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July 2024
What Does Exceptional End-of-Life Care Look Like?
End-of-life care for pets has evolved by leaps and bounds in recent years. Modern-day practices offer many different services around this sensitive time, going beyond the traditional, limited options.
Create an Experience That Stays with Your Clients—in a Good Way
End-of-life care for pets has evolved by leaps and bounds in recent years. Modern-day practices offer many different services around this sensitive time, going beyond the traditional, limited options.
“In years past, families had the option to consider natural death at home, or euthanasia,” says Sally Jo VanOstrand, LMSW, a veterinary social worker at Stack Veterinary Hospital in Syracuse, New York. But, she says, “Times have changed—and with that, so have our options for end-of-life care.”
Beyond Goodbye: Pre-euthanasia, Hospice, and Palliative Care
Today, end-of-life care (EOLC) encompasses far more than simply the process of helping a cherished pet pass peacefully. Many EOLC specialty hospitals offer families and their beloved pets services to help them well before that final day, as well as support for the family once they’ve said their final goodbye.
“Unfortunately, many people—both clients and referring veterinarians—think that all we offer is in-home euthanasia,” says Chelsea McGivney, DVM, general manager of Caring Pathways. The Colorado Caring Pathways practice was the first to achieve AAHA’s specialty EOLC accreditation in 2020.
Most pet parents agree that choosing to say goodbye even a day early is difficult, but it is preferred to being forced to say goodbye in an emergency or crisis where they have less control and choice around the situation.Chelsea McGivney, DVM
Caring Pathways
One of the biggest challenges Caring Pathways and other EOLC specialty practices face is increasing awareness about pre-euthanasia services, such as teleadvice, hospice, and palliative care.
“We know how challenging it can be to manage a beloved pet who is nearing life’s end,” McGivney says. ”We have a dedicated team with advanced training in hospice and palliative care to be able to support these families and their pet in the comfort of their home, ensuring that these beloved family members can continue to have the best possible quality of life until the family makes the decision to say goodbye.”
And by offering those pre-euthanasia services, they’re also able to offer families increased peace of mind when that final appointment is scheduled.
“Most pet parents agree that choosing to say goodbye even a day early is difficult,” McGivney says, “but it is preferred to being forced to say goodbye in an emergency or crisis where they have less control and choice around the situation.”
The Importance of a Team Effort
The services available to families and their pets are only part of the equation—the delivery of those services plays a crucial role, too, says VanOstrand. She added that proper delivery relies on teamwork, knowledge, and compassion.
“End-of-life care should be nothing short of exceptional when we consider the impact this care has on our patients and their families,” she says. “I like to consider the enthusiasm and thoughtfulness that goes into a patient’s first puppy/kitten visit. The staff is usually alert and anticipating these pediatric appointments, we tend to have educational material prepared for the family, we talk to the families in a way that conveys our understanding that they now have a new member of their family, and we make every effort to ensure that this puppy/kitten has an overall positive experience while in our hospital. Pets that are nearing the end of life should have similar considerations to these puppy and kitten visits,” she says.
To that end, she encourages her staff to think through the following:
- Have we anticipated the family and patient needs before they are here?
- Do we have information available that informs families of their options and relevant resources?
- Is each staff member prepared to interact with the families conveying that we understand they are losing a loved member of their family?
- Has every attempt been made to make this experience as peaceful as possible for the patient?
VanOstrand says that a true team approach is a must. “Quality teamwork in end-of-life care means that each staff member, including the receptionist, technician, assistant, and the doctor, can all rely on each other in knowing that the family and the patient will be well taken care of.”
This isn’t just helpful for the members of the veterinary team, but is beneficial for the family as well. After all, even if a client can’t exactly pinpoint what they’re looking for in EOLC, they will still take note when it’s not done well—and a bad experience can easily come down to a lack of teamwork.
End-of-life care should be nothing short of exceptional, when we consider the impact this care has on our patients and their families.Sally Jo VanOstrand, LMSW
Stack Veterinary Hospital
“Broken teamwork may leave an owner feeling neglected for a part of the end-of-life journey, and when this happens, it becomes one of the most memorable pieces of the experience,” says VanOstrand.
Take, for example, a family calling to set up a euthanasia. “[If] the receptionist that takes the call sounds bothered, distracted, or cold, this will take away from the entire end-of-life experience no matter how well the other team members convey their understanding,” VanOstrand says. “A team that works well together will have the security to go above and beyond for those facing the difficult process of losing a pet.”
Knowledge is crucial when helping families and patients through EOLC. “Veterinary staff should know what options a family has when discussing end-of-life care and should have a list of relevant resources easily accessible for families,” says VanOstrand. “Each staff member should have an understanding of trauma-informed care and how this recognition can reduce harm to some families experiencing end-of-life care with their pets. Knowledgeable staff can facilitate a smoother process for our patients and their families.”
An Elevated Approach to EOLC
Since earning their initial EOLC accreditation in 2021, Caring Pathways’ Colorado practice has been reaccredited, and their Virginia Beach practice (Hampton Roads Veterinary Hospice) has also become AAHA EOLC-accredited. “Each time I walk through the accreditation process I notice that some of the standards of care have changed or that there are new standards, which is a good thing!” McGivney says. “I love that AAHA continually strives to re-evaluate their standards to ensure that all of their accredited practices are evolving and staying relevant with today’s standards of excellence.”
Going through the accreditation process helped to reaffirm that many of their current practices were in line with the AAHA standards of excellence, McGivney says, but she says they were also able to take feedback from that experience to “up our game even further.”
Accreditation has had a positive effect over at Stack Veterinary Hospital as well.
“Going through the AAHA EOLC accreditation [in 2022] impacted our client and patient care in powerful ways,” says VanOstrand. “Families have sought our hospital out because we have this accreditation. The EOLC accreditation lets families know that we take the end-of-life process seriously and we go to great lengths to have a team that is continuously learning about it. AAHA has been continually helpful in our journey to provide the best end of life care possible.”
Margaret Spalletta, RVT, one of AAHA’s practice consultant managers and an EOLC advocate and evaluator, hopes that more veterinary practices will take note of ways they can elevate their EOLC protocols.
“We become so consumed and busy with our day-to-day that euthanasias take a back seat,” she says, noting that these events, which are truly life-altering for the families experiencing them, can sometimes be seen as “just another appointment” on the schedule. And, she says, it’s so much more than that.
“Exceptional end-of-life care is truly individualized and should be reflective of how special that pet is to their pet parent,” Spalletta says. Doing EOLC well means that a practice should strive for the same overall process of positive experiences, she says, but, at the same time, each one is different and will mean different things to different people.
And, she adds, communication and team culture are vital to achieving that. “I’ve noticed that teams [providing exceptional EOLC] are very close knit and set high expectations for themselves for maintaining that level of communication.”
Her advice for practices aiming to elevate their level of EOLC is to employ the same enthusiasm you have for other aspects of medicine to your EOLC standards. “Medicine has evolved over the years,” she says. “We constantly go to CE courses to elevate our knowledge about medicine; we should do the same for end-of-life care.”
To learn more about AAHA’s End-of-Life Care Accreditation, visit aaha.org/eolc, or email [email protected].
AAHA End-of-Life-Care Accreditation
In 2020, AAHA launched an EOLC accreditation. The association developed the guidelines for EOLC in cooperation with the International Association for Animal Hospice and Palliative Care (IAAHPC) in 2016, and AAHA has maintained an ongoing relationship with the IAAHPC, which offers a comprehensive certificate training program for veterinarians who’d like to specialize in animal hospice care.
Seven practices have been EOLC-accredited since the program began, including two mobile-only practices in Ontario, Canada, three mobile-only practices in the United States, and two US-based traditional practices with EOLC accreditation.
To be eligible for AAHA’s EOLC accreditation, a practice (whether it’s brick-and-mortar and/or mobile) must be limited to EOLC or be already AAHA-accredited and wishing to add an EOLC practice. Practices that are not AAHA-accredited and are not standalone EOLC practices are not eligible for AAHA’s EOLC accreditation.
While not every practice will be eligible for this accreditation, the guiding principles followed by practices with that accreditation are useful for any practice looking to provide the best possible experience for pet parents who are going through their most difficult moments.
Visit aaha.org/eolc to learn more.
Photo credits: rai/iStock via Getty Images Plus, Linda Raymond/iStock via Getty Images Plus, Caring Pathways Marketing Director Josh Lewis