Senior care: What's holding you back?

In 2004, the American Animal Hospital Association (AAHA) reported that only about 14 percent of elderly pets got basic, recommended health screens. Experts now estimate that number to be less than 10 percent. Seniors make up the majority of the pet population, plus many would argue they need wellness screens the most. So why are their wellness numbers so low?

Greg Paprocki

You might not like the answer: Lack of a clear recommendation from the veterinary team is the main obstacle to senior care compliance, according to the 2004 AAHA Senior Care Guidelines. Either team members aren't talking to clients about geriatric care, or, if they are, they're not emphasizing its value. Don't let your team fall short on senior care. Avoid these common missteps to give your elderly patients a strong foothold on good health.

Misstep: No program in place

Here's the good news: At least 50 percent of small animal practices offer some form of senior care program, says Dr. William Fortney, an assistant professor of diagnostic medicine and pathobiology at Kansas State University's College of Veterinary Medicine and a long-time advocate for geriatric care. The bad news: By Dr. Fortney's figures, some 40 percent of hospitals haven't established any type of senior program. With no set guidelines to follow, many teams may not know where—or when—to begin.

To help older pets, you need to know what you're looking for and why, says Caitlin Rivers, a Firstline Editorial Advisory Board member and technician trainer at Metzger Animal Hospital in State College, Pa. A senior program helps familiarize you with common conditions older pets are likely to develop, such as obesity and periodontal, heart, kidney, liver, and thyroid disease. It also teaches you how to talk to clients about senior care.

For example, too many times clients mention their pets' listlessness only to chalk it up to old age. You must explain to clients that a pet may slow down, but if it's not moving around anymore, it isn't because of old age, says Gina Toman, a Firstline Editorial Advisory Board member and practice manager at Seaside Animal Care in Calabash, N.C. Most likely, the immobility happens because the pet is in pain, perhaps from osteoarthritis, she says. For more information on setting up a geriatric wellness plan, including recognizing senior disease symptoms and communicating with clients, search for "senior care programs."

Misstep: Not communicating value

"A lot of clients tend to only bring their pets into the practice when there's a visible problem," says Jennifer Graham, receptionist at Ellwood Animal Hospital in Ellwood city, Pa., who admits to being guilty of this herself. "It's hard for clients to wrap their minds around paying for tests when their pets look perfectly healthy."

A great way to start the conversation, says Toman, is to tell clients that you're not necessarily looking to find something, but rather to build a baseline. For example, say: "I'm sure Scooter is doing fine. And that's why these tests are useful now. They'll give the doctor a record of what Scooter's normal ranges are so we'll have something to compare future tests to." Then be sure to explain how rapidly disease can develop in seniors and encourage rechecks every six months.

You should also emphasize the proactive aspect of twice-a-year senior wellness tests, Toman says. For example, tell clients, "As good as our doctors are, they can't see inside your pet. These tests will give them an inside look at Scooter's overall health, which can greatly improve his life quality and expectancy."

To drive home the point, Toman follows up with an illustration of how early detection can save a pet's life. With kidney disease, for example, she suggests saying, "By the time you see changes in the blood chemistries, 75 percent to 85 percent of the pet's kidneys could be gone, and, like people, pets need at least 50 percent to function. Now, if you opt for urinalysis every six months, we could catch low specific gravity levels at 65 percent and place Scooter on a special diet or supplements to curb the problem."

To prove to clients that their senior pets truly need regular wellness screens, Metzger Animal Hospital puts its money where its mouth is, Rivers says. When clients bring in their elderly pets for vaccines, team members have the green light to say, "Here's the thing. You were planning on spending a certain amount of money on vaccines today. But we've decided that it's just as important for your senior pet to get blood work done, so we're willing to give you the vaccines for free if you sign up for a senior blood work panel." This still adds to the client's bill, Rivers says, but it shows how vital we consider senior wellness screenings to be.

Misstep: Thinking clients can't pay

"Team members are often uncomfortable with the perception of selling," Rivers says. "But selling senior care isn't like selling a car. It's practicing good medicine." When you realize you're working to educate clients and provide a necessary—and possibly life-saving—service, the salesperson-feeling goes down and the conversations with clients go up, Rivers says.

It's your job to always offer the optimal recommendation, regardless of the price. Sure, pet owners may still decline your recommendations because they believe their healthy pets don't need care or because they can't afford it. Remind these pet owners of the value of gaining a baseline for comparison, and let them know about alternative payment options including third-party payment plans or pet insurance. After all, it's never too late for pet insurance. If the pet is healthy and without existing conditions, it may make a fine candidate for pet insurance, regardless of its age.

If the gold-standard care is still out of reach for clients, go ahead and offer them the doctor's Plan B, Toman says. "Maybe they can't do the specialty diet right now, but they could try something comparable. Maybe they can't afford the anti-inflammatory but they could pick up fish oil," she says. There has to be open communication and flexibility among the doctors, team members, and clients if you want to help care for the pets, Toman says.

Tip: Increase client compliance and save pet owners money by bundling senior services together. Clients will be more receptive to getting all of the services in one visit for a lower lump sum rather than paying more in the long run for individual tests.

Misstep: Not buying in

While you shouldn't take a client's noncompliance personally, Toman says, you should take senior care personally—and that goes for your own pets. Staff members' cats and dogs need to follow the practice's senior care program. After all, if you're not complying, why should clients?

At Seaside Animal Clinic, all team members receive free annual blood work for their pets, Toman says. This helps the team members connect with clients because they can share personal examples. By telling clients how you helped your own pet take off excess pounds, for example, or how you added years onto your pet's life by screening for and catching hypothyroidism, they'll be better able to see the benefits.

Since her senior cat's diagnosis, Graham has become the unofficial hyperthyroid expert at her practice. "It's easier for me to get clients to comply because I'm going through the same thing," she says. "I can say, 'My cat has this too and here's what I do.' I'm passionate about it and it comes through." And that's what you want, River says—passionate people who will spearhead your senior program and work to get everyone on board and educated.

Don't miss the opportunity to be someone's hero. By advocating senior wellness care, you can help detect many diseases, slowing their progression and making patients more comfortable. And, in some cases, if you help catch illness early enough, the veterinarian may be able to eradicate the problem. So take the time to put a senior care program in place—or evaluate your current one—and help older pets get a leg up on good health.

Please send questions and comments to firstline@advanstar.com.