End-of-Life Decision Making: Family Needs and Practical Considerations

It’s important to consider the pros, cons, risks and benefits of starting any proposed treatment plan with your pet. This will depend on many different factors related to both your family and to the patient.

This can be especially true for hospice patients, whose needs may be simple or very complicated. We must consider what care is going to be necessary and whether there are sufficient resources (time, energy, emotional and financial) to carry it out. Can your pet’s needs be realistically met by the proposed treatment plan?

In this second of two parts, let’s take a look at the home environment and the people who will be responsible for carrying out the plan. You can read more about the patient’s potential needs in part one.

Here is a checklist, adapted from the AAHA/IAAHPC 2016 Guidelines on End-of-Life care, of the common issues that are faced by many elderly pets and their families. If you don’t know the answers to some of these questions, a veterinarian who knows your pet well can help guide you.

Family Needs and Practical Considerations

Once you have thought about what your pet’s needs are going to be, what is it going to take to meet them?

  • Who will be providing the day-to-day care? This usually falls upon one or more household members. How much nursing care will be needed, and how often? Are there other people who can help? For example, patients who are confined to bed must be turned every two hours to prevent bedsores and other problems, and soiled bedding must be changed as soon as possible. Will someone be available to provide this frequent care?
  • Will the primary caregiver be able to get some “down time” on a regular basis? Are they able to still maintain their own normal routines, get enough sleep, and enjoy life?
  • Are there family members who are willing and physically able to perform the necessary treatments?
  • Will the caregivers’ schedule allow for the needed level of supervision?
  • Can the environment be modified to be safe and comfortable for the patient?
  • Will caregivers and other members of the household be safe? Is the patient stressed by treatment or touching, and might snap or bite to defend themselves? Can the household be kept clean and free of urine and feces? Are there young children around?
  • Are there enough financial resources for continued treatment? Hospice is more affordable than a hospitalization or major treatment, but house calls, nursing visits, medications and supplies can add up quickly.
  • What other responsibilities do the caregivers have? Are they going to be affected by the caregiving duties, or is the increased workload going to cause stress?
  • How are household members, both human and animal, affected emotionally by the presence of a sick pet?
  • Is anyone in the household overwhelmed at the prospect of treatment, or of facing the impending death of the pet?

You may be thinking that this seems like a lot! It certainly can be, and the help of a trained veterinary hospice team can make it more manageable by, for example, helping you explore ways to solve mobility or safety challenges. Scheduling problems or caregiver stress can often be alleviated by hiring professional help to assist with caregiving duties.
Sometimes, there are just too many challenges to overcome, or it’s not realistic to meet all of the pet’s needs. That’s OK, too – and facilitating a peaceful, gentle passing with the gift of euthanasia (which comes from the Greek “good death”) can be a selfless and loving decision, as hard as that may be.

Finally, know that there may be no “perfect” decision or time. We all make the best decision we possibly can, based on the information we currently have. If that choice comes from a place of love, then that is what matters most.

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