Buch, Englisch, 352 Seiten, Format (B × H): 175 mm x 249 mm, Gewicht: 703 g
Buch, Englisch, 352 Seiten, Format (B × H): 175 mm x 249 mm, Gewicht: 703 g
ISBN: 978-1-394-26606-7
Verlag: Wiley
A practical, one-stop resource for veterinary technicians offering end-of-life services for companion animals
In Companion Animal End of Life Care for the Veterinary Technician, an experienced interdisciplinary team delivers a comprehensive guide for veterinary technicians seeking a resource covering all aspects of the veterinary technician’s role in companion animal end-of-life care. The book explores everything from palliative nursing strategies to euthanasia techniques, with special attention to supporting and communicating with caregivers throughout the end-of-life period.
The editors offer invaluable support, knowledge, and skills to enhance your ability to provide patients with comfort and offer empathy to caregivers in challenging situations. In this book, you will find a practical approach and user-friendly format, a handy and accessible reference for daily veterinary practice. you will also discover: - Hospice and palliative care principles, philosophy, and methods of delivery
- A thorough exploration of quality of life and end-of-life decision-making
- Practical communication skills and case study applications
- Euthanasia best practices
- The valuable role of veterinary social work and perspectives on pet loss support
- Grounded approaches to maintain technician and team wellbeing
- Careful alignment with evolving standards of end-of-life care and client expectations
- Distillations of expert insights from authoritative texts and current literature, providing access to the most relevant information for technicians in the field of end-of-life care
Perfect for practicing veterinary technicians with a desire to improve their standard of end-of-life care, Companion Animal End of Life Care for the Veterinary Technician will also benefit students of veterinary technology start their careers with the mindset and tools to lean into the meaningful experiences that can be accessed through compassionate end-of-life care.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
List of Contributors xvii
Acknowledgments xix
Introduction xxi
About the Companion Website xxv
Part I Overview of Hospice and Palliative Care 1
1 Introduction to Animal Hospice and Palliative Care 3
Alyssa Eslinger
1.1 Introduction 3
1.2 Terminology and Definitions 4
1.3 Psychosocial Considerations 5
1.4 The Interdisciplinary Team 5
1.4.1 Role of Veterinary Technicians 8
1.4.2 Role of Veterinary Social Workers 8
1.4.3 Effective Use of Interdisciplinary Teams 9
1.5 Hospice Care Approach 9
1.6 End-of-Life Care Delivery Models 10
1.6.1 Role of Telemedicine 11
1.6.2 Informed Consent and Liability Considerations 13
1.7 Takeaways 13
References 13
2 Pain Recognition and Assessment 15
Alyssa Eslinger and Amy Birchall
2.1 Introduction 15
2.2 The Physiology and Classification of Pain 15
2.2.1 Somatic and Visceral Pain 17
2.2.2 Acute vs Chronic Pain 17
2.2.3 Neuropathic Pain 17
2.3 Pain Recognition 18
2.3.1 Fear, Anxiety, Stress, and Pain Recognition 19
2.4 Pain Assessment Tools 20
2.4.1 Simple Pain Scales 20
2.4.2 Multidimensional Acute Pain Scales 21
2.4.3 Multidimensional Chronic Pain Scales 22
2.5 Practical Pain Assessment 28
2.6 Caregiver Communication and Education 29
2.6.1 Caregiver Myths and Misconceptions 29
2.7 Takeaways 30
References 31
3 Pain Management 33
Alyssa Eslinger
3.1 Introduction 33
3.2 Role of Veterinary Technicians and Approach to Pain Management 33
3.3 Pharmaceutical Pain Management 35
3.3.1 NSAIDs 35
3.3.2 Opioids 36
3.3.3 Corticosteroids 38
3.3.4 Gabapentinoids 38
3.3.5 NMDA Receptor Antagonists 39
3.3.6 Other Adjunctive Analgesics 40
3.3.6.1 Local Anesthesia 41
3.3.6.2 Monoclonal Antibody Therapy 41
3.3.6.3 Bisphosphonates 41
3.3.6.4 Cannabidiol 41
3.4 Physical Modalities 42
3.4.1 Manual Therapy Techniques 43
3.4.2 Thermotherapy 43
3.4.3 Therapeutic Laser 43
3.4.4 Electrotherapy 44
3.4.5 Therapeutic Ultrasound and Extracorporeal Shockwave Therapy 45
3.4.6 Acupuncture 47
3.5 Nutrition, Nutraceuticals, and Herbal Medicine 47
3.5.1 Nutrition 47
3.5.2 Chondroprotectants 48
3.5.3 Herbal Medicine 48
3.6 Pain Management Case Studies 48
3.6.1 “Leo” – Canine Osteosarcoma 48
3.6.2 “BB” – Feline Osteoarthritis and Intestinal Lymphoma 49
3.7 Exotic Pet Pain Management 50
3.8 Caregiver Education and Communication 51
3.9 Takeaways 51
References 52
4 Hospice and Palliative Nursing Care 55
Alyssa Eslinger
4.1 Introduction 55
4.2 General Comfort Care 56
4.2.1 Environmental Modifications 56
4.2.2 Mobility 57
4.2.3 Hygiene and Toileting 60
4.2.4 Nutrition 61
4.2.5 Mucous Membrane Comfort 63
4.2.6 Fluid Support 63
4.2.7 Medication and Treatment Administration 64
4.2.8 Mental and Emotional Wellbeing 65
4.3 Sign-Specific Nursing Care 65
4.3.1 Recumbency 66
4.3.2 Wounds 66
4.3.3 Gastrointestinal Signs 67
4.3.4 Respiratory Distress 67
4.3.5 Musculoskeletal Signs 68
4.3.6 Neurological Signs 68
4.3.6.1 Neuromuscular or Spinal Disease 68
4.3.6.2 Intracranial Disease 69
4.3.6.3 Cognitive Dysfunction (CD) 69
4.3.7 Neoplastic Signs 69
4.4 Comfort Kits 70
4.5 Takeaways 73
References 74
5 Understanding and Assessing Quality of Life 75
Alyssa Eslinger
5.1 Introduction 75
5.2 Quality-of-Life Assessments 76
5.2.1 Effective Use of Quality-of-Life Assessments 76
5.3 Components of Quality-of-Life Assessments 78
5.3.1 Physical Wellbeing 78
5.3.2 Social Wellbeing and Mental Stimulation 79
5.3.3 Emotional Wellbeing and Autonomy 80
5.3.4 Other Considerations 80
5.3.4.1 Global Score 80
5.3.4.2 Caregiver Burden 80
5.4 Selected Quality-of-Life Assessment Tools 80
5.4.1 Selected Quality-of-Life Assessments 81
5.4.2 Individualized Quality-of-Life Questionnaire 83
5.5 Role of Telemedicine 85
5.6 Large Animal and Exotics Considerations 87
5.7 Takeaways 87
References 88
Part II End-of-Life Communication and Decision-Making 91
6 Building Essential Communication Skills 93
Joye Sears and Becky Taylor
6.1 Introduction 93
6.2 Core Communication Skills 93
6.2.1 Nonverbal Communication 94
6.2.2 Asking Questions 95
6.2.3 Active Listening 97
6.2.4 Showing Empathy 100
6.3 Emotional Intelligence 101
6.3.1 Self-Awareness 102
6.3.2 Self-Management 103
6.3.3 Social Awareness 104
6.3.4 Relationship Management 104
6.4 Team-Based Communication 104
6.4.1 Getting the Team on Board 104
6.4.2 Building Skills Within the Team 105
6.5 Takeaways 105
References 105
7 Supporting Difficult Conversations 107
Joye Sears
7.1 Introduction 107
7.2 Difficult Clients vs Difficult Situations 107
7.3 Applying Communication Skills to Difficult Conversations 108
7.3.1 Partnership Statements 108
7.3.2 Warning Shots 108
7.4 A Model for End-of-Life Conversations 109
7.4.1 Setting 109
7.4.2 Perspective 109
7.4.3 Invitation 109
7.4.4 Knowledge 109
7.4.5 Empathize 110
7.4.6 Summarize and Strategize 110
7.5 Conflict Resolution 110
7.6 Types of Difficult Conversations 112
7.6.1 Grief 112
7.6.2 Delivering Bad News 112
7.6.3 Anger 113
7.6.4 Financial Conflict 114
7.6.5 Disagreement Within the Team 116
7.6.6 Disagreement Among Caregivers 119
7.7 Assess for Success 121
7.8 Takeaways 121
References 121
8 Ethical End-of-Life Decision-Making 123
Alyssa Eslinger
8.1 Introduction 123
8.2 Communication in EOL Decision-Making 124
8.3 Caregiver Perspectives on EOL Decision-Making 124
8.3.1 Conflicting Caregiver Perspectives 127
8.4 Factors for Veterinary Team Consideration in EOL Decision-Making 128
8.4.1 Quality-of-Life Assessments in EOL Decision-Making 128
8.4.2 Caregiver Burden and EOL Decision-Making 129
8.4.3 Caregiver Preferences and Euthanasia Timing 130
8.5 Considerations for Hospice-Supported Natural Death 131
8.6 Ethical Dilemmas and Moral Stress 132
8.6.1 Convenience Euthanasia 133
8.7 EOL Decision Documentation and Debriefing 134
8.8 Takeaways 134
References 134
9 Death and Dying 137
Alyssa Eslinger
9.1 Introduction 137
9.2 Animal Experience of Dying 138
9.2.1 Signs of Dying 138
9.2.2 Signs of Death 140
9.3 Natural Death vs Hospice-Supported Natural Death 140
9.4 Informed Consent for Hospice-Supported Natural Death 142
9.5 Ethical Challenges in Hospice-Supported Natural Death 143
9.6 Nursing Care in Hospice-Supported Natural Death 145
9.6.1 Environment and General Comfort 146
9.6.2 Anxiety 146
9.6.3 Pain 146
9.6.4 Nutrition and Fluids 147
9.7 Takeaways 147
References 148
Part III Euthanasia 149
10 Providing a Compassionate Euthanasia Experience 151
Kathleen Cooney
10.1 Introduction 151
10.2 Defining Euthanasia and Dysthanasia 152
10.3 Meaningful Components of the Euthanasia Appointment 154
10.3.1 Grief Support Materials Provided 155
10.3.2 Outline Caregiver and Pet Preferences 155
10.3.3 Offer Privacy Before and After Death 156
10.3.4 Deliver Proper Technique 156
10.3.5 Establish Rapport 156
10.3.6 Use Pre-euthanasia Sedation or Anesthesia 157
10.3.7 Thorough, Complete Consent 157
10.3.8 Helpful and Compassionate Personnel 157
10.3.9 Adequate Time 157
10.3.10 Narrate the Process 158
10.3.11 Avoid Pain and Anxiety 158
10.3.12 Safe Space to Gather 158
10.3.13 Inclusion of Loved Ones 158
10.3.14 Assistance with Body Care (Aftercare) 158
10.4 Technicians in the Role of Euthanasia Provider 159
10.5 Communicating Effectively Before, During, and After Euthanasia 160
10.5.1 Establish Rapport 161
10.5.2 Find Comfort with Silence 162
10.5.3 Use the Basics of Good Communication 162
10.5.4 Offer Praise 162
10.5.5 Piece It Out 163
10.5.6 Create Partnership 164
10.5.7 Attend to Emotional Intelligence 164
10.6 Medical Records 165
10.7 Takeaways 165
References 166
11 Anatomy of a Humane Euthanasia 167
Kathleen Cooney
11.1 Introduction 167
11.2 Technicians as Euthanasia Attendants 167
11.3 Euthanasia Methods and the Physiology of Death 168
11.3.1 Methods of Euthanasia 168
11.3.2 Body Changes 169
11.4 Pre-euthanasia Sedation and Anesthesia Protocols 171
11.4.1 Effects of Pre-euthanasia Sedation and Anesthesia Protocols 173
11.4.2 Administration of Pre-euthanasia Sedation or Anesthesia 174
11.5 Euthanasia Room Comforts 177
11.5.1 Euthanasia in the Hospital Setting 177
11.5.2 Euthanasia in the Home Setting 179
11.6 Balancing EOL Work and Well-Being 180
11.7 Takeaways 181
References 181
12 Euthanasia Techniques in Companion Animals 183
Kathleen Cooney
12.1 Introduction 183
12.2 Euthanasia Injection Techniques 185
12.2.1 Intravenous (IV) Injections 186
12.2.2 Intracardiac (IC) Injections 188
12.2.3 Intrarenal (IR) Injections 190
12.2.4 Intrahepatic (IH) Injections 191
12.2.5 Intraperitoneal (IP) Injections 193
12.3 Alternative Euthanasia Administration Techniques 194
12.3.1 Oral Administration of Euthanasia Drugs 194
12.3.2 Intrathecal Anesthetic Euthanasia 194
12.3.3 Physical Methods of Euthanasia 194
12.3.4 Euthanizing Fetuses 195
12.4 Physical Changes During Death and Pronouncing Death 195
12.5 Exotic Pet Considerations 197
12.5.1 General Considerations for Patient Comfort 198
12.6 Unique Circumstances 199
12.7 Takeaways 200
References 201
13 Respectful Deceased Body Care 203
Kathleen Cooney
13.1 Introduction 203
13.2 Aftercare Ordering Models 205
13.2.1 Veterinary Aftercare Ordering Model (VAOM) 205
13.2.2 Client Aftercare Ordering Model (CAOM) 205
13.3 Respectful Body Containment 205
13.4 Moving a Deceased Body 208
13.5 Modern Options in Aftercare 209
13.5.1 Cremation 211
13.5.2 Burial 212
13.5.3 Aquamation 214
13.5.4 Body Preservation 215
13.5.5 Educational Memorial Body Donation 216
13.6 Minimizing Aftercare Mistakes and Exceeding Expectations 217
13.7 Expected Postmortem Changes and Decomposition 218
13.7.1 Decomposition 219
13.8 Takeaways 221
References 221
Part IV Grief and Memorialization 223
14 Introduction to Grief 225
Sarah Bernardi
14.1 Introduction 225
14.2 The Fundamentals of Grief 225
14.3 The Human–Animal Bond: A Unique Loss 227
14.3.1 Guilt and Regret 229
14.3.2 Anger 231
14.4 Recognizing Grief Responses 231
14.4.1 Uncomplicated Grief 231
14.4.2 Disenfranchised Grief 232
14.4.3 Anticipatory Grief 232
14.4.4 Prolonged Grief Disorder and Suicidality 234
14.5 Factors Impacting Grief Responses from Pet Loss 234
14.5.1 Euthanasia 235
14.5.2 Sudden Loss 236
14.5.3 Loss of Service Animals 236
14.5.4 Culture and Spirituality 237
14.5.5 Perceived Social Support 238
14.5.6 Age 239
14.6 Considerations for a Grieving Pet 241
14.7 Takeaways 241
References 243
15 Pet Loss Support 245
Sarah Bernardi
15.1 Introduction 245
15.2 Language Sensitivity in Grief Support 246
15.3 Providing Grief Support and Memorialization 246
15.3.1 Aftercare Services 246
15.3.2 Memorial Activities and Keepsakes 249
15.3.3 Follow-Up Care and Support 252
15.3.3.1 Post-Death Phone Call 252
15.3.3.2 Sympathy Cards 253
15.3.3.3 Picking Up Remains 255
15.4 Developing a Pet Loss Resource Guide 255
15.4.1 Essential Components of a Pet Loss Resource Guide 255
15.5 Addressing Specific Grief Responses 256
15.5.1 Anticipatory Grief: Preparing Caregivers 256
15.5.2 Integrating Cultural Sensitivity in Grief Support 258
15.5.3 Integrating Spiritual Sensitivity in Grief Support 259
15.5.4 Supporting Grieving Pet Owners with Suicidal Ideation 259
15.6 Takeaways 260
15.a Pet Loss Resource Guide Template 262
15.b Suicide Response Guidelines for Veterinary Practices 263
References 264
16 Children and Pet Loss 267
Sarah Bernardi and Amy Sugar
16.1 Introduction 267
16.2 The Role of Technicians in Supporting Families with Children 268
16.3 Children’s Perceptions and Age-Specific Advice 269
16.4 Talking to Children About Death and Loss of a Pet 272
16.4.1 Use Simple and Direct Language 272
16.4.2 Validate Feelings 272
16.4.3 Be Patient and Nonjudgmental 274
16.4.4 Avoid Euphemisms 275
16.4.5 Avoid Lying 275
16.4.6 Avoid Blame 276
16.4.7 Spiritual and Religious Considerations 276
16.4.8 Parent/Caregiver Resources for Children of All Ages 277
16.5 Supporting Children Through Diagnosis and Treatment of a Pet’s Serious Illness 278
16.6 Involvement of Children Through Euthanasia 279
16.6.1 Preparing the Family for Euthanasia 279
16.6.2 Explaining Euthanasia to Children 280
16.6.2.1 Why Is This Happening? 280
16.6.2.2 What Does It Mean? 280
16.6.2.3 How Does It Happen? 281
16.6.3 The Presence of Children During Euthanasia 281
16.6.3.1 Children Under the Age of Five 282
16.6.3.2 Middle to Late Childhood (6–13 Years) 283
16.6.3.3 Teens and Young Adults (14–21 Years) 283
16.6.4 Preparing the Veterinary Team for Children-Present Euthanasia 283
16.6.4.1 EOL Comfort Kits for Children 284
16.7 Preparing for the Unexpected 286
16.8 Supporting Children’s Grief Through Memorialization 287
16.9 Considerations for Getting a New Pet 289
16.10 Takeaways 289
References 291
Part V Team Wellness and Growth 293
17 Empathic Strain and Veterinary Team Wellness 295
Sarah Bernardi and Kathleen Dunbar
17.1 Introduction 295
17.2 Empathic Strain in Veterinary Practice 295
17.2.1 Causes of Empathic Strain 297
17.2.2 The Role of Moral Distress in Empathic Strain 297
17.3 Personal Approaches to Mitigating Empathic Strain 298
17.3.1 Empathic Strain Personal Warning System 298
17.3.2 Mindfulness Practices 299
17.3.3 Professional Support and Mentorship 300
17.4 Organizational Strategies for Enhancing Well-Being 300
17.4.1 Leadership’s Role in Ensuring Psychological Safety 300
17.4.2 Developing Policies and Procedures 301
17.4.3 Peer Debriefing 302
17.4.4 Integrating Veterinary Social Work 303
17.5 Takeaways 303
References 304
18 The Future Is Bright 307
Alyssa Eslinger and Joye Sears
18.1 Technician Utilization and Lifelong Learning 307
18.2 Meaningful Purpose and Leadership 307
18.3 Business Considerations 308
18.4 Veterinary Social Work 309
18.5 Specialization and Collaboration 309
18.6 Quality of Life Perspectives 309
18.7 Research Priorities 310
18.8 Conclusion 310
References 310
Index 311
