Quality of Life in Senior and End of Life Years - Alice Villalobos, DVM, FNAP
For us, the human-animal bond is more necessity than luxury. Pets give us a daily dose of joy and playfulness as well as providing feelings of belonging, loving and being loved, responsibility and personal contact. Pets may make us feel safer, enrich the lives of children, and provide motivation to carryon when life is hard. People with pets have been shown to have shorter hospital stays. Your chance of surviving one year post heart attack increases from 72% to 94% if you have a pet. Dogs especially, encourage us to walk which has great health benefits.
As our dogs age or become ill, our bond with them only grows stronger and we want to make the best decisions possible in regard to their quality of life. Cancer is the most common cause of death in dogs (25% of deaths under 10 years of age, 50% of deaths at greater than 10 years of age).
Questions to ask yourself when making end of life decisions for your pet:
- What are your priorities?
- What are your goals?
- What are your fears?
Not everything needs to be "medicalized". For example, it is OK to decide not to treat cancer in an aged pet or one with co-morbidities such as severe arthritis, kidney failure or other conditions. The decision comes down to treatment vs. hospice-like palliative care vs. euthanasia. Dr. Valla lobs said that frank conversations (with your vet) about incurable diseases and the prognosis for terminally ill dogs will help avoid unhelpful surgery and futile medical efforts.
The Quality of Life Scale: This scale may be used on an as needed basis from hourly to monthly depending on the condition of the pet.
Scoring is from 0 (worst) to 10 (best) in each category with a total score of 35 or over indicating an acceptable quality of life.
- HURT-Is pain control well managed? Can the pet breathe properly?
- HUNGER- Is the pet eating enough? Are nausea and vomiting under control?
- HYDRATION-Is the pet drinking enough? Getting IV or SubQ fluids? Diarrhea under control?
- HYGEINE-Can the pet be kept clean? Adequate wound care? Pressure sores managed?
- HAPPINESS-Is the pet responsive and interested in surroundings? Happy to see family?
- MOBILITY-Can the pet get up unassisted? Walk with assistance?
- MORE GOOD DAYS THAN BAD-When the bad days outweigh the good; quality of life may be too compromised.
For more information on making end of life decisions and coping with death Dr. Villalobos recommended the books:
- Being Mortal-Medicine and What Matters in the End by Atul Gawande, MD (2014)
- Knocking on Heavens Door-The Path to a Better Way of Death by Katy Noura Butler (2013)