What Makes a Palliative Pet?

14 Dec

What makes a palliative pet? Primarily personality and physical attributes. Not every dog or cat can become a palliative pet. Just as you would not ask an old Pekinese to herd cattle in the Australian outback nor should you expect a young Border Collie to engage in palliative care. There are exceptions to the rule of course but on the whole, personality is greatly influenced by breed and a palliative pet must have a specific personality type. Let’s look at what services a palliative pet provides to help clarify an animal’s suitability for the role.

Palliative care is an approach to health care and delivery of medical services for people who are living with a life-threatening illness. The focus of care is on achieving comfort and ensuring respect for the person nearing death and maximizing quality of life for the patient, family and loved ones. Palliative care does not seek to cure, instead the intent is to manage pain and other symptoms, provide social, psychological, cultural, emotional, spiritual and practical support. Further, the role is to support caregivers and provide support for bereavement.

In a private setting or hospital or hospice, the environment is generally calm, quiet and temperate. Persons nearing the end of life do not engage positively for any length of time with high energy hyperactive people or animals. In my experience, a palliative pet must be calm by nature, enjoy the company of people without exhibiting excessive vocalizations or physical reactions. How would I define excessive? A simple greeting should not include barking, whining, pawing, scratching, jumping up, mouthing, nipping or licking. While engaging with a patient, the animal should be calm, submissive and willingly accommodate petting and stroking.  The animal should not negatively react to gentle stroking or touching any part of its body.  Small dogs and cats often find themselves invited to join the patient on the bed and should be comfortable with that. In such a situation, it is not unusual for a palliative pet and the patient to fall asleep together.

A patient’s day is often unmarked by change and a visit from a palliative pet is often a well anticipated highlight. The pet visit provides an opportunity for the patient to engage socially, emotionally and often precipitates enjoyable discussions of childhood memories and life experiences with animals.

So a palliative pet should be healthy, safe, and not pose any type of risk to the people being visited.  They must be the appropriate size and age while possessing an appropriate attitude and aptitude for quiet interaction.  A palliative pet requires well developed interactive skills that positively engage their end of life clients.

As a pet owner, you may have tremendous confidence that your animal meets these behavioural criteria, yet in a hospital or hospice situation more may be asked of you.  It is often expected that an independent agency such as a veterinarian, the SPCA or a group dedicated to companion or service animals such as Pets and Friends or the Delta Society evaluate your animal for suitability.  Not only does this ensure the suitablility of your pet for the job in also ensures that liability insurance issues can be dealt with appropriately.  You should also be expected to provide documented evidence that your animal has received its full complement of vaccinations and that it is free of transmissible disease.

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Season’s Greetings

1 Dec

As we pass into December, thoughts turn to Christmas and decorations come out, a tree goes up and the efforts of volunteers over the past year are celebrated at the hospice.  This season for most of us is a happy time spent with family and friends.  It is a time to reflect on the year gone by and to lay plans for the coming one.

For some patients and their families in the hospice, this holiday season will be indelibly marked by sadness.  Future Christmases will be remembered as the time a loved one died and forever more will be absent from family celebrations.  Yet many residents in the hospice embrace the opportunity to focus on the happy vibe that runs through the medical staff.  There is a special energy at this time of year and it feels good for some patients to participate actively; to focus on living, not dying.

Abby, my therapy dog, was a Christmas puppy and I remember her arrival to our home eleven years go.  We had taken several visits out to the breeder’s farm and were able to meet her father , a red poodle and her mum, a grey cockapoo cross.  They were both very calm with good social skills and full of energy.  As a family, we agreed on which puppy we wanted and when the day came to pick her up and take her home, we were vibrating with excitement.  Many professionals counsel against adding a puppy to the family at Christmas time on the grounds that there is too much going on, too much activity, too many strangers and thus too little focus on ensuring the proper training and socialization of the puppy.  For us, the opposite was true.  As the children were home from school and I was on holiday from work, we had scads of time to focus on Abby and develop consistent rules, boundaries and limitations.  With everyone at home she was able to bond with her pack and when visitors came to the house, we were able to ensure the greetings were appropriate, controlled and positive.  With four pairs of eyes on her during her waking hours, house training went quickly with few lapses.  It was also so incredibly cute to see her peering out from under the Christmas tree as she explored her new world.

Christmas Eve that year had us all reflecting on her Christmas stocking.  We assigned to Abby the stocking her predecessor Lily, a Cavalier King Charles Spaniel, had used for the previous six years.  As is the case for too many Cavs, Lily died from the inherited heart defect so common in the breed.   So it was with a mix of sadness and joy that we set out Abby’s stocking for Santa’s attentions.

This season Abby will be wearing a Christmas bow to the hospice and will bring smiles, joy and love to all.  May your holiday season be filled with the same.

But These People Are Dying!

4 Nov

But these people are dying!  Isn’t it incredibly depressing when you are regularly meeting with people who are treading the last steps of their lives?  Actually, no.

One of the purposes of moving into a hospice for a patient is to optimize the remaining days of one’s life.  The medical and support staff are charged with providing an environment that is engaging and full with all the daily physical needs taken care of as best they can.  By doing so, this environment provides the patient with opportunities to deal with emotional, spiritual, relationship and intellectual issues.  So in many cases, volunteers are meeting with patients who are often committed to savouring personal interactions.  The ensuing conversations can be meaningful, educational and positive for both parties.

In an earlier blog I talked about death anxiety and for many, talking about one’s anxieties is a way of working through them.  Volunteers are not skilled to provide anxiety counselling and in fact are guided to leave that depth of interaction to the professional staff at the facility.  What the volunteers bring to the environment, are opportunities for the patients to engage socially and in some simple way, confirm their humanity.  Through the simple act of daily discourse, they are helped to ease their anxiety.

In this modern world, it is common that family members are scattered at great distances from their parents and homes where they grew up.  Regular visits to a dying relative can then be difficult.  Further, family dynamics may be such that regular visits to a dying relative in a hospice are not desired by either or both parties.  Volunteers and their palliative pets can fill this social void.

People often find that it is easier to talk about difficult subjects when engaged in physical activity; walking for instance, however most hospice residents are no longer capable of strolling through a garden or the halls of the facility.  The simple act of stroking a palliative pet seems to engage the same easing of the barriers to meaningful dialogue that walking triggers and consequently volunteers are often offered opportunities for active listening.

Chatting with an individual over a period of weeks can build bridges of friendship that sadly are always broken.  Yet knowing that inevitable outcome at the start of these relationships allows the volunteer to savour each interaction and learn so much from such a fleeting acquaintance.  Each personal interaction at a hospice, whether it be with your pet, the patients, the staff, or the medical professionals provides an opportunity to learn about one’s own relationship with the inevitability of death and in doing so the value of living each day to the fullest.  Volunteers do not work in a vacuum.  Hospices provide emotional support not just for patients and grieving families but for staff and volunteers as well.  The relationships that develop with the patients are real, however short, and counselling services are available at hospices for all who require assistance in working through issues that may arise as volunteers engage with patients in such intimate surroundings.

A Visit

16 Oct

It is visiting day and Abby comes to sit at my feet.  She sticks her head out, eager to wear the ‘Pets and Friends’ bandana and get started.  We hop in the car and head to the hospice.  Normally on leash she walks beside or slightly behind me, but as we leave the car and head along the sidewalk she is out front leading the way.

We enter the building and head to reception.  Abby wriggles a greeting to the receptionist who voices an enthusiastic hello and rubs Abby’s ears.  We chat briefly and then stop in to see the volunteer coordinator who gives Abby a rub and chatty hello.  As we head out into the hall, the chaplain meets us.  Two residents have died in the night and he has been dealing with the families, one of which has taken the death particularly hard.  The chaplain kneels down to pat Abby and I tell her to stay while I duck into the lunch room to grab my name tag from a drawer.  When I return, Abby’s tail is sweeping broadly and she is ‘smiling’ at the chaplain and he is smiling in return.  He stands and enters his office as we head down the hall.  We stop in to touch bases with the Director of Care who is just hanging up the phone.  It is a busy day what with the two deaths and consequently the two open beds to fill.  She leaves her chair to greet Abby and enjoys a very brief hiatus in her day.  She tells me which of the residents have died.  One had always been eager to have Abby visit and I will miss our time together.

We head down to the nursing station and say a brief hello.  They are settling back into the routine of the day after losing two of their patients.  I pull out the ‘volunteer book’ in which we volunteers record the details of our visits.  The notes give the volunteers a running non-medical history of each of the residents – preferred topics of conversation, who is eager for visits, who is not and who is fading.  I chat with the nurses to decide who may be up for a visit and then together Abby and I move down the hall.

I give a little rap on the door and stick my head in.  B is sitting quietly atop the bedclothes on her bed.  She is wearing sweat pants, a tee shirt and a lovely hand knit sweater.  She is seventy-two and has fought a long losing battle with cancer.  She sees Abby and her face lights up.  Abby wriggles her greeting and I lift her up onto the bed.  They give each other full attention and then after a couple of minutes Abby lays down with her head on B’s lap.   As B and I chat, her right hand fondles Abby’s ears continuously.  A few minutes later, some of B’s friends arrive and we all chat about ‘dogs’ for a while.  Abby and I leave B with her friends and duck into the next room.

D is almost gone.  We have been visiting him for over a month now and at the beginning he delighted in having visitors.  His wife and son have gone to catch a quick late lunch and will be returning shortly.  He smiles weakly as we enter and Abby quickly settles onto the bed.  He is heavily medicated for pain and abruptly drifts off to sleep.  Abby joins him in sleep and she begins to snore.  We went for a long walk this morning and she has some catching up to do.  A few minutes pass and D awakens picking up mid-sentence where he left off our conversation.  He strokes Abby’s back and I talk about a fishing trip I recently went on with my cousin.  D was a fisherman here on the west coast and he enjoys tales of the sea.  Five minutes later he has drifted off again.  This cycle of wakefulness and sleep continues until his family return.  They are relieved to find us at his bedside and find comfort in knowing that he has not been alone.

As we walk down the hall, a young Asian woman steps out from her mother’s room.  “The nurses told me you were here.  My name is W and I was hoping you two could stop in and see my mum.  We have a dog at home and she misses her tremendously.  My mum doesn’t speak English though.”  We enter the woman’s room and when she sees me her face shows a flash of concern.  As her daughter explains our presence, her mother catches sight of Abby and a lovely smile spreads across her face.  Up on the bed, Abby soaks up the attention both women lavish upon her.  They are chatting now in Cantonese spattering the conversation with laughter.  Abby then sits up on her haunches like a Meerkat.  “That means scratch my tummy please.”  They oblige and giggle as Abby’s eyes slide shut in contentment.  “Does she do any tricks?” asks the daughter.  I nod and lift Abby to the floor.  “Point your finger at her and say BANG!”  W raises her arm and shoots Abby who immediately drops like a stone onto her back.  More laughter.  A nurse comes in, curious about all the joyful noise.  Abby flips back onto her feet, expectant for a treat.  I pull one from my pocket and give it to W who offers it to Abby.  More chatting ensues till the nurse hears a bell chime from another room.

After a few more short visits, we stop back at the nurse’s station and fill in our record of visits, then we offer our goodbyes to the staff and head home.  It has been a good afternoon.

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Death Anxiety

13 Oct

After discovering a lifeless bird or cat at the roadside a young child may ask of her parent why the animal is dead.  Then after processing the answer will follow up with “Will I die?”  Later as teenagers, we may engage in risk taking behaviours such as drug taking or drinking and driving – as if testing the boundaries of our existence.  At some point we will encounter the reality of death as a friend or grandparent dies.  Throughout our adult life we commonly ignore the existence of the door ‘over there’ without actually acknowledging that some day we will be passing through it.  The door may become exquisitely clear as when your parent or child dies but then we quickly hasten to conclude our death is a long way away at some time far in the future.  Pay it no attention and it isn’t really there seems to be a common mind set.  We even build elaborate mental processes to soften the reality.  Many religions have us simply passing out of this life into another.  Regardless of what happens to us as and when we die, there is a thread of anxiety about death that runs throughout our living years.  For some this anxiety becomes very profound after being diagnosed with a life threatening illness.  This anxiety may then be heightened when the physician recommends that the patient be transferred to a palliative care ward or a hospice.

Regardless of the reason, caregivers in palliative situations all have agendas when dealing with patients.  Director’s of care are actively engaged in coordinating the medical services patients receive, physicians treat outstanding medical issues, nurses tackle the day-to-day personal care, chaplains seek to address religious concerns while family and friends visit with issues related to personal relationships.  In each of these cases the intent is to assist the patient, yet everyone in some way is asking for something from the person approaching death.  Be it information on pain levels, bowel function, drug reactions, crises of conscience or legal matters, the patient is asked to give of themselves.  Many of these interactions do little to reduce death anxiety.

The Hospice Education Institute is a U.S. based non-profit organization whose mission is to inform, educate and support the delivery of hospice programs.  They suggest that there are five principal methods for addressing patient anxiety in palliative care settings.  They are counseling, visualization, cognitive methods, drug therapy and relaxation therapy.  Palliative pets can play a role in this last category.  For animal lovers approaching the end of life, contact with the familiar positive interactions with pets helps to normalize the hospice environment.  In the case of a palliative pet and the volunteer that brings the animal to the hospice, the role is simply to give of themselves.

On numerous volunteer visits when entering a hospice room with Abby, the first expression I have seen on the face of the patient is one of concern.  I can almost hear them thinking.  ‘An unknown person is entering my space.  What do they want?  Why are they here?  What now?’  However, when they see the dog, a smile spreads across their face and they are suddenly eager to engage.  As the hospice coordinator of volunteers at the hospice where I attend is often wont to say, ‘There is no I in volunteer’ and the role of the volunteer and the palliative pet is simply to give without thoughts of outcomes and expectations.  And that is what dogs do.  In bringing the familiar to the room, the dog brings comfort and relaxation.  Conversations initially focus on the dog, the patient’s pets present and past.  Later, as trust is established, the conversations often become more wide reaching, all at the pleasure of the patient.  The opportunity for a patient to physically engage an animal whose essence is just ‘to be’ is the key factor in reducing anxiety during a visit from a palliative pet.  As discussed in the Health Effects blog at this site, pets have been clinically shown to reduce stress and anxiety levels.  In my experience, unlike watching a television program or listening to a radio which act more like distractions from mental and emotional states, the act of stroking a dog quietly resting on the bed engages the mind of the dying to live in the moment and carefully explore the reality of what remains of their lives.

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Pet Health Effects

3 Oct

There is a growing body of scientific evidence that conclusively affirms the numerous positive health effects attributed to human-animal interactions.  Interacting with a pet has been shown to decrease anxiety and to activate the sympathetic nervous system in humans.  Other studies have shown increased survival rates in individuals who had suffered a myocardial infarction (heart attack).  In an article published in Companion Animals in Human Health, Friedman and Thomas examined a group of coronary artery disease sufferers who had experienced a heart attack.  One year survival data conclusively found that those individuals who owned a dog were significantly less likely to have died in the one year duration of the study.  Given that most dog owners take their animal out for regular walks and hikes, it is not surprising that not only is the dog being exercised but so is the owner.  Interestingly, a positive benefit was not found for cat owners.  While one might initially suppose that owning a dog was related to differing physical characteristics of the patients than non-owners, such was not the case.  The dog owners were not found to be ‘healthier’ sick people at the beginning of the study and the positive benefit was found to be solely attributed to dog ownership.

In the April 2010 edition of the scientific journal Acta Medica Okayama, the authors investigated the effects of service dogs on health-related quality of life issues.   In the study, the researchers utilized a detailed survey that evaluated various health indicators of persons with significant disabilities such as spinal cord injury or multiple sclerosis.  The experimental group lived with a therapy dog and those in the control group did not.  The results show that persons living with therapy animals have reduced physical and mental stresses and higher self esteem.

Susan Swartz writing for The Press Democrat interviewed health professionals who have found that dogs have become an essential part of their practice.  Dogs are now a key piece in fully engaging teens and war vets in counseling sessions where the animals act as conversation starters and safe surrogate companions.

Anxiety is a common emotion for persons entering a hospice.  For those that are mentally competent, they are fully aware that this is the last stop on the train of life.  Even those who hold devoutly religious beliefs, the knowledge that their life is rapidly coming to an end can induce fear and apprehension.  In my experience, the very act of entering a room with a palliative pet tends to normalize the environment, especially for a new resident.  The relief on the patients face and through their bodies is immediately evident and those that are comfortable with dogs very quickly engage with the animal before fully engaging with me, the dog’s leader who after all is just another stranger in this new strange environment.  The animal’s presence immediately elicits physical contact and calming repetitive stroking of the dog straight away precipitates a relaxed interaction.   Even for those patients with advanced dementia, palliative pets can generate positive responses.  In my experience physical contact with a dog can trigger some deep rooted reaction in an otherwise socially unresponsive dementia patient.  Whether this response is innate or memory-based is unclear but I have witnessed otherwise unengaged patients who have been physically challenging to care givers become calm and relaxed in the presence of and contact with a palliative pet.

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Behaviour

25 Sep

Even the most independent of outdoor working dogs enjoys a good scratch behind the ears from his owner/leader but a palliative pet must be willing to accept and enjoy a flood of affection from strangers.  Acceptance of continual petting, patting, stroking and hugging is the bread and butter of a palliative pet.  Further, given the mental and physical states of some hospice residents, over exuberant contact such as tugging, pinching and accidental pain from a wheel chair must not elicit a bite response.

Many outdoor working dogs have been bred for hunting, but even the best field dog has been trained to elicit its innate special character.  Young pointers are taught to point and retrievers are taught to retrieve.  Setters have been bred to have a natural proclivity to hunt birds and puppies which show excitement and interest in birds are described as being “birdy”.  Training setters to become effective hunting companions is often accomplished using domesticated fowl such as pigeons.

It is not surprising then that palliative pets can be trained to maximize their inner ‘care giver’ through ongoing training.  It is rare for humans to engage in intimate physical touch with strangers and so it is not too surprising that dogs commonly reflect this same aversion to unsolicited contact.  But just as humans overcome hesitance to touch through formal societal niceties such as handshakes, some dogs can be taught not only to accept physical contact with strangers but to seek it out.

Entering into the world of palliative care, a pet should come prepared with basic formal obedience training that is exhibited at the highest level of leader control.  Having to repeat commands to an animal is a clear sign that the leader does not have complete control over the pet and that more training is warranted.  Further, the palliative pet must be taught that there are no circumstances wherein a bite response is an acceptable behaviour.  Handling and gentling exercises especially those that eliminate nipping, scratching, clawing, kicking, growling, pawing, jumping up, and all forms of dominant behaviour should be the ongoing focus of palliative pet training.

It is a treat to come home from a long day at work and find the aroma of dinner wafting through the air.  The smell of garlic or the scent of baking bread or perhaps cinnamon rolls is a treat for the senses.  Humans can distinguish these different odours but imagine what the world is like for a dog.  A scent hound like a beagle has millions more scent receptors in their noses than do humans giving them an exquisitely sensitive sense of smell.  We have less than 2% of the number of scent receptors in our noses than does a blood hound and areas in dogs’ brains have evolved to put that exquisitely sensitive nose to good use.  For instance, dogs are now used in cancer detection.  Given this incredibly sensitive capacity for scent it is reasonable to assume that when a dog enters a hospice facility for the first time it is able to detect the unique smell of human bodies in a state of decline.  Further, it may be that although a dog has superior social skills that this new smell may trigger a reaction that initially limits the dog’s engagement with the dying.  Positive reinforcement and motivational training can be used to overcome such initial hesitation.  Negative reinforcement or punishing a dog for refusing to engage in social behaviours in a palliative care environment is contrary to obtaining the optimum outcome you seek.  Often a dog’s negative response to new situations is due to inappropriate or limited instruction.  Simply assuming a dog will respond the same way in all environments to all people is erroneous.

A dog that is not engaging normally in this new environment does not have “a behaviour problem”.  Nor should one think that when one is training the animal that one should be training solely to avoid “behaviour problems”.  Modern training methods rely on reinforcing positive responses.  For instance, rather than punishing a puppy for peeing on the carpet, modern training focuses on where the puppy should pee, reward him for peeing there, providing consistent positive support and guidance.  Within a short time the puppy will seek out the positive responses and ignore opportunities to pee on the carpet where there is no positive response given.  Urination is a normal body function and the only thing wrong about the location is a human imposed restriction that takes some time for an animal of limited intelligence to understand and then act upon accordingly – likewise for palliative social interactions.  Expectations of humans must be introduced to the dog in a positive way so that the animal enjoys the environment.  Reflecting back on parent directed childhood visits to a dull and unengaged relative it was not surprising that such interactions resulted in equally unengaged responses from myself and my siblings.  Regardless of the fact that people are dying in a hospice facility, it is vital that the leader make the environment enjoyable, supportive and engaging to the palliative pet as no amount of “correction” will instill the social responses the owner/leader is seeking.

Some breeds have only limited social behaviours encoded in their DNA and in such cases these animals have limited use as palliative pets.  Further, within breeds individual animals may be more or less suited for palliative environments.

The American Temperament Test Society, Inc. (ATTS) is a U.S. based not-for-profit organization founded in1977 that promotes uniform temperament evaluation of purebred and spayed/neutered mixed-breed dogs.  In pursuit of their motto “a sound mind in a sound body”, certified ATTS testers have evaluated more than 30,000 canines.  Upon successful completion of the pass/fail test, an animal is awarded certification. Many breeders utilize these evaluations as a fundamental tool in establishing their breed lines. The minimum age for the ATTS to evaluate a dog is 18 months.

If an owner/leader is wishing to select a puppy that when grown will be suitable for volunteering in palliative care environments, the process of determining suitability is less clear or rubust.  Given the ATTS age limit, pet owners/leaders must look elsewhere for guidance.

Jack and Wendy Volhard  are renowned for their expertise in assessing the conformation and behavior of canines.  With 13 books to their credit and numerous articles and videos based on a motivational-based training methodology they have created an effective and simple puppy evaluation tool.  The Volhard Puppy Aptitude Test for prospective owners is used to assess the following behaviours which then lead to an overall score.  Social Attraction, Following, Restraint, Social Dominance, Elevation, Retrieving, Touch Sensitivity,  Sound Sensitivity, Sight Sensitivity, Startle response to a strange object are the ten categories used and ranked by an unbiased party in a surrounding unfamiliar to the animal.  An owner wishing to select a puppy for palliative environments may find this or similar evaluation tools of use in the selection process.

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Alzheimer’s Disease and Palliative Pets

22 Sep

The American Psychiatric Association characterizes Alzheimer’s Disease as a progressive brain disorder that exhibits symptoms of cognitive impairment to memory, language, judgement and abstract reasoning.  On average, this life limiting disease results in a life expectancy following diagnosis of approximately seven years and is identified as the fourth leading cause of death in the United States.  In recent years medical professionals have seen a growing interest in the therapeutic effects of animal assisted therapy and activities.

A study published in “Companion Animals in Human Health (see References section)” by Kathryn Batson et al titled “The Effect of a Therapy Dog on Socialization and Physiological Indicators of Stress in Persons Diagnosed with Alzheimer’s Disease” concluded that pets can serve as a useful intervention for increasing socialization in Alzheimer’s sufferers.  These researchers looked at the impact of a trained therapy dog, in this case a miniature schnauzer, on a variety of social interaction variables such as smiling, tactile contact, verbal praise, physical engagement as well as physiological factors such as heart rate and blood pressure.

The presence of the therapy dog enhanced nonverbal communication as shown by increases in looks, smiles, tactile contact and physical warmth.  The findings of the study support the advantages of short-term visits on the mental state and quality of life of person’s suffering from Alzheimer’s Disease.  The results fit with similar research on the effects of pets on socialization of the elderly and suggest that the greater alertness of the research subjects suffering from profound impairment may activate a more basic form of communication and socialization than verbal interaction.

The study concludes that given the simplicity and ease with which pet interactions can be offered, such interventions can and should be woven into the fabric of care for Alzheimer’s patients.

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The Pet and Leader Duo

21 Sep

The palliative pet and its leader/owner make up a volunteer duo that brings much joy, serentity and vitality to a person at the end of their life.  In support of the dying, many compassionate people find volunteering in an end-of-life care facility or residence to be rewarding as well as a challenging endeavour.  To effectively lead your palliative pet in dealing with dying individuals it is essential that not only is the pet suitable for the role, but that the pet’s leader is equally appropriate and prepared for the environment.  Encountering death is not a common occurrence in our modern-day world and volunteering with a pet in such an environment can be profoundly emotionally impactful.  To ensure that volunteers can effectively function with the dying, their relatives, friends and colleagues, most hospice facilities will require that the volunteers receive training in:

– Awareness of the philosophy of Palliative Care and Hospice Culture

– Understanding the medical issues volunteers may be faced with

– Loss, Grief & Bereavement Care

– Multicultural awareness

– Self-Care for the Volunteer & Caregiver

– Personal/Practical Care in each setting

– Spiritual Care/Psychosocial Care

– Communication skills/Active Volunteering

– Funerals/End of Life Celebrations

When a volunteer visits a person receiving end-of-life care, it is imperative that one has a genuine support for and belief in the hospice palliative care concept.  Having a warm, friendly and mature outlook and being willing to listen without judgement are essential facets of effective volunteering.  We live in a multicultural society and respect for religious beliefs of others without imposing one’s own is fundamental.  It is not ‘about’ the volunteer, it is ‘about’ the person at the end of their life and respecting their beliefs, however foreign, contrary or unjustifiable to you as a volunteer is vital.  Although the visits palliative pets and their leader engage in are often memorable and impactful, the volunteer must at all times respect the confidentiality of the dying.  As a volunteer you will be required to participate in ongoing training and supervision and to follow guidelines developed and implemented by the care facility.  Flexibility is key in volunteering and you may be asked to see patients in hospitals, hospices and private homes.  As you will be engaging with people at the end of their lives, you may become aware during a visit of a medical issue arising during a visit and you must be willing and comfortable with sharing pertinent information with members of the health care team.

Together, the well trained pet and leader duo can provide a positive, engaging and life affirming presence in end-of-life situations not only to the patients but to facility staff and the health care team as well.

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A Pet’s Nurturing Soul

8 Sep

A Pet’s Nurturing Soul – Where does it come from?

A palliative pet lies on a bed with a dying man and licks his hand and rests its head on his lap.  Is the dog feeling compassion?  Probably not.  Stanley Coren, the renowned psychologist at the University of British Columbia, explains in his new book “Do Dogs Dream? Nearly Everything Your Dog Wants to Know” that a dog’s range of emotion is roughly equivalent to that of a child at the age of two and a half years.  It is likely then that such a complex emotion as compassion is not within the scope of a palliative pet.  What dogs do feel beyond the basics of distress, contentment, disgust, fear and anger are the more complex emotions such as joy, suspicion and true affection.  Multifaceted emotions such as contempt, guilt and pride appear to be beyond the scope of a dog’s emotional spectrum.

So in the above scenario so familiar to hospice volunteers and staff, what are we witnessing?  Probably an extension of an innate nurturing quality.  A mother dog with her pups is finely tuned to signals of physical and emotional distress in members of her litter and as a member of a pack, a dog is by nature acutely aware of the status of the members of the pack.   As dogs themselves feel distress, it is not surprising then that they can pick up on the emotional states of persons at the end of life and recognize that these newly adopted members of their pack require nurturing.   Outside the structure of the pack the ability to pick up on emotional and physical distress of prey was key to successful predatory behaviour in their evolutionary history.  However within the pack, nurturing served to maintain the overall wellbeing of the group.

Are some dogs better suited emotionally for palliative care environments?  Coren describes research that clearly shows that personality (dogality?) testing on first generation puppies of crossbred Border Collies and Newfoundlands showed a blending of the personality types of the parents.  Newfoundlands are generally very social, calm and affectionate.  Border Collies are generally high energy, intense and focused on herding opportunities.  The emotional profile of the offspring of these parents showed that they were “more affectionate than their Border Collie father, but more intense and excitable than the Newfoundland mother.”  Clearly then, genetics play a major role in the emotional profile of dogs.  Hence animals bred for their sociable nature rather than guarding or fighting are on the whole more likely able to tap into the nurturing, affectionate, and loving nature so valued in palliative pets.

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