Interview with Chelsea McGivney, DVM: Hospice Care and Saying Goodbye at Home
The concept of hospice care (also known as palliative care) for pets is not a new one.
In fact, it has been around for decades. However, only recently have specialty services been created to help guide pet owners through the last moments of a beloved pet’s life.
Chelsea McGivney, DVM, an associate veterinarian at Home to Heaven, P.C. (a hospice service), says hospice care makes a lot of sense but unfortunately many pet owners are unaware that this type of service is available. “If someone can have veterinary care provided to their elderly pet at home, and then allow them to either pass away naturally or through humane euthanasia at home, isn’t that preferable to taking them to an unfamiliar environment where their last days or moments could potentially be spent in fear?” McGivney points out.
We talked to McGivney to find out more about what hospice care (or pawspice) can offer to both animals and pet parents.
THK: Hospice care for animals is a very new concept. Can you explain to our readers what a hospice service does and doesn’t do for animals and what pet owners should expect?
Chelsea McGivney: Animal hospice care is reserved for animals who have been diagnosed with a terminal illness or who are nearing the end of their natural life span. When an owner decides, either by themselves or with their veterinarian, that they no longer intend to pursue extensive or invasive testing or treatment for their pet, at-home hospice is an appropriate alternative.
The goal of animal hospice care is to keep the pet as comfortable as possible and provide them with as much dignity as possible, until the pet either passes away naturally or the owners elect for humane euthanasia.
Animal hospice care does not include wellness care such as vaccinations, or any other diagnostics or invasive treatments that you might expect to find at a veterinary hospital or clinic (i.e. x-rays, ultrasound, blood transfusions, etc.). Owners who elect to provide at-home animal hospice care should expect an increased time and emotional commitment as they provide care for their pet. Owners should also expect to have regular communication with a hospice veterinarian in order to ensure that any changes in the pet’s status can be quickly and appropriately addressed.
THK: What animals are good candidates for at-home hospice care and which ones aren’t? Is at-home end-of-life care meant to always replace euthanasia (and instead allowing pets to die on their own, without assistance)?
Chelsea McGivney: A consult with a hospice veterinarian is a good place to start to determine whether a particular pet would be a good candidate for at-home hospice care. All companion animals are potential candidates for home hospice care; however, it may prove more challenging to provide care for some animals over others. For example, caring for a 150-pound Great Dane that can no longer stand or walk on her own will be more difficult than for a 15-pound Dachshund, and owners should be aware of the physical and emotional requirements.
Animal hospice care is not intended to replace euthanasia; it can be an alternative to euthanasia if a family wishes for their pet to be able to pass away naturally, or it can be a means to keep a pet as comfortable as possible until the family is emotionally ready to euthanize, or they feel the pet no longer has a good quality of life and elect for humane euthanasia. As a veterinarian, I would never recommend seeking absolutely no care for an animal at the end of their life, as many diseases can cause pain, discomfort or distress as they progress. Electing not to provide any comfort or relief to an elderly pet who is approaching the end of their life, whether through hospice care or humane euthanasia, may be unnecessarily cruel or undignified.
THK: While human hospice care is often done in special clinics, end-of-life care for pets is done at home. Why is this and what does it mean for pet owners?
Chelsea McGivney: Many pets can become easily distressed when having to go for car rides or into unfamiliar settings such as veterinary hospitals or clinics. Providing end-of-life care in the home, where the pet is comfortable and familiar with the environment, can help reduce stress.
Providing animal hospice care at home requires a commitment, of which owners should be aware. It might not be in the best interest of the pet to leave them alone for many hours out of the day or there may be frequent medication or other treatments that are required. Ensuring that the family’s schedule can accommodate the needs of their elderly pet should be a priority when considering providing at-home animal hospice care.
THK: What kind of care do pets receiving at-home end-of-life assistance receive?
Chelsea McGivney: The type of care that an animal hospice patient may receive depends on the individual patient and diagnosis, but may include administering pain medications or other supplements, acupuncture, laser or massage therapy, subcutaneous fluid therapy, environmental modification or enrichment or appropriate grooming to keep the animal clean and dry.
Minimizing stress is an extremely important component of hospice care, as many elderly pets have compromised immune systems, and stress will only exacerbate that immunosuppression. Modifying the home environment to further decrease stress for the pet may be an important part of the animal hospice plan. Simple changes like reducing noise, playing gentle music, laying down carpet runners on slick floors or ramps over stairs, or ensuring an elderly pet has adequate cushioning on his or her bed are some examples of modification recommendations. Large or expensive changes or equipment are typically not recommended or needed for a pet in hospice care.
THK: How much of the care received by pets in this type of program falls on their owners? Do pets receive regular visits by vets or other health professionals or is the care mostly focused on things the owner can do himself/herself (with guidance from a vet/clinic)?
Chelsea McGivney: The hospice team may consist of any combination of the following personnel: primary caregivers (owners), veterinarians, veterinary technicians or assistants, specially trained groomers, mental health professionals, chaplains, pet sitters, pharmacists and pet crematory/cemetery staff. Depending on the needs of the individual pet, regular home-visits by a veterinary professional may be recommended or required.
Owners can and should feel comfortable providing many treatments themselves after receiving appropriate training and guidance from veterinary professionals. Owners wishing to provide at-home animal hospice care for their pets should do so under the supervision of a veterinarian who they can communicate with openly and regularly regarding the status of their pet.
THK: What about the emotions involved in this type of care/situation? Are pet owners guided in how to deal with the emotions of seeing their pet dying?
Chelsea McGivney: There are many avenues of support for owners who are providing animal hospice care for their furry loved one. Home to Heaven offers several resources to support owners during their difficult time of caring for their elderly pets to include reading materials/workbooks, pet loss support groups and even one-on-one counseling with a grief counselor. Owners who may be having a particularly difficult time emotionally treating their sick pet, or after their pet has passed, are encouraged to seek professional counseling or help.
THK: What would you say are the main benefits of hospice home care for pets (as opposed to hospitalizing pets who have no choice of recovering or taking them into a clinic to be euthanized)?
Chelsea McGivney: Minimizing stress and confusion for an elderly or sick pet is one of the best gifts that we can give to our companion animals as they approach the end of their life. Caring for a sick pet in their home, or making the difficult decision to say goodbye in the home through humane euthanasia, will not only allow for privacy for the family, but also comfort and dignity for the animal as they are able to rest or pass away peacefully in a familiar environment. Being surrounded by the people who make them feel safe and comfortable, in the home that they know and love, is a beautiful gift that we are able to give our companion animals who have given us so much during their lives.