorities have issued “stay at home” orders. Veterinary clinics have been exempt from this mandate because healthcare for animals is deemed, rightly so, an essential service. However, this designation of “essential” does not apply to all veterinary services. Public health experts are calling on practices to limit their activities to managing urgent cases, alleviating pain, or performing otherwise time-sensitive procedures (such as puppy and kitten vaccinations). We are being asked to do this both to reduce person-to-person contact and also to conserve critical medical supplies for dealing with a surge of COVID-19 cases in hospitals.
The way veterinary services are being delivered has changed dramatically in recent weeks. I have seen many veterinary clinics move to a “curbside” practice model to mitigate exposure and spread of the virus. This strategy reduces person-to-person contact and limits foot traffic and contamination in public spaces. They are also using protective gear and practicing social distancing as much as possible between team members. It is indeed a fine balance to continue providing needed services to the community without unnecessarily increasing the public health risk.
To recap, socially responsible veterinary clinics are 1) cutting back their services to those which are essential and/or time sensitive and 2) changing the way they work to reduce contact between people.
How do house calls fit into this calculation? Plainly, non-elective euthanasia is necessary for humane reasons – to prevent distress and relieve suffering, both for the pet and for their family. Delivering this needed care in the home setting, however, carries a much, much higher risk to the client, the veterinarian, and most of all, to the community at large.
At first glance, it may seem safer to have someone come to your home instead of venturing out in public for veterinary care. Consider, however, that it is difficult if not impossible to maintain social distancing in a home setting, especially for procedures like euthanasia which require close contact. Diligent professionals will be taking precautions such as asking screening questions and using PPEs, but they will also be visiting other homes.
While you may do the responsible thing by being respectful of social distancing requirements and sharing any symptoms or potential exposure history, the previous family, or the one your vet visited two days ago, may not have been so careful. Given that people can spread the virus without showing any symptoms, house calls entail a much higher risk at both the personal level and for public health reasons. The American Veterinary Medical Association has recognized this and is encouraging the delivery of care outside the home whenever possible.
Certainly, there are situations where home euthanasia is still the best or even the only option, perhaps if the family doesn’t have transportation, or if the patient is a large dog who is unable to walk or can’t easily be moved.
So before calling a mobile vet for help, please ask yourself, is there a need to have this service at home right now, or is it just something that would be really nice to have? In-clinic euthanasia isn’t ideal, I know. That’s why I do what I do, obviously. Sometimes, disappointing and painful sacrifices are necessary and worthwhile if they can save lives and serve the greater good.
Why we are not doing house calls at all
If there are some situations where home euthanasia really is essential, you might ask why we aren’t willing to see at least those select cases. To explain, I am going to share more information about my personal life than I normally do because my situation is a little unique for a few reasons.
First, I happen to share a household with one of the few ICU doctors in our community. Healthcare workers are one of our most precious resources right now, and if I were the one to get someone on the front lines of this crisis sick, that could mean many more lost lives down the road. On the flip side, it also means that by proxy I am at higher risk of being exposed and therefore more likely to spread it to you and your loved ones before I realize I am carrying the virus.
Second, if this crisis does deepen and the hospitals are overwhelmed, I expect to become my childrens’ sole caregiver for an extended period of time. With this much uncertainty, it is difficult to make promises to clients and reasonably expect to keep them.
Finally, although it’s the least of my concerns and I really have no idea how much it matters (because the science is just not available yet), I happen to have an immune system disorder that could theoretically put me at higher risk of serious complications than there might normally be for a healthy person my age.
These are scary times and I want to repeat that we are available to offer you guidance and support if you are trying to make decisions for a seriously ill pet. I am so hopeful that sooner than later, I’ll be able to once again serve families in their homes and continue this valuable work that we do. For now, my higher calling is to stay home and do my part to #flattenthecurve and protect our beautiful island community. I love you all. Be well, my friends.