The heartfelt role of veterinary technicians in feline hospice and palliative care

Photo: Alexandr/Adobe Stock

Veterinary technicians play an important role in hospice care and the euthanasia process of feline patients. In her lecture “The Technician’s Role in Euthanasia, Hospice and Palliative Care Appointments,” at the 2024 New York Vet Show in New York, New York, Jamie Rauscher, LVT, hospital manager of Animal Hospital of Towne Lake, and president of the National Association of Veterinary Technicians in America (NAVTA), outlined 5-step guidelines for hospice and palliative care that veterinary practices can implement for an effective care plan.¹

The 5 steps of the Feline Hospice and Palliative Care Guidelines by the Feline Veterinary Medical Association (FelineVMA), formerly the American Association of Feline Practitioners (AAFP), comprise an evaluation of the caregiver’s needs, education about the disease process, development of a personalized plan for the patient and the caregiver, application of hospice or palliative care techniques, and emotional support during the care process and after the death of the cat.¹

Step 1: The evaluation

Caregiver needs, beliefs, and their goals for the feline patient will be different for every client, Rauscher explained. Moreover, the severity of the disease will impact the level of caregiving that is necessary. “When we talk about caregiving, how involved we are in our caregiving process is influenced by how severe the disease is,” said Rauscher during her session.¹

Rauscher explained that to evaluate the caregiver’s needs, it can be beneficial to think about the client’s "personal budget," which consists of the caregiver's available time, financial, emotional, and physical resources. Clients should consider factors such as:

• Whether they have the finances needed to care for their cat, and if their feline companion’s medications and treatments could cause a financial strain
• Whether caring for the patient will interfere with the client’s physical wellbeing, such as the amount of sleep they get
• Whether or not the client can realistically take care of the patient, and if there is anyone that can support or help the client care for the patient
• Whether or not the cat is physically able to receive the necessary care (ie., is the cat able to take medication or receive subcutaneous fluids?)
• Whether or not the client has the emotional capacity to provide the patient with the required level or care

Quality and duration of life should also be discussed with the client, as well as whether the client prefers euthanasia or hospice-assisted death. When the entire staff is busy, the veterinary technician should take the time to talk to the client, explained Rauscher. “So you’re the technician, you go in that room, and you sit down whoever your client is, [and] start... to ask questions and talk to them about what their personal budget is and what their goals are for cat,” said Rauscher.

Step 2: Educating the caregiver

Educating the client about the disease process and the delivery of care is just as important as the initial evaluation. The primary aim of caregiver education in hospice and palliative care is to ensure that caregivers fully understand all diagnostic and treatment options to prioritize their cat's comfort while being informed about the disease's progression and prognosis. This education should utilize a variety of instructional methods, including verbal, written, and visual aids, and adopt a “see one, do one, teach one” approach for hands-on tasks like administering subcutaneous fluids, according to Rauscher.

“Take your time to talk to your client and help make them, help them to make an informed decision. Get a stool, sit on that bench with your client, pull the tissues up, because your client is going to be upset with whatever's going on with her pet, but take your time to talk to them,” stressed Rauscher.

“Dr Smith [gave] a whole bunch of medical terms to this client. He has left the room, and this client is looking at you, they have no idea what to do. Or they say, ‘what would you do?’ Right? So sometimes we feel like we can honestly answer them. Other times, we feel like ‘oh my gosh, I cannot, because if I tell her what I would do, she's going to get mad,” continued Rauscher.

“But they do want you to be honest. They're there to talk to you, and they're there to get your opinion. So if you have a client that you have a relationship with, be honest with that client. …As long as your veterinarian or your practice owner— whoever is in charge—as long as they are fine with these things happening, then that's my recommendation for you.”

It is important that the caregiver feels comfortable asking questions and is not rushed into making treatment decisions. No matter what decisions are reached, the client should never feel criticized or judged.

Step 3: Developing a personalized plan

Creating a personalized care plan for both the cat and its caregiver should be a collaborative effort among the veterinary team. This plan should include clear communication of the cat's diagnosis and treatment options, an understanding of the caregiver's responsibilities and capacity to provide care, and a detailed written outline of the expected process, costs, and emotional support resources available to help the caregiver navigate this challenging time.

Step 4: Hospice or palliative care techniques

The use of hospice and palliative care techniques “empowers [the] caregiver to care for their cat in a homestead,” explained Rauscher. Discussion of these techniques includes instructing caregivers on various therapeutic approaches and how to assess their cat’s responses to treatment. Moreover, it is important for caregivers to recognize signs of decline, even if it is difficult to accept, as this awareness informs their care decisions.

Safe handling techniques and how to create a positive experience during treatments should also be discussed with the client, suggesting that interactions should be enjoyable and supportive to foster a better emotional environment for both the pet and caregiver. Evaluating and adapting the home environment for the safety and comfort of the patient is also essential, making necessary adjustments like ensuring easy access to food and water and providing optimal bedding.

“And then, how can our clients communicate with us?” posed Rauscher. “The goal is for us to be a patient advocate,” she continued. It is important to give the client resources to be able to communicate with the veterinary staff, possibly through telehealth or email, to ensure the cat's needs are continually met.

Step 5: Emotional support

“We want to help our clients when they first start to realize that they're entering their cat’s end-of-life stage,” emphasized Rauscher. Veterinary technicians and staff should offer emotional support to caregivers during their cat's illness and after the pet's passing. Caregivers often experience intense emotions like denial and grief, and it is crucial for veterinary practices to offer resources such as support groups and counseling to help clients navigate these feelings.

“You're going to reassure your client that it's okay and it's okay for them to cry. It's okay for them to be upset. It's okay for them to want to help out their pet the best they can,” said Rauscher.

Reference

1. Rauscher J. The Technician’s Role in Euthanasia, Hospice and Palliative Care Appointments. Presented at: New York Vet Show; November 7-8, 2024; New York, New York.