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2016 AAHA/IAAHPC End-of-Life Care Guidelines
Gail Bishop1, Kathleen Cooney, Shea Cox
1From Colorado State University Flint Animal Cancer Center, Argus Institute, and Colorado State University Pet Hospice, Colorado State University, Fort Collins, Colorado (G.B.); Home to Heaven, Loveland, Colorado (K.C.); Bridge Veterinary Services, Berkeley, California (S.C.); The Downing Center for Animal Pain Management, Windsor, Colorado (R.D.); Angel Care Cancer Center for Animals, Memphis, Tennessee (K.M.); Compassionate Veterinary Hospice, Chicago, Illinois (A.S.); Macungie Animal Hospital, Macungie, Pennsylvania (N.S.); North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina (B.S.); and Angel's Paws, Cincinnati, Ohio (T.W.).
Abstract:
End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place. Animal hospice care addresses the patient's unique emotional and social needs as well as the physical needs traditionally treated in clinical practice. An EOL treatment plan should consist of client education; evaluating the caregiver's needs and goals for the pet; and a collaborative, personalized, written treatment plan involving the clinical staff and client. Primary care practices should have a dedicated team to implement palliative and hospice care for EOL patients. How the healthcare team responds to a client's grief after the loss of a pet can be a key factor in the client's continued loyalty to the practice. Referral to professional grief-support counseling can be a helpful option in this regard.
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Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...