Tuesday, November 11, 2014

Caring for chronically ill pets

Caring for chronically ill pets can be a burden on carers too. Veterinarians can help alleviate some of the stress by remaining in contact and providing information.

The phrase “in sickness and in health” is built into wedding vows, but caring full time for an unwell spouse is (usually) the furthest thing from someone's mind when they marry. Similarly, when you adopt a pet, you don’t tend to think about additional care that might be associated with serious or chronic illness. It may feel like it’s “not what you signed up for”. As our pets age they need us more, not less, but being a carer can be stressful.

In human patients they talk about the “caregiver burden” – and to some degree, those caring for very ill companion animals may experience similar stress. As with any caring duties, this stress is reduced if the burden can be shared. But if you’re on your own caring for an animal, that can be tough. I know people who alter their work hours, change their routines, pop home at lunch time to medicate/check on a pet and so forth. Modifications to the home are not uncommon. Some owners of dogs with arthritis building ramps around the home, and some dogs suffering from visual deficits or dementia need toddler gates to prevent access to the stairs.

As a veterinarian I think it is important to be aware of the stressors faced by carers and providing support where possible.

There was an insightful study, published in 2013 (see reference below), documenting the impacts of caring for chronically ill dogs on the caregiver’s life.
In this study, twelve owners of dogs that required significant home care were interviewed.

Potential impacts on the life of an owner include:
  • Change in daily routine
  • Expenses associated with veterinary and nursing care
  • Stress about their animal being in pain
  • Fear that an animal may be hurt or die if unattended
  • Anxiety about the animal’s death
  • Changes in the behaviour of the animal
  • Being woken in the night
  • Increased cleaning requirements
  • More time spent at home/reduced ability to travel
  • Anticipatory mourning

The lesson here for veterinarians is that we need to inform owners as much as possible about the possible impacts on their lives, and provide support for people caring for unwell dogs. In particular, owners of unwell dogs appreciated:
  • Detailed information
  • Clear and thorough instructions for care
  • Being able to contact someone to answer questions
  • Advice on medication techniques
  • Advice on what to expect and monitor
  • Frank discussion about euthanasia

We also need to recognise that euthanasia is a blessing and a burden. Knowing that they can choose euthanasia may be a relief to some owners, restoring a sense of control even if they don’t take the option, while for others the burden of decision making is a stressor in itself.

Reference:

Christiansen SB, Kristensen AT, Sandoe P & Lassen J (2013) Looking after chronically ill dogs: impacts on the caregiver’s life. Anthrozoos 25(4):519-533.

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