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Gray matters

Veterinary nurses can help clients address age-related issues in an older pet and make appropriate health care decisions.

Gray matters
Many practices have developed patient care models to address and resolve specific age-related conditions.

I have yet to meet a veterinary professional who doesn’t love meeting puppies and kittens for the first time. It’s a joyous occasion for the team and pet owner and the beginning of what hopefully will be a lifelong relationship. Developing these relationships early on is essential. Regardless of whether the patient comes to us as a youngster or adult, we are now the client’s trusted resource for the life of the pet. This is a great position to be in, and the veterinary nurse is a key player in the partnership.

A study conducted by the analytics firm VetSuccess uncovered interesting and somewhat disturbing information. VetSuccess determined after examining data from 300 U.S. veterinary hospitals that a large percentage of patients fell into the geriatric category. The disturbing part was this: Of the geriatric pets euthanized in the practice, over 70 percent had not been seen by their veterinarian within the last year of life. The figures were 77 percent of cats and 70 percent of dogs.

Geriatric vs. Senior

We can, and should, work to reverse this situation. If we were lucky enough to know patients throughout their lives, we owe it to them and those who love them to provide continuous care in the last phase of life.

Patients over age 7 generally fall into the senior category. Does this mean all patients over 7 are geriatric? Not necessarily. Senior is an age, while geriatric is more of a condition. When defined as a patient in the last 10 percent of its life expectancy, “senior” could apply to a 9-year-old mastiff or a 15-year-old poodle. Age is only a number.

The veterinary team has a critical role in managing older patients and communicating with the clients to ensure that needs are addressed. Some needs might be subtle and others quite noticeable. We should see these patients more frequently, so what’s important is to seize every opportunity to work with their owners to address life changes.

Use a Patient Care Model

Many practices have developed patient care models (PCMs) to address and resolve specific age-related conditions. It’s an established approach within the hospital to treat a defined condition based on the best medical options. In addition, wellness plans can combine recommended services in a way that makes them affordable for the client. When we have these programs in place and administer them properly, we don’t lose the connection as the pet ages.

The most effective wellness plans are those developed with both the client’s and patient’s needs taken into consideration. They should be comprehensive yet flexible so that they are easily understood and easily administered.

As you develop your practice’s PCMs, you build wellness plans around them to address the level of care. The whole team plays a role in developing and administering the plans and patient care standards, so proper and complete training is essential. The message must be consistent no matter whom the client interacts with at your hospital.

These plans typically include unlimited exams, lifestyle-based immunizations, bloodwork, radiographs, dental procedures, products and other diagnostics. The more often we see these patients and clients, the stronger the relationship will be. Consider adding in extras like regular toenail trims, anal gland expressions and other age-related comfort options.

The Nurse’s Role

At some point, a senior pet’s health begins to deteriorate. Quite often, geriatric patients experience pain, decreased mobility, cognitive disorders, hearing and sight loss, irregular eliminations or incontinence, and appetite or dietary issues. A veterinary nurse who has developed a strong bond with the client and patient is in a great position to assist these patients through increasingly difficult times.

Helping clients understand the aging process and providing information and resources is essential. Nurses can talk with the owner of an aging pet to learn about her main challenges, frustrations and concerns. They can provide comfort and support solutions and make recommendations based on specific needs. They can ensure that visits to the hospital are as easy and stress-free as possible.

The nurse can assist in areas such as these:

  • Veterinary visits: Help the patient into the hospital as needed. Many of them might have mobility issues.
  • Medications and at-home treatments: Demonstrate how to administer drugs or treatments, and develop reasonable and easy regimen schedules.
  • Mobility: Recommend solutions for slippery surfaces. The answers could be rugs, yoga mats, booties and other non-slip options.
  • Lifting and climbing: Recommend and demonstrate harnesses, slings, ramps and furniture steps.
  • Hearing or vision impairment: Recommend gates, lights and environment modifications.
  • Diet: Recommend food appropriate for a specific need or condition. These might include soft or easily digestible diets and, if the veterinarian approves, a therapeutic diet.
  • Elimination: Discuss comfort and treatment options such as diet modifications, medications, potty pads, diapers and hygiene products.
  • Future visits: Forward-booking is important to ensure continued care as frequent visits become more likely. Schedule the next visit each time the pet comes in.

When the End Is Near

Despite your having provided the best care, the time will come when hospice and other end-of-life services become necessary. Conversations about the pet’s comfort and quality of life and, ultimately, euthanasia will be needed.

At this point, the client already will be grieving the inevitable. Help her on the difficult journey. Share information on the options available to her and how everything works. Hold her hand and hold the pet’s paw as they approach the final stage.

As hard as these moments might be, there is no better patient advocate than the veterinary nurse. It’s what we do best.

Getting Technical columnist Sandy Walsh is a practice management consultant, speaker, writer and instructor for Patterson Veterinary University.