Guiding Clients Through End-of-Life Choices During the Holidays

Laurel Lagoni, M.S.

Many years ago, my colleagues and I invited a panel of veterinarians to talk to our third year Colorado State University veterinary students during a course called “Managing Client Grief.”  During the question and answer phase, the discussion turned to helping clients whose pets are gravely ill during the days leading up to the holidays.  Since our class took place in January, one of our students had dealt with a client who experienced tremendous anxiety due to the decisions she had to make during the past holiday season.  Our student wanted to know how, given the added pressures of the holidays, she could have dealt with her client more effectively.

Her questions were good ones.  For example, she wondered,

  • should I have done everything humanly possible to keep the pet alive until the holidays had passed?
  • since my client was leaving town to visit relatives, should I have agreed to board her cat so it had proper medical care, even though we don’t provide that service?
  • if the cat had “crashed” on Christmas Day, should I have given up my own personal plans to be with my client when she needed me the most?

A veterinarian from the panel, who defined himself as “old school,” told the students he always provides the same solution in this case—immediate euthanasia. “Why prolong peoples’ suffering?” he asked the class. “I advise them to be rational about it and to let the animal go now, before the pet or the family has to experience any more pain,” he explained. “Let them get it over with before the holiday so death isn’t always part of their memories.”

Another veterinarian from the panel disagreed with that plan. “I think clients trust us and will often do whatever we ask them to do, even if that decision isn’t the right one for them,” she countered.  “We have to be careful that we don’t push them into decisions that they’ll regret later.  We can guide, but we shouldn’t ever tell them what to do.”

Since most of the students felt comfortable with the idea of guiding clients rather than telling them what to do, we ended the class with a brainstorming session about what guiding might look like.  Here are what the students believed to be the top three tips from that discussion:

1. Be clear about your own limits and schedule.

Most clients realize that you have a personal life, but they can be caught off guard if their expectations of you don’t match your willingness to “be there” for them 24/7.  If they know ahead of time that you are unavailable during certain hours or days, they’ll consider your availability as part of their decision-making process.

Even so, some clients will “test” the boundaries you set and ask you to make exceptions for them. While you need to assess each case on an individual basis, in most cases, you can feel comfortable about referring clients to your back-up resources when you know you have been clear about you availability from the beginning.

2. Get a grip on your own feelings of anxiety.

Knowing the holidays are approaching makes everyone a bit more jumpy when it comes to caring for a seriously ill pet. Sometimes it’s tempting to lead clients toward a more rapid decision, believing that waiting will only prolong their feelings of stress and anxiety. Yet, people have different tolerances for emotional pain and, for many, feeling they euthanized a pet too early, before they were emotionally ready to say good-bye, is worse than the indecision that is present before a pet’s death.

If you feel yourself growing impatient with a client’s indecision, gently remind them that feelings of grief will come with their loss, whether their pet’s death occurs today or two weeks from today.  Explore their reasons for waiting to treat or to euthanize with them.  Is there a valid reason to wait or are they truly trying to avoid the grieving process?  Remind them again of your own limits and schedule so your own anxiety about being pulled back into their case during your own holiday celebrations won’t be a factor.

3. Help clients project ahead to a time after their pet has died.

Help your clients explore the choices and decisions they can make now that will be comforting to them later. Ask them to also think through which decisions might cause them to feel regret later. For example, if your client is agonizing about leaving town to visit relatives because she will need to leave her very sick dog behind in the care of a pet sitter, gently ask her if it would be possible for her to stay home with her pet this year. Ask her to take a moment to search her heart to discover which will might regret more in the years ahead—disappointing her relatives or not being with her pet during the last few days of his life?

The answer will be different for each client and, of course, there should be no judgment made, regardless of the decision. Neither answer—staying home with the pet or going to visit relatives—is ‘right’ or ‘wrong.’ However, the point to make is that, when people are distressed, they often cling to familiar rituals and routines simply because it’s what they’ve always done.  As a guide, you can help your clients make conscious and deliberate choices that may impact their emotional futures in more positive ways.

After the discussion, our student concluded that she had, indeed, handled the case well. She had communicated her own boundaries and limitations while, at the same time, supporting her client’s decision to postpone euthanasia for her dog until after the holidays. “I spent a fair amount of time worrying that I would get ‘the call’ from my client on Christmas Day,” the student said, “and I wondered how far I would go to hold on to my own time with my family. At least now, after this discussion, I’ll feel more prepared next year when similar situations arise.”

Please share your wisdom on this topic in the comments below!

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© 2013. World by the Tail, Inc. All rights reserved.
Laurel Lagoni is a nationally recognized veterinary grief expert and the former Director of the Argus Institute atColorado State University’s Veterinary Teaching Hospital. She is President of World by the Tail, Inc., and directs the Veterinary Wisdom® Resource Centers at www.veterinarywisdom.com

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