Mary Gardner, DVM, Lap of Love, Yorba Linda, California
Mary Gardner, DVM, is cofounder of Lap of Love, the nation’s largest organization of veterinarians dedicated to end-of-life care in the home. Her goal is to increase awareness and improve medical care for the geriatric veterinary patient and to make the final life stage as peaceful as possible, providing dignity and support for all involved. A University of Florida graduate, she speaks regularly at national veterinary conferences.
FUN FACT: Mary was a baton twirler in high school and loves really scary roller coasters.
Although having a comfort room is a nice gesture, a room alone cannot provide comfort. Even an expensive spa-like room does not guarantee the veterinary team is affording clients any comfort other than a soft seat. Providing comfort means helping to alleviate a client’s (or pet’s) feelings of grief or distress.
A peaceful, comfortable room in which the family can say goodbye does help, but many practices do not have enough space for a room dedicated to euthanasia.
However, lack of space need not be a problem. Treating clients and patients with the utmost care in every aspect is what is most important. Here are a few tips to enhance a euthanasia from start to finish—and none require a specific room.
A common concern for team members is that no one is sure how to behave with the pet owner or knows what behavior is appropriate.
Within seconds, it is usually obvious that the client is calling to make this dreaded appointment. Express compassion instantly.
You may have 20 appointments that day, but this appointment is the most important for the family, and they should believe the team feels the same way. Slow down, take your time, and really be present in the moment. Try not to automatically discuss the process; instead, first listen to client’s concerns and grief points, repeat back some things they say, support their decision, and try to remove any guilt they may feel. Ask the family what makes the pet so special or what they will miss most. When you are truly a part of the appointment, the family will feel your compassion and support, which is invaluable during this time.
Here are some of my favorite expressions of care to comfort the client.
The actual euthanasia process is the make-or-break moment. Remember, the definition of comfort is to ease feelings of grief or distress,1 and both reach maximum levels at this point.
I cannot emphasize this enough: When beginning the process, do not remove the pet from his or her family if at all possible. According to a 2015 survey our practice performed, about 90% of the 400 practices that responded separate the pet and the family, which makes it worse for both. Even a short separation can feel like an eternity to the family and cause the pet undue stress. Simply removing a pet from the room to get the catheter in the vein is unnecessary and breaks the bond. Most pets at this stage are sick, aching, and distressed, and taking the pet to another treatment room and away from family is the furthest situation from comfort for the pet and the family.
Gently explain the euthanasia process to the family to set their expectations and answer any questions they may have. Learning about the peacefulness of the process and knowing sedation will make their pet calm and comfortable beforehand puts clients at ease. Many clients do not understand the euthanasia process and assume their pet is given a heart attack, so educating them that the second medication is simply an overdose of anesthesia will greatly decrease their stress level.
In my experience, honesty—without going into every small detail about every possible reaction—is the best policy. Prepare owners for the following side effects.
The entire veterinary team should work to make the euthanasia appointment relaxed, peaceful, dignified, and—dare I say—good. The most gorgeous comfort room in the world will not ensure a comfortable experience if the basics (ie, the way team members communicate and move, the way they handle the pet, the way the client feels after the appointment) are ignored. Euthanasia means “a good death,” and the veterinary team’s duty is to do everything possible to deliver on that promise.
1 Educate the team that their attitude and behavior is what ensures a peaceful euthanasia experience for the client and the pet, not a room with fancy furniture.
2 Learn to read the client’s nonverbal cues (eg, whether he or she wants to be hugged or touched) and how to send nonverbal messages of understanding to the client.
3 Ensure veterinarians are familiar with all AVMA-approved administration routes for performing euthanasia.
For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.
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