Tag Archives: healthcare

Survey finds a need for pet care during hospitalizations

It’s hard to heal in your hospital bed if you’re concerned about your pets at home.

Credit: Bryan McCullough

Tiffany Braley, M.D., M.S., an associate professor of neurology at University of Michigan Health, was surprised when a patient she was caring for explained why they needed to go home from the hospital as soon as possible: their pets.

After she heard several more patients voice concern for their cats, dogs and other animals at home as they sat in the hospital, she soon realized that this occurrence was not uncommon. In many cases, it involved patients who were the sole caregivers for their pets.

“I’ve had patients with acute strokes explain to me that they needed to get home to their pets, even though it was in their best medical interest to be admitted or remain in the hospital,” Braley said. “Through these interactions, it became evident to me that we needed to learn more about the scope of this problem and how we could find better ways to address it.”

Braley, who also loves animals, then reached out to fellow animal lover colleagues in neurology, social work, nursing, and U-M’s Office of Patient Experience to investigate this question.  The first step: learning about pet owner experiences from Michigan Medicine’s own patient advisors.

Study results

In partnership with U-M’s Office of Patient Experience, Braley and colleagues sent a survey to patient and family advisors who previously offered to help share their experiences to improve the patient experience. The purpose of the survey was to understand how a need to care for animals at home might affect how hospitalized patients follow their doctors’ recommendations.

Researchers published their findings in the Journal of Patient Experience.

More than half of the 113 people who responded to the survey (63%) reported difficulty figuring out pet care during their own hospitalization and/or that of a loved one.

Nearly a third reported that pet care needs impacted their decision, the decision of someone they knew, or both, about whether to stay at the hospital when the medical team recommended it.

And 16% of respondents said they know someone who has left the hospital against medical advice to go care for their pets.

“These patients are stressed already; how do you heal or accept staying in the hospital for treatment when you’re also worried about the welfare of your beloved pets?” said first author Carri Polick, R.N., a doctoral student at the U-M School of Nursing. “It can be hard if a patient doesn’t have a lot of social contacts or family members.”  “I’ve had patients with acute strokes explain to me that they needed to get home to their pets, even though it was in their best medical interest to be admitted or remain in the hospital.” Tiffany Braley, M.D., M.S.

Although social work is typically brought in to help patients come up with care plans for their pets, they may not be notified until several days into the hospitalization, typically when the situation is urgent, and are usually forced to turn to the patient’s social circle for help. Unfortunately, some patients do not have available social support, and there are limitations in what is available for assistance.

“We see a rising need for a formalized services to identify patients early in their course who need assistance with pet care, and a need to provide better resources, before it becomes a crisis and impacts their care or the welfare of their pets,” said Braley, the senior author and principal investigator.

The study team notes that, while this study is an important first step, the survey was small and included mostly women and white participants who live in nearby Washtenaw, Wayne and Oakland counties, which could indicate low estimations of the issue at large. To learn more about the overall scope and impact of pet care needs in a larger, more diverse group, the team is now studying people currently hospitalized or in the Emergency Department at Michigan Medicine to explore how pet care needs affect their hospital outcomes.

They’ve also started talking with potential local partners, including the Michigan Humane Society, to brainstorm what a future foster care collaboration could look like.

“This research is further evidence that pets are truly a part of the family and an important part of how and why we make decisions,” said Matt Pepper, the organization’s president and CEO. “Here at Michigan Humane, our work has taught us that people will forego their own health and safety for that of their pet. This study reinforces the need for communities to support families inclusive of the pet.”

Braley said a pilot program might start by focusing on a specific unit or patient population first – perhaps people needing inpatient rehabilitation, or parents of a child in the hospital who have an animal back at home. That way, the team could start helping people and their pets while they continue learning about the needs.

“Given the importance of pets to human health, follow-on studies are needed to explore how pet ownership impacts patients’ healthcare decision-making and outcomes,” Braley said. “If there is a link between pet ownership and adherence to medical treatments, I hope that early assessment of pet care needs and implementation of patient-centered methods to meet these needs will become standard of care for hospitalized patients.”

Additional authors include Jennifer W. Applebaum, M.S., Caitlin Hanna, Darnysus Jackson, II, M.S., Sophia Tsaras-Schumacher, LMSW, Rachel Hawkins, LMSW, Alan Conceicao, Louise M. O’Brien, Ph.D., M.S. and Ronald D. Chervin, M.D., M.S.

Paper cited: “The impact of pet care needs on medical decision-making among hospitalized patients: A cross-sectional analysis of patient experience,” Journal of Patient Experience. DOI: 10.1177/23743735211046089.

Source: University of Michigan Health

I wish we’d known about you sooner

Earlier this week, two dogs in my practice passed away.  As I was leaving one house for the last time, my human client said,  “I wish we’d known about you sooner.”

I know it was said in context of a thank-you and while I wanted to reply, “so do I”, I opted instead to thank them for allowing me to work with their dog over the last couple of weeks to make him more comfortable.  There was no need to make them feel more vulnerable (or guilty) at such a sad time.

The time for end-of-life and palliative care comes all to soon with our dogs – because they don’t live as long as we do.  My real passion is health & wellness care, helping dog parents play ‘the long game’ through preventative health care and, if necessary, rehabilitation.

So I’ll finish this post on a high note.  I also saw Blue this week.  He’s been a regular since October 2017 when his Dad picked up a brochure for my practice at one of my partner clinics.  He figured that since he used massage therapy for his health, Blue would benefit from it, too.

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In the years I have been working with Blue, he’s developed arthritis and had one severe episode of breakthrough pain which saw him at the vets and prescribed NSAIDs.  But since then, he continues to be a bright and happy boy.  Ever so playful, usually meeting me at my car with one of his soft toys in his mouth.  He is well looked after and taken for enriching activities including fishing trips to the Mackenzie Country and walks through the Heathcote Valley.

To me, Blue is a great example of health care – not sick care.

We’ve talked about when his time comes and what his Dad will do without his stellar presence in his life.  But that day wasn’t today; I hope it won’t be for a while yet.  And I hope I’ll be there to help him if his care becomes necessarily palliative.

Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

9 out of 10 nurses believe animals can improve patient health

Nine out of ten (90%) nurses believe animals can improve the health of patients with depression and other mental health problems, according to a survey of members of the Royal College of Nursing (RCN).

animal-therapy

The survey of more than 750 nursing staff also found that more than 80% think animals can improve communication difficulties such as for people with autism. In addition, 82% said that animals, dogs in particular, encouraged patients to be more physically active, while nearly 60% said just the presence of animals seemed to speed physical recovery.

Nearly half of those surveyed have worked with animals in their career, from dogs and cats to ponies and chipmunks, and of those 98% said it benefited the patient.

However, almost a quarter of staff questioned said no animals were allowed where they worked.

Amanda Cheesley, RCN Professional Lead for Long-term Conditions and End-of-life care, said: “I’ve seen patients with animals in hospitals and in their homes – the difference it makes is remarkable. I used to take my Great Dane with me when I was a district nurse and he could put a smile on any patient’s face.”

“The RCN is calling for better, more consistent access to animals for all patients who can benefit, as the evidence is clear that as well as bringing joyful moments to people when they are unwell, the clinical benefits are tangible. Nurses have told us of patients with reduced anxiety, better interaction and a whole reason to live – and we should listen to these experiences.”

Source:  Royal College of Nursing

Time to budget

It’s a holiday weekend in New Zealand  – for Labour Day.  And every year this holiday also marks the start of the pre-Christmas season.  christmas_dog_highdefinition_picture_168935

As many of you understand, Christmas falls in the summer school holiday period in New Zealand. Many companies shut down during this time and require their workers to take some of their annual leave, since trading can be minimal or non-existent.    If workers don’t have enough paid days, then it can mean time off without pay.

And every year, for a range of reasons including more money being spent on holidays, entertaining and gifts, I see owners who can’t fund the full costs of their dog’s care.

This blog post is a reminder about the items you need to set money aside for in your end of year budget. And the time to budget is NOW.

dog-budgeting

  • Food
  • Treats
  • Medications
  • Supplements
  • Costs for vet care, such as visits for required vaccinations if you are boarding your dog
  • Boarding and care costs, if you are heading away

Just as in people, medications and supplements are only effective if their dosage is kept up.  And dogs on things like pain medication will suffer with break-through pain as medications wear off.  In other cases – let’s say heart medication – stopping this medication could be life-threatening.

Because of their stoic nature, dogs often hide their pain and/or owners miss the signals – such as withdrawing from activity – which are indicators of a dog in pain.  For this reason, some owners think they can get away with a ‘short break’ from medication.

With supplements, once the loading doses are given and the effective dose is reached, there is a level of stability with the coverage given by the supplement.  Stop giving it and you are faced with starting a loading dose all over again.  Many owners miss this step and go back to regular dosages, further compromising the value to the dog of giving the supplement in the first place!

When we take on a dog into our family, we’re responsible for lifetime care as with any other family member.  When there is only so much money to go around, sometimes the silent member of the family – the dog – is the one to miss out.

Please remember health care is a basic right for all animals and plan your holiday budget accordingly.  If that means less money for Christmas festivities – so be it.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Minding the lumps and bumps

This week, I had the pleasure of working with a dog whose owner is very attentive and diligent.  She was the first owner in a long time to provide me with her dog’s ‘lump and bump’ chart.

Many dogs, particularly as they get older, develop lumps and bumps under the skin.  Noticing when a new lump appears, and getting your vet’s opinion about it, are very important.  Many lumps are not sinister and require no attention because they are benign.    Others aren’t.

Whenever I take on a new dog/client for massage and rehab therapy, I start keeping records of the dog’s muscle condition, problems areas, and lumps/bumps.   Since I see dogs on regular basis (the length between visits varies according to the dog’s condition), I can sometimes pick up changes that their owner misses.  This is yet another benefit of massage therapy!

But, for the most part, an owner should be familiar with their dog’s condition.  Through regular grooming, you will notice where your dog has lumps and bumps and know which ones have already been tested by your vet for ‘nasty’ cells.  So start with an outline of your dog’s body and record where they are.

Refer back to your chart periodically when you are bathing and grooming your dog.  If you find something that wasn’t there before, record its size and location on your chart and take your chart with you to the vet.

If you are local to the Canterbury area, we also discuss lump and bump charts and how to compile them in my dog massage workshops for owners.

Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Choosing a veterinarian

As a dog owner as well as a canine massage therapist, I can honestly say that one of the most important things you can do for your dog is to have a good veterinarian.    However, many people I have met through my practice seem to move from vet practice to vet practice – never really giving a vet the chance to get to know their dog.

Of course, sometimes the moving around can’t be helped – people change jobs or other circumstances happen that require them to move house and location.  However, in other cases, it seems the owner is looking for the ‘best deal’ in a consultation fee or they have had a bad experience with an office (not necessarily the vet) and don’t want to return there.

So, here’s my advice on finding a good (and possibly great) veterinarian:

  • Ask your friends who own dogs who they use and why
  • Similarly, ask other dog owners you meet through obedience classes, dog park, etc.
  • Phone around and enquire about consultation fees and office hours that fit your schedule and lifestyle
  • Book a single, short consultation appointment to allow your dog to visit with the vet – see how he/she reacts to the vet and whether you like your experience at the practice.  If not – keep looking!
  • Most vet practices have more than one veterinarian; most owners and dogs develop a favourite vet.  However, it is always a good idea to have an appointment with the alternate vet once in a while so they have some  experience with your dog.  If you have an emergency on a day when your favourite vet isn’t on duty, you’ll understand the importance of having done this!
  • Ask about the staffing arrangements at the practice.  How many qualified nurses/technicians are there at any given time?  Is there a dedicated receptionist (because the best receptionists get to know the patients very well!)?
  • Is the facility set up for surgery if your pet needs it or will you have to go elsewhere to a ‘sister’ clinic?
  • What options are there for after-hours care or emergencies?
  • If you may want to pursue complementary therapies for your dog, how receptive is the vet to these?  Is the vet trained in homeopathy, for instance?
  •  Do other specialists work from the practice or, at a minimum, are they available through referral?
  • What type of payment options are offered at the practice?
  • Does the practice charge extra for filing insurance paperwork (if you choose to have pet insurance)?
  • Will the vet write a script for medicine that you choose to buy from a (reputable, of course) online pharmacy?

Dr Tim Nottage of Merivale-Papanui Veterinary Clinic with a happy client

Finally, if you have been using a veterinary practice for some time but have become concerned that the treatment and level of care/attention is no longer up to par – I advise you to raise it with the veterinarian.  All businesses need feedback.  For example, I had one client who felt that the changes in staff at her local veterinary practice meant that the standard of care had gone down.  The nurses were all new, young, and inexperienced.  She still liked the vet, however.  A short discussion to share her concerns didn’t solve the problem overnight, but it started the vet thinking that the staff needed more training particularly in the area of customer service.   My client’s next experience at the office improved and she didn’t have to go in search of another vet.

Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand