The HHHHHMM scale is a tool to help an owner/caretaker objectively assess their pet’s quality of life. The patient’s needs are always the primary focus of concern. The paramount objective in hospice care is to maximize quality of life by minimizing discomforts and maximizing pleasures. Sources of pleasant feeling states include social companionship, mental stimulation and tasty foods. Unpleasant feeling states can also be emotional such as anxiety, loneliness, grief, frustration or boredom. Unpleasant feelings may be physical such as lack of oxygen, thirst, hunger, disease, nausea, full urinary bladder, itchiness, temperature extremes and pain. Quality of life is defined as the balance between pleasant and unpleasant feeling states. Other services that can help support patients and pet owners during the hospice period include acupuncture, laser therapy, massage, grooming, in home pet sitting and support groups or “old-dog play dates”. Symptoms like urine dribbling, nighttime panting/pacing and lack of appetite can often be managed with simple medications Hospice caregivers should be prepared to focus on pain assessment and management, maintenance of their pet’s body weight and nutritional status, hydration, respiration, mobility, hygiene and maintenance of a healthy, interactive human-animal bond. Some veterinary staff may be available to do house calls to provide subcutaneous fluids or to give injectable medications. They can provide strategies to prevent self -soiling. The veterinary staff can demonstrate wound care techniques and how to prevent bedsores by using egg crate mattresses and body rotation. The necessary support to accomplish at home hospice care begins most importantly with a strong veterinary-family partnership. Hospice care is usually provided in the home with the family. Palliative care focuses on the treatment of symptoms. The goal of hospice care is to provide palliative care that, although not curative, may help increase the time between diagnosis and death. Hospice care should be considered when the patient’s life expectancy is considered to be 3 months or less. Veterinary hospice is a family-centered service dedicated to maintaining comfort and quality-of-life for the terminally ill pet until natural death occurs or the family elects euthanasia. Seeing them age or develop disease can be very difficult. Our pets are integral parts of our family and we love them dearly. Let him know that he is loved and that he has been your best friend, and that he can go when he is ready.Share Hospice Care and End of Life Issuesīecause attachment behaviors are the essence of the human-animal bond, owners want to return the unconditional love offered by companion animals, especially senior pets who have become long term family members. Decide whether you want to bury him or have him cremated. If your dog hates going to the vet, look into at-home pet euthanasia services or ask about an oral sedative to give beforehand to make the process less stressful. If you opt for euthanasia, discuss with your vet the logistics of making an appointment (most hospitals try to schedule euthanasia appointments at the beginning or end of the day so you can have more privacy). Make a plan for your dog's end-of-life care.Since you are thinking in the short term, maximum comfort is more important than the risk of long-term side effects. These could range from pain medications to appetite stimulants and beyond. Consult with your veterinarian about medications to alleviate your dog's symptoms.If long walks are no longer an option, spend that time sitting together instead. Stick to your usual routines as much as possible so your dog has a schedule that he is familiar with and enjoys.Keep him company or leave him alone depending on his preferences.If he is supposed to be on a prescription diet but hates it, this is the time to let him eat whatever he wants. Make sure he has palatable food, such as canned food or some plain cooked chicken mixed in with his kibble.Provide a comfortable bed and a cozy resting spot.
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